1. Changes in blood pressure during the normal menstrual cycle are not well documented, and previous studies have given conflicting results. 2. Thirty normotensive women and ten mildly hypertensive women measured their blood pressure at home each morning for 6 weeks, under standardized conditions, using a UA-751 semi-automatic sphygmomanometer. All had normal menstrual cycles and subjects entered the study at difference phases of the cycle. 3. Blood pressure was higher at the onset of menstruation than at most other phases of the cycle (systolic blood pressure, P < 0.05; diastolic blood pressure, P < 0.001). Adjusted diastolic blood pressure was higher in the follicular than in the luteal phase (mean difference 1.23 mmHg, P < 0.001). Similarly, blood pressure was lower during days 17–26 than during the remainder of the cycle (adjusted mean difference in systolic blood pressure −0.65 mmHg, P = 0.07; adjusted mean difference in diastolic blood pressure − 1.19 mmHg, P < 0.001). 4. Similar patterns were seen in normotensive and hypertensive subjects, and changes in plasma 17β-oestradiol and progesterone concentrations were also similar in the two groups.

Individual tooth surfaces have vastly different susceptibilities to caries and this susceptibility also varies over time. The aim of this study was to develop a method of grouping tooth surfaces into a caries susceptibility classification based on their survival experience. The data used in the study were from a 3–year caries clinical trial. The definition of survival time was taken to be the time from the start of the trial to when a surface is recorded as decayed or filled. Cluster analysis was used to divide the tooth surfaces into groups in such a way that surfaces in the same group have similar survival time distributions. The 13 groups identified were ordered from 1 to 13 starting with the group with the shortest survival time, i.e. the occlusal surfaces of the four first molars. Approximately 80% of symmetrical pairs of tooth surfaces were in the same group. The groups obtained using cluster analysis were compared to groups defined using dental/anatomical criteria. It is concluded that the cluster analysis method developed for grouping the tooth surfaces cn provide a useful descriptive measure of caries susceptibility which can be applied to data from any longitudinal study of caries.

The decline in caries prevalence, the increases in the level of fluoride exposure, and the lack of placebo control subjects have complicated caries clinical trials in recent times. There has been a substantial increase in the numbers of subjects required for the detection of statistically significant differences between dental products, and hence, the cost of these trials has grown enormously. This study uses a new statistical approach to the analysis of the data from these trials with the ultimate aim of providing a more sensitive method of analysis. The new approach uses survival analysis, where the outcome measure is the survival time of an individual tooth surface. It exploits recent developments in the analysis of clustered survival data where survival times within the same cluster or subject are correlated. To illustrate, the new method of analysis was used for the North Wales, UK, caries clinical trial. It is concluded that survival analysis uses most of the data available in a caries clinical trial, an outcome measure that is easily understood and may lead to a more sensitive method of analysis.

Subnormal tHcy concentrations in male patients, the absence of a sex difference, and the positive association with age indicate that homocysteine metabolism differs between type 1 diabetic patients and control subjects. Homocysteine is unlikely to be of pathogenic significance in patients, particularly male subjects, with early microvascular disease and/or neuropathy.

Abnormalities of the renin-angiotensin system have been reported in patients with diabetes mellitus and with diabetic complications. In this study, plasma concentrations of prorenin, renin, and aldosterone were measured in a stratified random sample of 110 insulin-dependent (Type 1) diabetic patients attending our outpatient clinic. Fifty-four age- and sex-matched control subjects were also examined. Plasma prorenin concentration was higher in patients without complications than in control subjects when upright (geometric mean (95% confidence intervals (CI): 75.9 (55.0-105.6) vs 45.1 (31.6-64.3) mU I-1, p < 0.05). There was no difference in plasma prorenin concentration between patients without and with microalbuminuria and between patients without and with background retinopathy. Plasma renin concentration, both when supine and upright, was similar in control subjects, in patients without complications, and in patients with varying degrees of diabetic microangiopathy. Plasma aldosterone was suppressed in patients without complications in comparison to control subjects (74 (58-95) vs 167 (140-199) ng I-1, p < 0.001) and was also suppressed in patients with microvascular disease. Plasma potassium was significantly higher in patients than in control subjects (mean +/- standard deviation: 4.10 +/- 0.36 vs 3.89 +/- 0.26 mmol I-1; p < 0.001) and plasma sodium was significantly lower (138 +/- 4 vs 140 +/- 2 mmol I-1; p < 0.001). We conclude that plasma prorenin is not a useful early marker for diabetic microvascular disease. Despite apparently normal plasma renin concentrations, plasma aldosterone is suppressed in insulin-dependent diabetic patients.

The prevalence of hypertension was investigated in a systematically chosen sample of patients attending a diabetic clinic. One hundred ninety-one patients were classified as Type 1 (insulin-dependent), 183 were classified as Type 2 (non-insulin-dependent) and 12 were deemed unclassifiable. Two hundred fifty-five control subjects attending non-medical out-patient clinics were also examined under similar conditions. Hypertension was significantly (p less than 0.001) more common among Type 2 patients (38%) than among Type 1 patients (15%) or control subjects (16%). The difference between Type 2 patients and control subjects, but not between Type 2 and Type 1 patients, persisted when the influences of age and body mass index were controlled. We also investigated the prevalence of hypertension among the siblings of the hypertensive patients identified, together with a matched normotensive group. One hundred eighty-eight siblings were examined and historical details were obtained for a further 451 siblings. When age and body mass index were controlled for in examined siblings, the risk of hypertension was greater in those with a hypertensive proband than in those with a normotensive proband, in the control (p less than 0.06) and Type 1 (p less than 0.02) groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Dietary intake was assessed, using a 3-day recorded food diary, in 122 patients with insulin-dependent diabetes. Subjects were selected randomly from patients attending a diabetic clinic and stratified for age, sex, and duration of diabetes. The findings were compared to the dietary recommendations of the European Association for the Study of Diabetes (EASD) and to the findings in a recent Irish National Nutrition Survey. The average daily protein intake among diabetic patients was 18% of the total calories, significantly higher than recommended by EASD and significantly higher than in the age-matched general population. Dietary fat intake was on average 37% of total calorie intake, again significantly higher than recommended and greater than in the general population among older patients. Saturated fat intake was higher than recommended and polyunsaturated fat intake was low. The average carbohydrate intake was 42% of total calories, significantly lower than recommended and similar to that in the general population. Sugar intake was lower and starch intake was higher among patients than in the general population, however. Fibre intake was also lower than recommended, but was higher than in the general population. We conclude that the present dietary targets for diabetic patients are not being fully achieved.

Premature greying may be a weak marker for reduced BMD in women with a history of Graves' disease, but it is not a marker in normal women.