The Dalhousie ECG Program was designed specifically for the needs of epidemiologic studies, health surveys, and clinical trials. The program logic is dynamic in that it can accommodate any combination of ECG leads, record length and sampling rate. The NOVACODE module of the program classifies ECGs according to the Minnesota Code, supplemented with new sets of logic criteria for conduction defects, acute myocardial infarction, and serial ECG changes. Improved statistical models are incorporated for enhanced detection of myocardial infarction using the Cardiac Infarction Injury Score, and for quantification of left ventricular mass estimation. It is anticipated that these program improvements will enhance its utility particularly in monitoring progression and regression of cardiac involvement in hypertensive and ischemic heart disease, and in the assessment of the effectiveness of intervention on cardiovascular disease risk factors.

In the early to mid 1980s, the WHO MONICA Project conproportion of participants with untreated major elevation of BP ranged from 4.5% to 33.7% in men and from ducted cardiovascular risk factor surveys in 41 study populations in 22 countries. Study populations aged 35-1.9% to 22.3% in women. The proportions of participants receiving antihypertensive medication were 4.3-17.7% 64 years comprised 32 422 men and 32 554 women. Blood pressures (BP) and body mass index (BMI) were for men and 6.0-22.0% for women. These proportions were not correlated with the prevalence of untreated measured according to a standard protocol. Participants were asked about antihypertensive medication.hypertensives. Age-adjusted BMI was associated with SBP and accounted for 14% of the SBP variance in men In men, the average age-standardized BPs ranged among the populations from 124 to 148 mm Hg for sysand 32% in women. We found a large difference in SBP among the MONICA study populations and conclude tolic (SBP) and from 75 to 93 mm Hg for diastolic (DBP).The corresponding values in women were 118-145 that the results represent a valid estimate of the public health problem posed by elevated BP. We also have mm Hg for SBP and 74 -90 mm Hg for DBP. In all populations, women had lower SBP than men in the age shown that almost universally the problem of elevated BP is more prevalent in women than in men, especially group 35-44. However, SBP in women rose more steeply with age so that in 34 of 41 populations women in the older age groups. had higher SBP than men in the age group 55-64. The Keywords: blood pressure epidemiology; age factor; hypertension treatment prevalence index (BMI) and elevated BP is now generally Introduction accepted, to the extent that professional guidelines Blood pressure (BP) profiles in populations have for the non-pharmacological treatment of hypertenbeen compared by many investigators. [1][2][3][4][5][6][7][8] These sion recommend measures to reduce body weight as studies have made major contributions to hypertenan initial step. 11 One may therefore expect that difsion research by generating hypotheses about the ferences between population in means of BMI may mechanisms that cause elevated BP, such as the salt also account for some of the differences in means hypothesis. 9 BP can be affected by medical interof SBP. vention as well as environmental factors such as BP data from different populations sometimes are lifestyle and diet. The large changes in these factors difficult to interpret because few of the data have that are occurring in westernized as well as been collected using a common study design and the developing countries may provide new information number of populations involved may be small. For about factors that influence human BP. Such inforthese reasons, the WHO MONICA Project 12 provides mation may help to identify possible ways in which an attractive framework for the inter-population BP is influenced at the population level, either by study of BP. The WHO MONICA Project was antihypertensive medicat...

Changes in patient profile did not affect long-term prognosis; instead, treatment modalities accounted for the observed improvement in five-year survival.

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