The present guidelines were prepared by the Guidelines SubCommittee a of the WHO/ISH (International Society of Hypertension) Mild Hypertension Liaison Committee. They represent the third revision of the WHO/ISH guidelines and were finalized after discussions at the Sixth WHO/ISH Meeting on Mild Hypertension in Chantilly, France, on 28-31 March 1993. The new guidelines discuss the cardiovascular risk in patients with hypertension, the definition and classification of mild hypertension, drug treatment (including the elderly) and non-drug measures, cost-effectiveness, and further research.

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Epidemiological, pathological, clinical, and experimental studies over the past 40 years convincingly show that physical inactivity and low physical fitness contribute substantially to the major chronic diseases prevalent in industrialised societies. Several industrialised countries around the world report increases in physical activity participation among adults in recent years, but the prevalence of inactivity remains high. These increases in voluntary exercise are at least partially offset by decreasing daily energy demands due to increased mechanisation at home, at work and during leisure-time. In developing countries, physical inactivity is becoming a prevalent lifestyle due to rapid social and economic changes. Clinical interventions and mass appeals to be more physically active are limited in effectiveness against the background of increasingly sedentary lifestyles. Exercise scientists and public health officials need to turn attention to public policy and legislative initiatives to restructure physical and social environments to encourage more physical activity and discourage sedentary habits.

We studied the relative importance of the initial BP and associated factors in adolescents to predict stable high BP. Out of 17,634 children aged 12-13 yrs an upper group/the upper 5% of the distribution curves for both SBP and DBP/a lower group/10% random from the remainder/were yearly followed for 4 yrs/boys: 1680, girls: 1643/. About 2/3 of children remained at the same percentile point: less than 30% and greater than or equal to 70% of SBP and half of them of DBP distribution. Significant positive tracking correlations were found both for SBP and DBP between the initial BP and follow-up BP readings in the same individual. Stepwise regression analysis showed that the SBP taken at the fourth follow-up can be explained by 29% in boys, 24% in girls on the basis of screening SBP and by 47% in boys, 42% in girls on the basis of SBP measured at the four previous examinations. Using discriminant analysis, 6-9 variables out of 18 studied could correctly allocate adolescents with stable SBP or DBP/less than 70% or greater than or equal to 70% at least 3 examinations/. Our study shows the importance of initial BP and a number of factors associated with stable high BP.

ABSTRACT. A total of 17,130 children of both sexes born in 1964 and living in Hungary, USSR, GDR and Cuba were examined in 1977. The children were grouped in upper (U) and lower (L) blood pressure groups and 3,640 children were re‐examined in 1978–1981. The parents’age, smoking habits, marital status, the children's order of birth, number of siblings, and proportion of twins did not differ between U and L. The prevalence of hypertension and diabetes in the medical history of the children, and the prevalence of hypertension and stroke and diabetes in the medical history of the parents were significantly higher in U than in L. Signs of left ventricular hypertrophy and systolic murmurs, the magnitude of R and S waves in the ECG, and mean values of cardiothoracic and heart volume indices were higher in U than in L. Children in U were sexually more developed, taller, more obese (greater Quetelet's index and skinfold thickness) and less active physically. Average values of blood sugar and serumuric acid were also higher in U than in L. No difference was found between the two groups in the proportion of smokers and in mean cholesterol values. These differences between U and L were strengthened in comparison of children who showed repeatedly low (below the 30th percentile) or high (at or above the 70th, 90th and 95th percentile) readings in the SBP and DBP distribution curves. Since we did not find important differences when we related various factors to blood pressure taken on one or two separate occasions we emphasize the importance of casual blood pressure measurement in childhood.