Eighty-eight women visiting a gynecologist were tested for an estrogen receptor B-variant allele. The women were ethnically and racially homogeneous to a large degree. They were from a suburb of Long Island, and most were white. The 12% incidence of hypertension in women with the estrogen receptor wild-type allele is comparable to the 13-32% incidence in the general population of women aged 55-64 years. However, the 48% incidence of hypertension in women with the estrogen receptor B-variant allele is considerably higher than in the general population of women in this age group. We conclude that the presence of the estrogen receptor B-variant allele might have increased the prevalence of hypertension in the women in this study. T he prevalence of hypertension in men and women is different and depends on age. In subjects aged 25-54 years, hypertension is more prevalent in men; but in subjects older than 54 years, hypertension is more prevalent in women.1 At least one gene has been implicated in the genesis of hypertension. 2We recently documented the existence of a variant allele of the human estrogen receptor (ER) gene. We reported that women with breast cancer and this variant allele had a high incidence of spontaneous abortion. 3The variant gene differs from the wild-type gene within the B domain. 4 A single point mutation, a guanine-to-cytosine transition at position 261, causes a silent mutation in codon 87. 5-6 Of interest is the fact that the unmutated sequence, GCG, codes least frequently for alanine in humans (7.1% of cases); the silently mutated codon GCC codes most frequently (29.5% of cases).7 No doubt another mutation, segregating with the silent mutation, plays a role in producing the high incidence of spontaneous abortion.We now report that the ER B-variant allele is associated with hypertension in women. Furthermore, women with the variant allele are significantly younger than those without the variant. MethodsTo identify the B-variant, we used the polymerase chain reaction to amplify genomic DNA around the polymorphic region of the ER gene, followed by allelespecific oligonucleotide hybridization. This analysis used DNA obtained from blood lymphocytes of women, as we have described.8 Both the wild-type and variant alleles were specifically identified in the genotyping.Eighty-eight women of all ages visiting a gynecologist were studied. Women were excluded if they had cancer or other serious illness. A nurse or physician made a single measurement of blood pressure. The technicians genotyping the blood lymphocyte DNA were blinded as to the blood pressure status of the patients. The women were ethnically and racially homogeneous to a large degree. They were from a suburb of Long Island, and most were white. None of the women who were approached refused to participate in the study.A woman was classified as hypertensive if she had a systolic blood pressure ^140 mm Hg and a diastolic blood pressure £90 mm Hg or if she was being treated for hypertension with antihypertensive medications. She was classif...

An electronic, computerized voiding diary, "Compu-Void" (patent pending) was developed in order to simplify, augment, and automate patients' recording of bladder symptomatology. A voiding diary as a tool has the potential to provide essential information for a more complete diagnostic and therefore therapeutic picture for each patient. Two major problems with the standard written voiding diary have been a lack of patient compliance and the limited amount of information it garners. Twenty-five women with various types of voiding dysfunctions were compared to twenty-five age and parity-matched control women in order to determine patient preferences of the Compu-Void when compared to the standard written voiding diary, compliance with each method, and amount and quality of information obtained with each method. Over 90% of subjects and over 70% of control group patients preferred the Compu-Void over the written diary (P < 0.005). The amount and quality of information obtained with Compu-Void exceeded that obtained with the written method.

A comprehensive program was founded in 1982 to provide adolescents with prenatal and family planning care. The program's impact through its first five years of operation on medical aspects of pregnancy course and fetal outcome will be the subject of a separate report. This study examines subsequent maternal and infant health of the patients attending the program compared to a control group. Four hundred ninety-eight adolescents and their newborns attending the program's mother-baby family planning clinic from 1982 to 1989 (subject group) were compared to ninety-one adolescents and their newborns receiving postpartum family planning and pediatrics clinics from 1980 through 1989 (control group). Seventy-five percent of the subject group regularly attended mother-baby clinic, compared to 18% of the control group attending family planning and pediatric clinics (P less than or equal to .0001). The subject group experienced less maternal and infant morbidity, greater school attendance, graduation, employment, and contraceptive use than the control group (P less than or equal to .0001). Many parameters improved with each program year indicating continued wide acceptance of our program by area adolescents.

We previously identified a polymorphism in the human estrogen receptor gene. In a preliminary study on women with estrogen receptor positive (ER+) breast tumors, we found that the presence of the rarer of the two alleles, the B' allele, is correlated with a history of spontaneous abortion. Because that study evaluated only women with estrogen receptor positive (ER+) breast cancer, it was unknown whether the observed correlation was restricted to the cancer group or was independent of breast cancer. We have now extended our analysis to include not only additional women with ER+ breast cancer, but also those with estrogen receptor negative (ER-) breast cancer and women without cancer. Results of the current study continue to show an association between the B' allele and a history of spontaneous abortion in the ER+ breast cancer group. There was no such correlation either in the ER- breast cancer group or in the group without cancer. Also, we continue to observe, in the ER+ breast cancer group, a significantly higher concentration of ER protein in tumors from homozygous wild type women (genotype BB), than in the tumors from women who are heterozygous for the rarer allele (genotype BB'). We conclude that the combination of spontaneous abortion and the BB' ER genotype may be a marker for breast cancer susceptibility.