In a randomly selected population screening study of 8450 men and 9039 women 33 to 71 years of age conducted in Iceland in 1967-1977, 27 men and 17 women were found to have left bundle branch bock (LBBB). The prevalence of LBBB at that time was 0.43% for men and 0.28% for women. The incidence of LBBB was 3.2 per 10,000 per year for men and 3.7 per 10,000 per year for women. All except one of 37 alive patients with LBBB were examined in 1984 including chest X-ray, echocardiography and exercise testing (Bruce protocol). Eight men had had myocardial infarction (P less than 0.05), 12 had angina pectoris, 15 had hypertension, 7 had cardiomyopathy, 13 had primary conduction disease, and 3 had pacemakers. Five men and two women had died in comparison with 18 men and 1 woman in an age-matched control group of 176 people (P : ns). Three of 5 decreased LBBB men had cardiomyopathy at autopsy. Three men died suddenly. The two women died of noncardiac causes. Only one patient in the control group had cardiomyopathy (P less than 0.01). There was no significant difference in other cardiac diagnoses between the groups. Eleven LBBB women out of thirteen had a normal exercise duration (greater than or equal to 6 min) and 11/17 men exercised normally (less than or equal to 7 min). In comparison with the control group, the LBBB patients had an increased LV diameter 2.85 +/- 0.38 vs 2.58 +/- 0.38 cm m-2 body surface area (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
In a randomized, cross‐over study 27 patients had diastolic blood pressure of ≥ 96 mmHg during four visits without treatment. Following captopril 25 mg b.i.d. nine patients' blood pressure was ≤ 90 mmHg. The remaining 18 were randomized into two treatment modalities, captopril and moderate dietary salt reduction, and captopril and hydrochlorothiazide 25 mg daily. Following a wash‐out period the groups crossed over to the alternative treatment. At the end of the control period the average blood pressure was 151/100 ± 12/6 mmHg recumbent and 140/91 ± 11/7 standing, following captopril 144/94 ± 13/5 and 132/92 ± 12/6, respectively, with low salt diet addded to captopril 140/91 ± 12/6 and 128/89 ± 11/6 and with hydrochlorothiazide and captopril 133/86 ± 12/7 and 120/84 ± 11/7 mmHg supine and erect, respectively. It is concluded that moderate dietary salt reduction, which is easily advised, will significantly potentiate the blood pressure fall following captopril treatment in moderate arterial hypertension.
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