Blood pressure was measured in a birth cohort of 5362 subjects at the age of 36. The prevalence of hypertension in men (blood pressure greater than 140/90 mm Hg) was almost twice that in women, although women received treatment more often. Deaths of fathers of subjects from hypertensive and ischaemic heart disease were associated with significantly higher mean systolic and diastolic pressures in both sexes. Cigarette smoking was not strongly associated with blood pressure in men and not associated at ali in women. Of the social factors, low social class of family of origin was associated with high blood pressure in both sexes; but the strongest association was with current body mass, and birth weight also contributed.Differences in blood pressures between the sexes may have been related to protective biological factors, such as endogenous sex hormones, in women and also to differences in types of employment, smoking habits, and body mass. Differences in blood pressures related to the social class of family of origin may reflect long term influences of class differences on diet, exercise, and educational achievement. The importance of measuring secular trends in obesity and blood pressures is emphasised.
Since 1944, when Hamman and Rich published their third paper on diffuse interstitial pulmonary fibrosis, details of many cases have been recorded: the subject has recently been reviewed by Livingstone, Lewis, Reid, and Jefferson (1964 Wallgren (1962). The ages of the children ranged from 3 months to 13 years, and death was reported in all but 3. There are no reports from English-speaking countries of recovery of a child with the histologically-proven syndrome: the following case is, therefore, of interest.Case Report A 13-year-old boy was first seen at Bristol Children's Hospital in October 1962, with an 8-month history of increasing breathlessness and cyanosis on exercise. He had previously been well and there was no relevant family history. At this time, he was unable to walk more than 100 yards on the flat without stopping, and he had to rest while climbing one flight of stairs. For 2 months he had had a non-productive, shallow cough. On examination, he was noted to be plethoric at rest and cyanosed on exertion. The temperature was normal and there was no finger clubbing. There was dyspnoea at rest, with a respiratory rate of 35 per minute, but nothing abnormal was found clinically in the lungs.The cardiovascular system was normal apart from accentuation of the pulmonary second sound. There were no other abnormal clinical findings.Investigations. Haemoglobin 15 g./100 ml.; white blood cell count and film normal; ESR 3 mm./l hour; Heaf test negative; Mantoux test (1: 3,000 and 1: 100) negative; sputum, gastric washings, and urine showed no tubercle bacilli; sputum contained no fungi or haemosiderin; lumbar puncture CSF normal; tests for LE cells Received September 13, 1965. and for psittacosis and Q-fever antibodies negative; ECG normal; Kveim test negative; liver biopsy normal; serum alkaline phosphatase 37, 35, 31 KA units, returning to normal in 3 months; serum bilirubin normal.Chest radiograph showed diffuse mottling throughout both lung fields (Fig. la).Respiratory function tests: resting ventilation 11 litres/min.; respiratory rate 39/min.; vital capacity 950 ml. (predicted normal 2,500 ml.); spirogram showed no evidence of expiratory obstruction; arterial blood pH 7 45, CO2 tension 31 mm. Hg at rest and on exercise; oxygen saturation 96% at rest and 89% on exercise.
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