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SummaryA controlled prospective survey of women taking oestrogen-progestogen oral contraceptives showed increases in mean systolic and diastolic blood pressure of 14-2 mm Hg and 8-5 mm Hg respectively after four years. The largest increases in individual cases were 36 mm Hg systolic and 20 mm Hg diastolic. Blood pressure returned to pretreatment levels within three months after oral contraceptives had been stopped. These changes in blood pressure were unrelated to the progestogenic potencies of the preparations being taken.

A prospective controlled study investigated the effects of oral contraceptives on blood pressure in 485 women who were between 17 and 46 years of age and had blood pressures of < 140/90 mmHg at entry. The women were divided into seven groups depending on the chosen method of contraception: intrauterine device o r barrier method (control group): ethinyl oestradiol 3 0 p g plus levonorgestrel 150 p g (Microgynon-30 or Ovranette); norethisterone 350 p g (Micronor): norgestrel 75 pg (Neogest): norethisterone oenanthate 200 mg intramuscularly every 2 months for the first 6 months, then every 3 months thereafter; ethinyl oestradiol 30 pg plus ethynodiol diacetate 2 mg (Conova-30); and ethynodiol diacetate 500 p g (Femulen). Blood pressures were measured every 3 months by the family planning clinic nurse under standardized conditions using an Elag-Koln automatic sphygmomanometer. After one year, blood pressure had risen significantly (P(0.05) in the 137 women taking ethinyl oestradiol plus levonorgestrel (mean systolic and diastolic rises 6 . 4 and 2 . 7 m m H g respectively) and in the 91 women taking ethinyl oestradiol plus ethynodiol diacetate (mean systolic and diastolic rises 6 . 2 and 3 .O m m H g respectively). The 9 4 women taking the progestogen-only preparations and the 143 women in the control group showed n o increases in blood pressure. These d a t a were confirmed after 2 years of follow-up.

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The incidence of headache has been assessed in 100 patients with high blood pressure and in 100 normotensive controls. Headache was more frequent in patients with diastolic blood pressures of 130 mm. Hg and over, being typically diffuse, occurring in the morning and tending to ease after a few hours. It is likely to be relieved by control of the blood pressure. No difference in incidence of headache was found between the normotensive controls and the hypertensive patients with diastolic blood pressures less than 130 mm.Hg. In hypertensive patients with occipital headache unrelieved by moderate or good blood pressure control, cervical spondylosis should be considered as a possible cause of the headache.

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SummaryCirculating levels of renin, angiotensin I, and angiotensin II were increased in six patients with chronic renal failure and hypertension uncontrolled by dialysis and hypotensive drugs. Lower and often normal levels were found in 10 patients whose blood pressure was controlled by dialysis treatment. For a variety of reasons all patients were subjected to bilateral nephrectomy. The logarithm of the decrease in plasma concentrations of renin and angiotensin II was significantly related to the fall of blood pressure after operation. Plasma renin concentration correlated significantly with blood angiotensin I concentration and with plasma angiotensin H in samples taken before and after nephrectomy. Renin, angiotensin I, and angiotensin II were measurable in samples ofblood taken 48 hours or more after the operation.

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