Still nobody's business? Prevention of coronary disease through primary care.
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Biomedical subjects
Publications and source records attributed to J T Hart.
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The blood pressure, body weight, mean 24 hour urinary electrolyte excretion, and plasma renin activity in offspring whose parents both belonged to the top third of the distribution of blood pressure in their 5-year age-group were compared with those in offspring whose parents belonged to the bottom third. Altogether 116 offspring, aged 10-43 years, took part in the study. Systolic pressure was higher in the offspring with a family history of high blood pressure, but there was no difference in 24-h urinary electrolyte excretion or plasma renin activity. The study had a power of over 80% to detect a 20 mmol difference in sodium excretion, and it provides evidence against the hypothesis that hypertensives have an avidity for sodium.
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Eighteen patients with stable mild hypertension (mean blood pressure 144/93 mm Hg) restricted their sodium intake for eight weeks while taking part in a double blind randomised crossover trial of slow sodium and placebo tablets. Mean 24 hour urinary sodium excretion was 143 mmol(mEq) during the period on slow sodium and 87 mmol during the period on placebo. Five patients were unable to reduce their sodium intake below 120 mmol, but the others had a mean 24 hour urinary sodium excretion of 59 mmol during the period on placebo. There was no significant difference in blood pressure between the slow sodium and placebo treatment periods, although the study had a power of 99% to detect a difference of 5 mm Hg in mean arterial pressure between the two periods. Moderate dietary sodium restriction does not lower blood pressure in patients with this degree of hypertension.
The gene which specifies a subunit of RNA polymerase II, ama-1, is assigned to chromosome 7 in the Chinese hamster. The assignment of genes coding for TK, GALK, and ACP to chromosome 7 is confirmed, with a provisional regional assignment of TK and GALK to 7q. On the basis of one clone with six subclones, a provisional assignment of TPI to Chinese hamster chromosome 8 is made. With the assignment of tk and ama-1 to chromosome 7 in the CHO cell line Ama1, this chromosome is shown to have two selectable markers.
The native Chinese hamster DHFR gene was localized to 2pter----q14 using a combination of somatic cell hybrid technology and molecular techniques. In addition, PGD, ENO1, and DTS, previously mapped to Chinese hamster chromosome 2, were localized to 2q14----qter. Localization of PGM1 to this region was confirmed. The relationship of the site of the native DHFR gene to the location of the homogeneously staining region in methotrexate-resistant cells is discussed.
Eighteen patients with mild hypertension in general practice restricted their sodium intake for eight weeks while taking part in a double-blind randomized crossover trial of sodium and placebo tablets. There was no difference in blood pressure between the two periods of the trial despite a substantial difference in sodium intake. Sodium restriction is not indicated in the management of patients with this degree of hypertension.
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Ideas about general practitioner specialism may have been hampered in the past because of the three models of general practitioner specialism - in the hospital service, the fee-earning specialoid or the general practitioner obstetrician - none of which is satisfactory.However, general practitioner specialism can be justified in guaranteeing standards by concentrating groups of patients, accepting responsibility, and planning care. Medico-political changes may be needed to achieve improvement in clinical standards.
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