Children in a persistent vegetative state.

years of the North Karelia study the mortality from cardio-vascular disease in women aged 30 to 64 fell from 2 5 to 1-7 per 1000 person years compared with a fall from 7-7 to 6-3 in men. 19 Mortality from stroke fell in women by half, and this is likely to be sustained by the continuing fall in blood pressure .8 A 12 year follow up study in Gothenburg of 1462 women found that 13% of women at baseline had untreated hypertension.20 21 The mean blood pressure level fell in these women during the first six years of follow up but had risen to baseline level by the twelfth year, despite 58% having treatment with specific drugs. These women, however, did not have an increased incidence either of stroke or of myocardial infarction compared with the normotensive women. Conversely , the women already having treatment at baseline, who were probably more severely hypertensive, did have a higher risk of cardiovascular events. In summary, women with hypertension have the same risk of stroke as men but a lower risk of myocardial infarction. Given this observation, it is not surprising that no significant benefit of treatment of hypertension has been found in mildly hypertensive women. A rational policy, therefore, is to treat women with severe hypertension (diastolic blood pressure over 105 mm Hg) as vigorously as men but (pending any new findings from the Medical Research Council trial) not to give active treatment in mild to moderate hypertension.22 The presence of other risk factors-for example, cigarette smoking should lead the doctor to consider intervention. Finally, as case finding is becoming an established part of general practice, at least for younger women, population based active screening programmes are unlikely to be cost effective.23 1 Hodes C, Rogers PA, Everitt MG. High blood pressure: detection and treatment by general practitioners. BrMedj 1975;ii:674-7. 2 Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension: results in patients with diastolic blood pressures 12 Hypertension Detection and Follow-up Program Cooperative Group. Five year findings of the hypertension detection and follow-up program. I. Reduction in mortality of persons with high blood pressure, including mild hypertension. 13 Hypertension Detection and Follow-up Program Cooperative Group. Five year findings of the hypertension detection and follow-up program. II. Mortality by race, sex and age. JAMA Morbidity and mortality in relation to blood pressure and antihypertensive treatment. A …