Hypertension and coronary occlusion.

The problem of the r'elationship between hypertension and coronary occlusion has been r'e-examined. Using newly established limits of hypertension, 600 consecutive private patients with coronary occlusion-500 men and 100 women-all under 65 years of age, were studied. Hypertension did not appear to be a factor in producing coronary disease and occlusion among men, but was a definite factor in its causation among women. The possible relation of the serum cholesterol, the Sf 12-20 lipoprotein fraction, and the sex hormones to atherosclerosis and hypertension is discussed. E VER since coronary occlusion became a well recognized clinical entity, many writers have suggested that hyperten-sion was a common antecedent of the condition in both men and women, and a significant factor in its etiology.1-25 My colleagues and I, also, have reported similar findings,'0 14, 19 and have concurred in these opinions. Thus, in 1939, Master, Dack, and Jaffe'4 studied 500 patients with coronary artery oc-clusion, 387 men and 113 women. Using a sys-tolic pressure of 150 mm. Hg and/or a diastolic pressure of 90 mm. Hg as a definition of hyper-tension, they found that 219 of the men (56.5 per cent) and 90 of the women (80 per cent) were hypertensive; an average of 61.8 per cent. The number of patients who had had hyper-tension prior to the coronary occlusion was found to increase with advancing age. Thus, only 28 per cent of the men below 35 years of age were hypertensive, but the incidence rose rapidly to 80 per cent, at and above the age of 70 years. In the women with coronary occlu-sion, hypertension was found to be even more common than in the men, and to increase in frequency more rapidly; it was present in only 25 per cent of those below 35 years and in from 90 to 100 per cent of those who were 45 years of age or over. In 1943, in a similar study, Master, Jaffe, Dack and Silver,19 employing a systolic blood pressure of 150 mm. Hg and/or a diastolic pressure of 96 mm. Hg as evidence of hyperten-sion, found that 69 per cent of all the patients 170 had suffered from hypertension before the coronary artery occlusion had occurred. From the foregoing reports, it appeared that hypertension was an important predisposing factor in coronary occlusion, particularly in the older age groups and especially in women. Apparent confirmation of this opinion was found in the …