Financial cost as an obstacle to hypertension therapy.

A home health interview, including blood pressure measurements, was conducted on 4,688 adults representing the noninstitutionalized population of Georgia. Subjects with diastolic blood pressure greater than or equal to 90 mm Hg or on antihypertensive medication were considered hypertensive. The prevalence of uncontrolled moderate or severe hypertension (diastolic greater than or equal to 105 mm Hg) was 1.9 per cent. With the exception of White women, all race-sex groups with uncontrolled moderate or severe hypertension reported substantially lower per capita income than their mild or controlled hypertensive counterparts. A larger percentage of the uncontrolled moderate to severe hypertensives on medication, as compared to their mild or controlled counterparts, reported economic barriers to pharmacologic and medical care on cost of medicines (36 per cent vs 22 per cent); refills (36 per cent vs 16 per cent); and office visits (26 per cent vs 16 per cent). Black women reported these barriers more than Whites. These findings suggest that costs of antihypertensive care may be an obstacle in blood pressure control for certain population subgroups.     

The effects of family involvement and practitioner home visits on the control of hypertension.

The effectiveness of two social support strategies designed to lower hypertensive patients' blood pressure were compared to each other and to a control group (N = 63) receiving routine care in a randomized clinical trial extending over a period of two years. Group 1 (N = 99) received visits and had family members actively participate in their care through home blood pressure monitoring; Group 2 (N = 56) received home visits from nurses and pharmacists. All groups were predominantly Black. After the first year of the trial, the proportion of patients with uncontrolled diastolic blood pressure (greater than or equal to 95mm Hg) had declined significantly for all three groups; no group showed a statistically significant advantage. However, during the last six months of the second year (after visiting had ended), both Groups 1 and 2 demonstrated clear superiority in DBP control over Group 3, achieving borderline statistical significance (p = .07) when multivariable analysis was performed to control for potential confounders. Supplementing routine care with periodic home visits produced an additional 21 per cent of patients with well-controlled DBP, while involving family members plus visits produced a 17 per cent improvement in the percentage of patients with DBP less than 95mm Hg. However, neither support strategy was clearly more effective than the other over time. The efficacy of the interventions is discussed with respect to cost and feasibility of implementation.     

唐山地区原发性高血压与Y染色体非重组区HindⅢ酶切位点多态性的研究

目的探讨Y染色体非重组区HindⅢ酶切位点多态性与唐山地区汉族人群原发性高血压的关系.方法入选男性研究对象412名,原发性高血压患者225例、正常对照人群187名.所有研究对象用常规方法提取白细胞DNA.采用多聚酶链反应结合限制性内切酶（HindⅢ）方法检测Y染色体非重组区HindⅢ酶切位点多态性.结果对照组和原发性高血压组Y染色体HindⅢ酶切位点多态性各基因型的差异有统计学意义（P=0.007）.HindⅢ（＋）基因型较HindⅢ（）基因型收缩压、舒张压、脉压和平均动脉压均明显降低（P＜0.05）.结论Y染色体HindⅢ酶切位点多态性与唐山地区汉族人群原发性高血压有关,可能是唐山地区汉族人群原发性高血压的一个遗传标志.     

Blood pressure and excretion of sodium, potassium, calcium and magnesium in 8- and 9-year old boys from 19 European centres

We have measured systolic and diastolic blood pressure and excretions of sodium, potassium, calcium and magnesium in groups of about 50 8- and 9-year-old boys from 19 European centres using standardized methods for the measurement of blood pressure and collection of urine, and by carrying out all analyses in one laboratory. Weight, height, pulse rate and environmental temperature were also studied. Mean systolic blood pressure ranged from 91 to 105 mm Hg and diastolic blood pressure from 51 to 66 mm Hg. Mean 24-h excretion of sodium was between 91 and 146 mmol/d, that of potassium between 29 and 60 mmol/d, that of calcium between 1.5 and 2.6 mmol/d and that of magnesium between 2.7 and 4.2 mmol/d. Mean sodium excretion tended to be lower and potassium excretion tended to be higher in the boys from the north-western parts of Europe. Relations between either systolic or diastolic blood pressure and electrolyte excretions were generally weak or absent. Most remarkable is that only the association between mean diastolic blood pressure and 24-h magnesium excretion (partial regression coefficient (b +/- s.e., -5.04 +/- 2.08 mm Hg/mmol/d) was statistically significant after adjusting for differences in creatinine excretion and environmental temperature. Mean systolic blood pressure was not significantly related with any of the variables measured. The partial regression coefficient (b +/- s.e.) for diastolic blood pressure on weight was 0.186 +/- 0.062 mm Hg/kg, on height 0.165 +/- 0.056 mm Hg/cm, on pulse rate 0.364 +/- 0.100 mm Hg/beats per min and on outside temperature -0.25 +/- 0.07 mm Hg/degrees C.     

Alternatives to the mercury sphygmomanometer

The mercury sphygmomanometer was introduced over 100 years ago. Mercury, however, is a potent human neurotoxin. An international effort has developed to eliminate health-care sources of mercury--the thermometer and sphygmomanometer--and replace them with less toxic alternatives. There is concern regarding the accuracy of these alternative devices. We conducted a literature review of articles published between 1995 and 2009 evaluating the accuracy of mercury, aneroid, and oscillometric blood pressure devices. Mercury sphygmomanometers fared the best although they do not always perform as expected, failing calibration tests between 1 and 28 per cent of the time. Up to 61 per cent of aneroid sphygmomanometers failed. Recently calibrated aneroid devices performed well. Oscillometric devices were less studied and their performance was variable. All three devices showed variable performance. They should be validated before purchase and calibrated on a regular basis.     

A method for estimating year of birth using social security number

A method for estimating year of birth using only Social Security number is described. The method relies on estimating the year of issue of the Social Security number, using either precise information from a Social Security Administration table (for numbers issued since 1950) or extrapolation (for numbers issued before 1951). Age at issue was estimated using data from individuals in an occupationally defined population for whom both birth date and Social Security number were known. Year of birth is then year of issue minus age at issue. A highly statistically significant correlation of 0.91 for known vs. estimated year of birth was observed. Predictions correct within +/- 5 years were achieved for 78 per cent of the entire study population. For individuals born after approximately 1934, predictions within +/- 5 years of the correct year were achieved 95 per cent of the time, and within +/- 2 years 77 per cent of the time. The method may be useful in epidemiologic research in situations in which date of birth is missing. Some applications are discussed.     

The costs of treating hypertension--an analysis of different cut-off points

In this article the effects of different cut-off points for hypertension treatment are analysed, with respect to treatment costs. A theoretical blood pressure distribution is used to calculate the potential annual cost of treating all persons in Sweden above certain cut-off points for drug treatment. A lowering of the cut-off point from 105 mm Hg to 100 mm Hg diastolic blood pressure could potentially lead to an increase in annual costs of approximately 80m pounds. Further lowering from 100 to 95 mm Hg in turn could increase annual costs by about 110m pounds. The potential annual cost of treating all persons (roughly 1.6 million) with a diastolic blood pressure of greater than or equal to 95 mm Hg with drugs is calculated as being roughly 40 pounds per inhabitant in Sweden. The Swedish cut-off point for treatment (95 mm Hg) can be expected to lead to roughly 50 per cent higher treatment costs than the British cut-off point (100 mm Hg).     

Blood pressure change with weight loss is affected by diet type in men

BACKGROUND: Weight loss reduces blood pressure, and the Dietary Approaches to Stop Hypertension (DASH) diet has also been shown to lower blood pressure. OBJECTIVE: Our goal was to assess the effect on blood pressure of 2 weight-reduction diets: a low-fat diet (LF diet) and a moderate-sodium, high-potassium, high-calcium, low-fat DASH diet (WELL diet). DESIGN: After baseline measurements, 63 men were randomly assigned to either the WELL or the LF diet for 12 wk, and both diet groups undertook 0.5 h of moderate physical activity on most days of the week. RESULTS: Fifty-four men completed the study. Their mean (+/-SD) age was 47.9 +/- 9.3 y (WELL diet, n = 27; LF diet, n = 27), and their mean baseline home systolic and diastolic blood pressures were 129.4 +/- 11.3 and 80.6 +/- 8.6 mm Hg, respectively. Body weight decreased by 4.9 +/- 0.6 kg (+/-SEM) in the WELL group and by 4.6 +/- 0.6 kg in the LF group (P < 0.001 for both). There was a greater decrease in blood pressure in the WELL group than in the LF group [between-group difference (week 12 -baseline) in both SBP (5.5 +/- 1.9 mm Hg; P = 0.006) and DBP (4.4 +/- 1.2 mm Hg; P = 0.001)]. CONCLUSIONS: For a comparable 5-kg weight loss, a diet high in low-fat dairy products, vegetables, and fruit (the WELL diet) resulted in a greater decrease in blood pressure than did the LF diet. This dietary approach to achieving weight reduction may confer an additional benefit in reducing blood pressure in those who are overweight.     

Practical value of echo Doppler evaluation of aortic and mitral stenosis: a comparative study with cardiac catheterization

This retrospective analysis compares data derived by echocardiography and cardiac catheterization in the evaluation of aortic and mitral valve stenosis. Sixty-seven patients, aged 69 +/- 12 years, underwent 76 catheterization procedures. In all studies the Doppler recording was technically adequate. In 64 studies of patients with aortic stenosis, correlation was good between the gradient obtained at catheterization (peak 51 +/- 28 mm Hg, mean 48 +/- 24 mm Hg) and the Doppler gradient (peak 73 +/- 29 mm Hg, mean 41 +/- 17 mm Hg) (R = 0.78 peak, 0.77 mean). In 15 studies the aortic valve area, 0.8 +/- 0.2 cm2, calculated by the simplified continuity equation, correlated well with the catheterization valve area, 0.7 +/- 0.3 cm2, calculated by the Gorlin equation (R = 0.80). In 14 studies in mitral stenosis patients, the mean gradient at catheterization was 11 +/- 5 mm Hg compared to the Doppler gradient of 8 +/- 4 mm Hg (R = 0.58). The mitral valve area was 1.1 +/- 0.3 cm2 by the Gorlin equation and 1.2 +/- 0.3 cm2 by echo Doppler, using pressure half-time. When cardiac rhythm, the presence and severity of regurgitation, and the cardiac index were analyzed, none was shown to have demonstrable influence on the accuracy of the Doppler study. Doppler echocardiography can be used reliably to assess valvular stenosis in a clinical, noninvasive laboratory where routine tests are performed and interpreted by more than one individual.     

Effects of occupational noise exposure on blood pressure

We measured 24-hour ambulatory blood pressure and 16-hour noise exposure continuously for 20 automobile workers, and used linear mixed-effects regression models to estimate transient and sustained effects of noise exposure on blood pressure. The occupational noise levels of the high-exposure workers with 85 +/- 8 dBA were significantly higher than those of the low-exposure workers with 59 +/- 4 dBA (P < 0.05). We found a significant difference of 16 +/- 6 mm Hg in sleep-time systolic blood pressure (SBP) existed between 2 exposure groups, and a marginal increase of 1 mm Hg SBP per 1-dBA increase in occupational noise exposure at a 60-minute lag time during work (P = 0.07). Occupational noise exposure had both transient and sustained effects on workers' SBP.     

Acute dark chocolate and cocoa ingestion and endothelial function: a randomized controlled crossover trial

BACKGROUND: Studies suggest cardioprotective benefits of dark chocolate containing cocoa. OBJECTIVE: This study examines the acute effects of solid dark chocolate and liquid cocoa intake on endothelial function and blood pressure in overweight adults. DESIGN: Randomized, placebo-controlled, single-blind crossover trial of 45 healthy adults [mean age: 53 y; mean body mass index (in kg/m(2)): 30]. In phase 1, subjects were randomly assigned to consume a solid dark chocolate bar (containing 22 g cocoa powder) or a cocoa-free placebo bar (containing 0 g cocoa powder). In phase 2, subjects were randomly assigned to consume sugar-free cocoa (containing 22 g cocoa powder), sugared cocoa (containing 22 g cocoa powder), or a placebo (containing 0 g cocoa powder). RESULTS: Solid dark chocolate and liquid cocoa ingestion improved endothelial function (measured as flow-mediated dilatation) compared with placebo (dark chocolate: 4.3 +/- 3.4% compared with -1.8 +/- 3.3%; P < 0.001; sugar-free and sugared cocoa: 5.7 +/- 2.6% and 2.0 +/- 1.8% compared with -1.5 +/- 2.8%; P < 0.001). Blood pressure decreased after the ingestion of dark chocolate and sugar-free cocoa compared with placebo (dark chocolate: systolic, -3.2 +/- 5.8 mm Hg compared with 2.7 +/- 6.6 mm Hg; P < 0.001; and diastolic, -1.4 +/- 3.9 mm Hg compared with 2.7 +/- 6.4 mm Hg; P = 0.01; sugar-free cocoa: systolic, -2.1 +/- 7.0 mm Hg compared with 3.2 +/- 5.6 mm Hg; P < 0.001; and diastolic: -1.2 +/- 8.7 mm Hg compared with 2.8 +/- 5.6 mm Hg; P = 0.014). Endothelial function improved significantly more with sugar-free than with regular cocoa (5.7 +/- 2.6% compared with 2.0 +/- 1.8%; P < 0.001). CONCLUSIONS: The acute ingestion of both solid dark chocolate and liquid cocoa improved endothelial function and lowered blood pressure in overweight adults. Sugar content may attenuate these effects, and sugar-free preparations may augment them.     

Estimating HIV incidence rates from age prevalence data in epidemic situations.

We present a method of estimating HIV incidence rates in epidemic situations from data on age-specific prevalence and changes in the overall prevalence over time. The method is applied to women attending antenatal clinics in Hlabisa, a rural district of KwaZulu/Natal, South Africa, where transmission of HIV is overwhelmingly through heterosexual contact. A model which gives age-specific prevalence rates in the presence of a progressing epidemic is fitted to prevalence data for 1998 using maximum likelihood methods and used to derive the age-specific incidence. Error estimates are obtained using a Monte Carlo procedure. Although the method is quite general some simplifying assumptions are made concerning the form of the risk function and sensitivity analyses are performed to explore the importance of these assumptions. The analysis shows that in 1998 the annual incidence of infection per susceptible woman increased from 5.4 per cent (3.3-8.5 per cent; here and elsewhere ranges give 95 per cent confidence limits) at age 15 years to 24.5 per cent (20.6-29.1 per cent) at age 22 years and declined to 1.3 per cent (0.5-2.9 per cent) at age 50 years; standardized to a uniform age distribution, the overall incidence per susceptible woman aged 15 to 59 was 11.4 per cent (10.0-13.1 per cent); per women in the population it was 8.4 per cent (7.3-9.5 per cent). Standardized to the age distribution of the female population the average incidence per woman was 9.6 per cent (8.4-11.0 per cent); standardized to the age distribution of women attending antenatal clinics, it was 11.3 per cent (9.8-13.3 per cent). The estimated incidence depends on the values used for the epidemic growth rate and the AIDS related mortality. To ensure that, for this population, errors in these two parameters change the age specific estimates of the annual incidence by less than the standard deviation of the estimates of the age specific incidence, the AIDS related mortality should be known to within +/-50 per cent and the epidemic growth rate to within +/-25 per cent, both of which conditions are met. In the absence of cohort studies to measure the incidence of HIV infection directly, useful estimates of the age-specific incidence can be obtained from cross-sectional, age-specific prevalence data and repeat cross-sectional data on the overall prevalence of HIV infection. Several assumptions were made because of the lack of data but sensitivity analyses show that they are unlikely to affect the overall estimates significantly. These estimates are important in assessing the magnitude of the public health problem, for designing vaccine trials and for evaluating the impact of interventions.     

Self-regulation of food intake among rural Mexican preschool children

Access to food and the amount consumed were investigated within a group of 45 children aged 33 to 60 months, among whom growth stunting was common. Children were observed throughout 1 day; all foods offered and consumed were weighed, and food-related behaviors noted. Children ate frequently, at least 2 meals and an average of 7.4 +/- 2.6 snacks daily. Children had access to 2029 +/- 575 kcal (8493 +/- 2407 kJ) yet only consumed 1528 +/- 343 kcal (6396 +/- 1436 kJ) daily; thus food availability was not restricting intake. A higher proportion of snacks than meals (85 per cent vs. 71 per cent) was consumed. Children requested foods frequently (x = 9.2 +/- 4.3) and 76 per cent of requests were fulfilled. Neither amount of accessible food nor amount consumed differed by age, gender, or socioeconomic status. The importance of the child's role in determining food intake, and of snacking to overall food consumption, was demonstrated.     

Field evaluation of the Copal UA-231 automatic sphygmomanometer.

Automated sphygmomanometers should be evaluated in field studies before being recommended for epidemiological use. In this study an automated sphygmomanometer, the Copal UA-231, was evaluated on the basis of duplicate blood pressure measurements, one with this machine and one with a Hawksley random zero machine, taken on 1536 participants in a health survey. The Copal-random zero differences had a mean of 2.3 mm Hg for systolic blood pressure and 1.9 mm Hg for diastolic pressure, the Copal reading higher than the random zero. The standard deviations of these differences were similar to the standard deviations of the differences between two random zero measurements taken on subjects in a separate survey. However, Copal-random zero differences varied systemically with blood pressure levels. In this study a 10 mm Hg increase in systolic blood pressure was associated with a 1.22 mm Hg increase in the Copal-random zero difference and a 10 mm Hg increase in diastolic blood pressure was associated with a 1.15 mm Hg increase in the Copal-random zero difference. The Copal UA-231 is recommended for use in field surveys, but it should be recognised that a small systematic increase in Copal-random zero difference with increasing blood pressure may complicate interpretation of epidemiological associations.     

A choice of diastolic Korotkoff phases in mercury sphygmomanometry of children.

Blood pressure, anthropometric variables, and blood hemoglobin were measured in 3,524 children, ages 5–14 years, of a total geographic community. Six blood pressures were taken on each child by trained observers on mercury sphygmomanometers in a rigid, randomized design. At the end of each examination day, a random sample of children was reexamined by the same observers. Both Korotkoff fourth and fifth phases were recorded, and measurement reliability was systematically maintained. Six percent of the fifth phase pressures were 0 mm Hg. After elimination of the children with recorded fifth phases under 20 mm Hg, the difference between age-specific mean fourth and fifth phase pressures was 16 mm Hg. The standard deviation of the mean difference between station pressures was 8.2 mm Hg for fourth and 12.3 mm Hg for fifth phase, the latter significantly larger than the former. Likewise, the standard deviation of the mean difference (keeping the same examiner) between examined and reexamined pressure was 6 mm Hg for fourth and 9 mm Hg for fifth phase, the latter again significantly larger than the former. In multiple regression analysis with fourth and fifth phase pressure as the respective dependent variables, the significant effects due to the individual examiners averaged 4.7 mm Hg for fourth and 7.5 mm Hg for fifth phase. Despite painstaking efforts, fifth phase measurements did not seem to approach the consistency and replicability of the fourth phase measurements as an index of diastolic blood pressure in children in a survey conducted by trained observers.     

Out-of-hospital cardiac arrest: a review of major studies and a proposed uniform reporting system.

The scientific literature from January 1970 to June 1979 was reviewed for articles reporting outcomes from out-of-hospital cardiac arrest treated by paramedic programs. Only articles appearing in refereed professional journals and reporting 25 or more attempted resuscitations were included. A total of 21 articles from 15 U.S. locations were found. Four separate case definitions were distinguished. Methods and reporting formats varied considerably. Few studies used an experimental or quasi-experimental design, or control or comparison groups. The range of attempted resuscitations varied from 26 to 1.106 patients. Patients admitted to hospital varied between 22 per cent and 65 per cent (mean 38 per cent, S.D. +/- 12.4 per cent). Patients discharged alive varied from 3.5 per cent to 31 per cent (mean 17.2 per cent, S.D. +/- 7.1 per cent). Post discharge survival was either not reported or reported in different formats. A simplified reporting format is proposed using factors known to be associated with successful resuscitation: 1) underlying heart disease etiology; 2) witnessed arrest; 3) cardiac rhythm of ventricular fibrillation/ventricular tachycardia; 4) hospital admission and discharge and, when possible, by time from collapse to initiation of CPR and definitive care. Uniform reporting of outcomes will improve comparability and accurate measurement of the impact of emergency programs on out-of-hospital cardiac arrest.     

Seating position in cars and fatality risk.

Fatality risk in passenger cars according to seating position (front versus rear; left versus center or right) was examined using Fatal Accident Reporting System (FARS) data for 1975 through 1985. Comparing the fatality risk of unrestrained occupants matched in sex and age (within three years) revealed effects attributable to seating position, and not to occupant characteristics correlated with use of different seats. Fatality risk to drivers was the same as fatality risk to right front passengers to within 1 per cent; this was so for crashes in all directions and for frontal crashes. Fatality risk in rear seats was (26 +/- 2) per cent lower than in front seats, and lower in center compared to outboard seats by (22 +/- 4) per cent for front seats and (15 +/- 4) per cent for rear seats. The center rear seat was associated with the lowest fatality risk.     

Is higher dairy consumption associated with lower body weight and fewer metabolic disturbances? The Hoorn Study

BACKGROUND: Dairy consumption has been postulated to reduce the risk of obesity and metabolic disturbances. OBJECTIVE: The aim of this study was to evaluate the associations of dairy consumption with body weight and other components of the metabolic syndrome. DESIGN: We used cross-sectional data for 2064 men and women aged 50-75 y who participated in the Hoorn Study. The metabolic syndrome was defined according to the National Cholesterol Education Program Expert Panel. Dairy consumption was assessed by using a semiquantitative food-frequency questionnaire. RESULTS: The median consumption of total dairy products was 4.1 servings/d. After adjustment for potential confounders (ie, dietary factors, physical activity, smoking, income, educational level, and antihypertensive medication), total dairy consumption was significantly associated with lower diastolic blood pressure (beta +/- SE: -0.31 +/- 0.12 mm Hg/serving) and higher fasting glucose concentrations (0.04 +/- 0.02 mmol/L per serving), but not with body weight or other metabolic variables (ie, lipids, postload glucose, or insulin). When different dairy products were distinguished, borderline significant (P < 0.10) inverse associations were observed for dairy desserts, milk, and yogurt with systolic (-1.26 +/- 0.58, -0.57 +/- 0.34, and -1.28 +/- 0.74 mm Hg/serving, respectively) and diastolic (-0.58 +/- 0.31, -0.57 +/- 0.18, and -0.35 +/- 0.40 mm Hg/serving, respectively) blood pressure, whereas cheese consumption was positively associated with body mass index (0.15 +/- 0.08/serving). CONCLUSION: In an elderly Dutch population, higher dairy consumption was not associated with lower weight or more favorable levels of components of the metabolic syndrome, except for a modest association with lower blood pressure.     

Effect of DRGs on three-month readmission rate of geriatric patients with congestive heart failure.

We reviewed the three-month hospital readmission rates of 410 patients ages 70 years or older discharged alive with a first time diagnosis of congestive heart failure during the period January 1983-June 1986. The mean age was 79.8 years, 59.5 per cent were women. Mean length of initial hospital stay decreased from 10.8 days in 1983 to 7.8 days in 1986. One hundred-nineteen patients (29 per cent) were rehospitalized at least once within three months of initial discharge. The readmission rates by year were: 1983, 40.0 per cent; 1984, 27.5 per cent; 1985, 21.4 per cent; 1986, 23.2 per cent. During this same interval, the percentage of patients referred for home health care services increased from 3.3 per cent in 1983 to 13.0 per cent in 1984, 5.8 per cent in 1985, and 12.5 per cent in 1986. Thus, decreased length of hospital stay was associated with a parallel decline in early readmission rate and increased utilization of home health care services. Although this study has important methodologic limitations, the data suggest that shorter hospital stays under the DRG system are not necessarily associated with an increased rate of early rehospitalization.     

Dietary modulators of blood pressure in hypertension

To study the role of diet, 197 patients of essential hypertension were randomized to either experimental diet (group A, 97 cases) or normal diet (group B, 100 cases) with diuretics given to both the groups. The age varied between 25 and 65 years and 154 were males. The study diet included a significantly higher content of potassium (K), magnesium (Mg), calcium (Ca), polyunsaturated fat, and complex carbohydrates compared to the normal diet. At entry to the study, age, sex, risk factors, mean blood pressures, mean serum Mg, K, Ca, and Na, and drug therapy were comparable in both groups. After 1 year of follow-up, there were significantly fewer patients with resistant hypertension in group A (5) than in group B (17). Mean systolic (148.22 +/- 10.1 mm Hg) and diastolic (90.2 +/- 4.84 mm Hg) pressures in group A were lowered compared to mean systolic (160 +/- 12.0 mm Hg) and diastolic (103.3 +/- 5.8 mm Hg) pressures in group B and initial mean systolic (152.2 +/- 12.8 mm Hg) and diastolic (99.8 +/- 7.2 mm Hg) pressures. Mean serum magnesium (1.86 +/- 9.22 mEq/l) and potassium (4.86 +/- 0.39 mEq/l) levels in group A were significantly higher compared to mean levels of 1.56 +/- 0.11 and 4.0 +/- 0.29 mEq/l, respectively, in group B. However compared to initial levels, K and Mg showed no significant changes in groups A and B. There was a significantly lower incidence of complications in group A (58) compared to group B (100). It is possible that a diet low in Na/K ratio and rich in complex carbohydrates, polyunsaturates, K and Mg may cause a significant reduction in blood pressure and its complications.