Blood pressure and heart murmurs in a rural population in the ...

BLOOD PRESSURE AND HEART MURMURS91apex beat was recorded as being palpable or not,and the intercostal space in which it was located wasnoted. Cardiac murmurs were classified accordingto their intensity as recommended by Rose &Blackburn (14). No distinction was made betweenejection and pansystolic murmurs. Murmurs werealso classified according to their area of maximumintensity as apex and mitral, left lower border ofsternum (LLBS), pulmonary, aortic, or other.The age given by the subject was accepted if it didnot differ by more than 5 years from that previouslyrecorded at census. If the difference was more than5 years, the person was questioned on importantdates in the Republic's recent past; one fifth of thesubjects were placed in a different age group fromthat determined by the census.RESULTSIn all, 608 persons were examined (333 men and275 women), the overall response rate being 86 %.These appeared to be no significant differences withregard to age, sex, or geographical location amongthose who did not respond. Ninety-five percent ofthe subjects had been resident in the area for 5 yearsor more, over 90% were farmers, and 79% of thewomen and 48 % of the men had had no formalprimary education.The distributions of systolic and diastolic bloodpressures for all males and all females (Fig. 1 and 2)were approximately normal, with close similaritiesbetween males and females. The skew to the rightis slight but is more marked for systolic than fordiastolic blood pressure.The mean systolic and diastolic blood pressurelevels according to age and sex are given in Table Iand Fig. 3.Systolic blood pressureThe men showed no significant rise in meansystolic blood pressure level with age, whereas forwomen there was a consistent rise starting belowTable 1. Mean systolic and diastolic(pressures in kPa in parentheses)blood pressures in mmHg by age and sexMenWomen aAge group(years) Mean blood SD b Number Mean blood SD NumberpressurepressureSystolic25-34 120.1(16.0)11.2 81 117.6(15.6)15.5 6635-44 124.6(16.6)15.5 88 119.0(15.8)20.1 9445-54 122.7(16.3)21.8 75 124.3(16.5)19.1 5855-64 124.6(16.6)19.1 89 126.9(16.9)20.7 57Total 123.1(16.4)17.3 333 121.4(16.1)19.2 275Diastolic25-34 74.4(9.9)11.4 81 72.3(9.6)11.9 6635-44 77.0(10.2)11.6 88 74.8(9.9)11.3 9445-54 76.1(10.1)14.8 75 76.2(10.1)15.1 5855-64 77.5(10.3)13.2 89 75.9(10.1)13.5 57Total 76.3(1 0.1)12.7 333 74.7(9.9)12.8 275a Difference in mean blood pressure between women aged 25-34 years and those aged 55-64 yearsby the Student t test = 0.01 > P > 0.005.b SD = standard deviation.