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War Surgery and Medicine

First World War Cases of Hypertension Still Alive

First World War Cases of Hypertension Still Alive

In the following table 130 out of the 143 living cases of hypertension are studied. The remaining 13 are not included in the table as they were not deemed to be suffering from hypertension until after the year 1940. The ages of these 13 now (1952) range from fifty-five to sixty-five, and hypertension has been present for periods of one to eleven years. The table gives the age groups to which page 661 the 130 cases belong in 1952, average periods in years to date of the existence of hypertension, the standard deviation of each average, and the longest and shortest period of hypertension exhibited by a patient in each age group.

Table I
Age Groups 50–55 56–59 60–65 66–70 71–75 76–79 80–85
Number of cases 2 28 37 29 25 6 3
Average period of longevity to 1952 16 17 17 19 17 17 21
Standard deviation 0 3 3 5 5 2 7
Longest recorded period of longevity 16 24 23 34 24 20 30
Shortest recorded period of longevity 16 13 12 14 12 15 15

These patients are all living in 1952, and it may come as a surprise to many that such long periods of longevity are compatible with definite hypertension.

Notes of some illustrative cases are given:

Case 336: Born 1895. Bootmaker prior to 1914.

1916 Tonsillitis. 1918 suffered from Inflammation Connective Tissue of neck, impetigo and influenza with bronchopneumonia.

1919 Lungs clinically negative. ‘Some irritability of heart.’

1921 Effort syndrome. Apex Beat of heart inside N.L. Complained of palpitation and dizziness. Exercise tolerance test was 84–120–144–84. No complaint of breathlessness.

1921 Was better and pension ceased.

The Department had no further knowledge of this man until 1928 when he reported again with tachycardia (D.A.H.). Blood pressure was systolic 185 and diastolic 88. Urine negative. There was evidence of neurasthenia.

1930 B.P. 185/92. P.R. 128.

1931 He complained of headaches. B.P. 205/110. Pulse Rate 144, after exercise 156 and returned after 1 minute to 126.

1932 180/92. 1933 180/90. Main symptoms are those of neurosis.

1934 Admitted to Mental Hospital as a Voluntary Boarder.

1936 B.P. 168/110. Complained of giddiness, headaches and insomnia.

1943 B.P. 190/120. Admitted to Hospital for investigation of chest and mental condition.

1945 B.P. 192/116.

In 1951 he is in receipt of a total permanent pension for hypertension and neurasthenia.

[This patient, aged 57, has a record of blood pressure higher than the average normal for 24 years. His symptoms are mainly those of a neurosis rather than those of hypertension.]

page 662

Case 337: Born 1880. Bushman prior to enlistment.

1917 Suffered from ‘Pyrexia of Unknown Origin’ (P.U.O.). This was usually ‘Trench Fever’.

1918 Influenza, Debility.

1919 Complains of cough and diagnosed C.P.D.I. (‘Chronic Pulmonary Disease Indeterminate’). Heart Negative. Pulse Rate 96–108–96.

1920 Cough.

1921 Bronchitis and Emphysema.

1922 Bronchitis and ‘Known to take too much alcohol.’

1928 B.P. 200/120. Pulse Rate 108–144–90. X-Ray: Heart and Lungs Normal.

1930 B.P. 208/158. P.R. 95–130–144–96.

1931 B.P. 212/114. There is again reference to ‘alcohol’.

1932 B.P. 200/130.

1933 B.P. 218/108.

1934 B.P. 212/110. Urine negative for albumen and sugar.

1935 B.P. 240/120.

1937 B.P. 220/120. Urine Negative.

1938 B.P. 220/130. Urine Negative. Some neurosis present.

1940 B.P. 240/116.

1945 B.P. 204/120.

1950 B.P. 260/140.

In 1952, at the age of 72, he lives quietly at home suffering dizzy attacks at times but no headaches and no epistaxis. His heart is enlarged on clinical examination.

[For 24 years this man has had a systolic blood pressure of 200 or more and diastolic of 110 or more. It was first taken in 1928 and found to be 200/120, so the presumption is that it was abnormally high for an unknown period before then. He has had no special medication or surgery for the condition.]