J Natl Med Assoc
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The treatment of hypercholesterolemia in the black patient will be the next public health challenge facing physicians in the black community. Cost-effective care of hypercholesterolemia will be necessary and is possible, but it will require skill in the use of available therapies, extensive patient education, and excellent communication between patients and health care providers.
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Correlates of heart rate were investigated in youths aged 12 to 17 years examined in the United States National Health Examination Survey. Heart rate decreased with age in boys but no consistent trend appeared in girls. Girls had higher heart rates than boys. ⋯ Regression analyses within sex-race groups identified the following independent correlates of heart rate: white boys, age, systolic blood pressure, and body temperature; black boys, age, body temperature, subscapular skinfold, and systolic blood pressure; white girls, systolic blood pressure, body temperature, cigarette smoking; black girls, body temperature. Correlations of two heart rate measurements 28 to 53 months apart (median 44 months) ranged from r = 0.21 to r = 0.30. Although expanded blood volume and lower sympathetic tone in blacks have been hypothesized, further longitudinal studies are needed to explain the differences in heart rates between races and sexes and their relationship to hypertension in adulthood.
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A historical review of skin antisepsis is given. Current practices, rationales for skin antisepsis as a segment of total wound care, and bacteriological factors are discussed. ⋯ Discussion and conclusions relative to survey results and skin care agents are given. Characteristics of an ideal skin preparation yet to be obtained and some common myths relating to this subject are discussed.
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The total number of American blacks aged 65 years and over is estimated to be approximately 2.3 million, and the black elderly population will continue to increase faster than the white elderly population throughout the remainder of this century. During the period 1985 to 2025, the elderly population in the United States will increase to 105 percent. ⋯ Many factors are associated with the development of hypertension and diabetes in blacks. Specfic epidemiologic studies are necessary to identify black-white differences in risk factors, including biomedical risk, socioeconomic status, psychosocial risk, nutritional status, lifestyle, and genetic factors.
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Diltiazem hydrochloride was studied in 133 patients with angina to determine whether differing effects were produced in black patients (39 percent of patients) as compared with nonblack patients. The antihypertensive effect of the drug was also assessed. ⋯ Average decreases in this group were 18 mmHg in supine systolic pressures and 14 mmHg in supine diastolic pressures, as compared with decreases of only 4 and 3 mmHg in normotensives. Study results suggest that there is a difference in the type of angina afflicting blacks and nonblacks, that hypertension more often accompanies angina in blacks, and that diltiazem is equally effective in treating angina in blacks and nonblacks.