[Physical and psychological risk factors of ischemic heart diseases. Apropos of a prospective survey in Marseilles]. / Facteurs de risque somatiques et psychiques et cardiopathies ischémiques. A propos d'une enquête propsective marseillaise.

The results of a survey carried out in Marseilles between 1972 and 1979 are reported. A common protocol was used to compare results with two other surveys performed conjointly in Paris and Brussels. The protocol was designed with special emphasis on the psychological factors with respect to the risk factors for ischaemic heart disease (IHD). Seven hundred and eighty six men in a Marseilles administrative department, aged 40 to 60 years (mean age 48.5 +/- 4.5 years) were followed-up for 74 months. Apart from cardiovascular clinical examination with measurement of height, weight, blood pressure and ECG recording, the initial check-up included serum cholesterol, triglycerides and glucose determination and a study of psychological risk factors based on the Bortner's scale for the evaluation of type A profile, and on a questionnaire : the SHEPI for evaluation of the N score (neuroticism). The annual IHD incidence was 9.5% with 4.2% of major events (death or infarction), and 5.3% of minor events (angina pectoris, suggestive ECG changes). Age, tobacco consumption, average systolic blood pressure, serum cholesterol and obesity index were higher in patients who became ill than in those who remained healthy, but overall and separate analysis of major and minor events showed no significant difference apart from age. On the other hand, the study of increased risk according to the level of each of these major factors gave significantly positive results except for the serum glucose level. The correlations between incidence of IDH and the value of each risk factor were not always the same according to the clinical expression (major or minor events). Psychological factors also differed according to the clinical expression of IHD : the Bortner scale was higher in patients developing IHD than in healthy subjects, and higher in those who suffered major events than in those who suffered minor events. On the other hand, the N score was higher in patients with minor events than in those suffering major events. These differences which were not statistically significant in the Marseilles study alone, became significant in the Franco-Belgian cooperative study. The increased risk with the number of associated factors (including psychological) is significant from the association of 2 factors, but only in the fifth decade.(ABSTRACT TRUNCATED AT 400 WORDS)

[Prevalence of arterial hypertension and its treatment in 2,595 adults]. / Prévalence de l'hypertension artérielle et de son traitement chez 2,595 adultes.

The prevalence of arterial hypertension, as defined by the W.H.O. (systolic BP greater than 160 mmHg and/or diastolic BP greater than 95 mmHg), and the prevalence of its treatment were studied in 2595 local government employees of Marseilles, aged from 20 to 65 years. The prevalence of hypertension was 17.96 p. 100 (466/2595, including 222 men and 244 women). The prevalence of normal tension was 57.50 p. 100 (1492/2595, including 802 men and 690 women). The prevalence of treated hypertension was 37.98 p. 100 (177/466) divided into 29.27 p. 100 (65/222) in men and 45.90 p. 100 (112/244) in women (p less than 0.0001). Blood pressure was controlled by treatment in 32.30 p. 100 (21/65) of treated men and in 36.61 p. 100 (41/112) of treated women (NS). 81.14 p. 100 (198/244) of hypertensive women and 57/82 p. 100 (399/690) of normotensive women were active (managers, executives). In treated men, the plasma level of apoprotein A1 was decreased and that of apoprotein B was increased. Among men, the global score at Bortner questionnaire was significantly lower in the group of 175 untreated hypertensive patients (176 +/- 46) than in the group of treated hypertensive patients (192 +/- 48, p less than 0.05) and in the group of normotensive subjects (186 +/- 41, p less than 0.05). This indicated that untreated hypertensive men have a tendency to type B pattern and suggested a line of research aimed at a better understanding of the relative failure of anti-hypertensive treatments in the prevention of coronary disease.