Societies CVD risk-assessment programme/chart. Optimal cholesterol lowering should reduce the total cholesterol by 25% or LDL-cholesterol by 30% or achieve a total cholesterol of o4.0 mmol/l or LDL-cholesterol of o2.0 mmol/l, whichever is the greatest reduction (A). Glycaemic control should be optimised in people with diabetes, for example, HbA1c o7% (A). Advice is provided on the clinical management of hypertension in specific patient groups, that is, the elderly, ethnic minorities, people with diabetes mellitus, chronic renal disease, and in women (pregnancy, oral contraceptive use and hormone-replacement therapy). Suggestions for the improved implementation and audit of these guidelines in primary care are provided.

Objective-To demonstrate the magnitude, timing, and cause of changes in blood pressure that occur in migrants from a low blood pressure population on moving to an urban area.Design-A controlled longitudinal observational study of migrants as soon after migration as possible and follow up at three, six, 12, 18, and 24 months after migration. A cohort of controls living in a rural area who were matched for age, sex, and locality were also observed at the same periods. Viliages on the northern shores of Lake Victoria in western Kenya and Nairobi. Main outcome measures-A medical questionnaire and three 24 hour diet histories were completed by migrants and controls. Height, weight, pulse, and blood pressure were measured. Three 12 hour overnight urine samples were collected from all participants and analysed for sodium, potassium, and creatinine concentrations.Results-The mean systolic blood pressure of migrants was significantly higher than that of controls throughout the study, and the distribution of blood pressure was shifted to the right compared with controls. The mean diastolic blood pressure of the two groups diverged over time. Blood pressure differences were not due to selective migration. The migrants' mean urinary sodium:potassium ratio was higher than that of controls (p<0-001) throughout, and weight and pulse rate were also higher among migrants, although differences diminished with time.

Objective-To assess racial differences in cardiac structure and function in patients presenting with previously untreated hypertension.Design-Untreated black patients with hypertension were compared with untreated white patients matched for age and sex. Both groups had similar body mass indices, blood pressures, and reported duration ofhypertension. IntroductionStudies from the United States and the United Kingdom have shown that the prevalence of hypertension is higher in black than in white populations."4 Furthermore, the prevalence of left ventricular hypertrophy, a powerful independent predictor of sudden death, cardiovascular disease, and cardiac