British Medical Journal

doi: 10.1136/bmj.304.6842.i5pmid: N/A

Coid, J. W.; Cordess, C.

doi: 10.1136/bmj.304.6842.1581pmid: 1628081

Morley, V.

doi: 10.1136/bmj.304.6842.1582pmid: 1628082

McLauchlin, J.

doi: 10.1136/bmj.304.6842.1583pmid: 1628083

Chanarin, I.

doi: 10.1136/bmj.304.6842.1584pmid: 1628084

Williamson, R.

doi: 10.1136/bmj.304.6842.1585pmid: 1385746

Simpson, J.; Smith, R.

doi: 10.1136/bmj.304.6842.1586pmid: 1628085

doi: 10.1136/bmj.304.6842.1587pmid: N/A

Tyler, A.; Ball, D.; Craufurd, D.

doi: 10.1136/bmj.304.6842.1593pmid: 1385747

OBJECTIVE--To evaluate the United Kingdom Huntington's disease presymptomatic testing programme. DESIGN--Postal questionnaire survey to collect data on all tests performed by clinical genetics centres between 1987 and 1990. SETTING--Genetic centres providing presymptomatic testing in the United Kingdom. SUBJECTS--248 subjects at risk of Huntington's disease who had presymptomatic testing at their request. MAIN OUTCOME MEASURES--Sex, age, prior risk, and risk after testing. RESULTS--The risk of carrying the Huntington disease gene was reduced for 151 (61%) of the applicants and raised for 97 (39%). 158 (64%) of the subjects were female and 90 (36%) male. The median age at which the results were given was 32.5 years. CONCLUSIONS--The demand for testing was lower than expected and may have reached its peak in 1990. The excess of low risk results was not fully explained by the age effect. All the genetics centres concerned have agreed a common service protocol which requires extensive pre-test counselling and post-test follow up. The worth of the procedure remains to be decided. The availability of a large body of pooled data from all the United Kingdom testing centres, which individually are likely to have only a few results, will form a valuable resource for monitoring the long term psychosocial impact of testing.

Li, N.; Tuomilehto, J.; Dowse, G.; Alberti, K. G.; Zimmet, P.; Min, Z.; Chitson, P.; Gareeboo, H.; Chonghua, Y.; Fareed, D.

doi: 10.1136/bmj.304.6842.1596pmid: 1628086

OBJECTIVE--To compare the prevalence of electrocardiographic abnormalities and to evaluate the association between these abnormalities and the levels of coronary heart disease among Chinese living in different environments. DESIGN--Cross sectional surveys. SETTING--Beijing, China, and the island of Mauritius. SUBJECTS--Random samples of people aged 35-64 years in Beijing (621 men, 642 women) in 1984 and in Mauritius among Chinese (137 men, 130 women) and non-Chinese (1265 men, 1432 women) in 1987. MAIN OUTCOME MEASURES--Prevalence of electrocardiographic abnormalities suggesting coronary heart disease and of associated risk factors. RESULTS--Prevalence of electrocardiographic abnormalities suggesting coronary heart disease was significantly lower in Beijing (4.0%) than in Mauritian Chinese (24.3%) and Mauritian non-Chinese (24.5%). Mean serum concentrations of total and non-high density lipoprotein cholesterol were lower in Beijing Chinese than in Mauritian Chinese, but smoking and hypertension were slightly more prevalent. Overall, men with electrocardiographic abnormalities had higher risk factor levels than those with a normal electrocardiogram regardless of ethnic origin. CONCLUSIONS--The prevalence of coronary heart disease and associated risk factors was different among Chinese living in two different environments: in Beijing in the People's Republic of China and in Mauritius. Chinese, who traditionally have a very low frequency of coronary heart disease, are by no means protected against coronary heart disease and other non-communicable diseases. Therefore, primary prevention of coronary heart disease is a major challenge for preventive medicine in China, as well as in many other developing countries.