BLOOD PRESSURE IN ONE HUNDRED CASES OF TUBERCULOSIS AT HIGH ALTITUDE
Archives of Internal Medicine
In recent years mtich has been written concerning blood pressure and its relation to many pathologic conditions. Its relation to tuber¬ culosis has been discussed by many writers, but in all the literature I have failed to see any reports from sanatoria situated at high altitudes. From the observations made here in the Xew Mexico Cottage Sana¬ torium, at an altitude of G,000 feet, we are led to believe that altitude has an important influence on blood pressure. As will be shown in the course of
... wn in the course of this article, our average pressure is far higher than that at lower elevations or at sea level; and this, too, as a rule, with cases in the far advanced stages of the disease. Here the majority of our cases fall into this class; for it is a fact that in the west, nowadays, we see mostly advanced cases or those in whom the disease has made such inroads that a cure, according to the eastern standard of prognosis in tuberculosis, is difficult, if not impossible, of attainment. Yet, eontending with these disadvantages, we turn out, class for class, as many, if not more, cures than the eastern and northern sanatoria. It is at least worthy of suggestion that our results may be partly due to the stimulating effect of the dry mountain air, which increases the blood pressure through the building up of the general circulation. The results of blood-pressure observations in our cases, far from being indicative of tuberculosis, would signify almost perfect health; in fact, as a diagnostic sign blood pressure plays a minor rôle. It is far more valuable as a prognostic indication. The following observations were made on a series of 100 cases at the Xew Mexico Cottage Sanatorium at an elevation of G,000 feet. The pressure was taken with a Janeway sphygmomanomcter -ith the cuff applied to the left arm above the elbow, the patient in a sitting posture, the forearm flexed on a level with the heart. The systolic pressure alone was recorded, since for all practical purposes we feel that this is suf¬ ficient. The observations were made between the hours of 9 and 10 in the morning. Pressures were taken at different hours throughout the day. but onlv a sliffht difference in the reading was to be noted.