18.

1. Standardization as a technique of analysis in medical statistics. direct and indirect

method of standardization.
1. The reasons for standardization or adjustment of rates.
- to provide a summary of figure to compare the health outcomes across population
groups.
2. Direct method of standardization. Its main stages.
3. Cases of using direct method of standardization.
- when present adequate information on specific rates measured.
- present specific parameters such as age, sex, quantity and etc.
4. Indirect method. its main stages.
5. Cases of using indirect method of standardization.
- when there is inadequate information on specific rates.
- when absent information of specific parameters such as age, sex and etc.
2. Elevated blood pressure as a health risk.
1. Definition and magnitude of the problem.
- Elevated BP is defined as a health problem in which the BP is raised above the
maximum border line of the normal level (140/90mmHg) and lead the patient to harmful
health condition.
2. Health consequences.
a) heart- risk of myocardial infarction, ventricular hypertrophy, stroke
b) kidney- long standing elevated BP lead to proteinuria and progressing renal failure.
c) blood vessels- structural changes, artherosclerosis, arteriosclerosis, aneurysm
d) CNS- stroke, cerebral hemorrhage, hypertensive encephalopathy, papiloedema and
disturbance of neurological function.
e) retina- hypertensive retinopathy,
3. Intervention measures in primary care and recommended procedures for healthy blood
pressure.
Intervention measures in primary care:
a) non-drug therapy- correct obesity, reduce/ stop alcohol intake, quit smoking, restrict
salt intake, regular physical exercise, and adopted diet.
b) drug therapy
- diuretics and thiazide
- beta-blockers- metoprolol, atenolol
- ACE inhibitors- enalpril, ramipril

-calcium channel antagonists- verapamil, nifedipine

Recommended procedures:
1) measure blood pressure regularly- home measurement and consult professional.
2) education about elevated BP- knowing about the disease, the causes, risk factors.
3) Hereditary analysis and family history checking- those who are predisposed due to
hereditary and family history should take safety measures.
4) identify risk factors and avoid it- avoid smoking, alcohol intake reduced, control salt
intake, improve life style and etc.
4. Strategies of screening recommended for detecting hypertensive people.
- basic blood pressure measurement is carried out.
- blood pressure checked on both side of arm initially and monitored.
- equipment used, condition of patient and atmosphere are monitored. patient should be
calm, and not in stressful condition. equipment used are in good condition and absence of
error. Atmosphere should be normal and shouldnt influence the patients blood pressure.
- people who are in the risk factor group should be regularly checked and monitored.
blood pressure taken are recorded in chart and the mean level is measured.
- people who are hereditarily having the problem should be identified and the history is
collected.