§ Mr. Heddleasked the Secretary of State for Social Services what is the annual cost of hospital treatment for patients suffering from hypertension.
§ Sir George Young:This information is not available. I understand that hypertensive patients are usually treated by their family doctors.
§ Mr. Heddleasked the Secretary of State for Social Services why patients suffering from hypertension and needing 177W prolonged continuous medication are not entitled to exemption from prescription charges on medical grounds; and if he will make a statement.
§ Sir George Young:Patients suffering from hypertension are not entitled automatically to exemption from prescription charges on medical grounds because this condition is not included in the list of "specified medical conditions" which confer this entitlement.
The list includes only readily identifiable conditions which in virtually all cases call automatically for prolonged continuous medication; most of the listed conditions require specific substitution therapy. The list is compiled in conjunction with the General Medical Services Committee representing the medical profession. As a result of the campaign organised last year by the Cystic Fibrosis Research Trust my right hon. Friend considered the need for a further review of the list. Because of the increased costs if several new conditions were added to the list, and the need to view these costs in relation to the broad needs of the NHS as a whole, he reluctantly concluded that no change should be made in the present range of exemptions.
Some sufferers from conditions not on the list will qualify for exemption under the various other exemption categories. Others requiring frequent medication or
who are not entitled to exemption can limit their outlay on prescriptions by purchasing a prepayment certificate (season ticket).
§ Mr. Heddleasked the Secretary of State for Social Services whether his Department is sponsoring any research project into the medical condition known as hypertension.
§ Sir George Young:The Department has directly commissioned research into this condition. At Hammersmith hospital it is supporting two studies: one into the application of digital computers to hypertension clinic research; and also a randomised comparison of hospital and community care for the treatment of patients with the condition. At St. Thomas' hospital, London, there are controlled trials of treatment of moderate hypertension in general practice.
The main Government-funded body supporting research into this condition is 178W the Medical Research Council, from funds provided by the Department of Education and Science and the Health Departments.
The natural history of the condition is being researched as part of the council's overall programme and a major clinical trial is being carried out to assess the benefits of treatment of mild forms of hypertension in men and women between 35 and 64 years of age. The council is also supporting studies, as listed below, on the causes and treatment and on the methods for detection and measurement of the condition:
MRC Research Establishments, Staffs and Title
National Institute for Medical Research
Neuropharmacology of Chemosensitive areas near the surface of the brain stem.
Clinical Research Centre
Ambulatory monitoring by miniature tape recorders of EKG, EEG and BP.
Normal and abnormal steroid excretion patterns in hypertension; children; the perinatal period, a primate model.
Computer based records for hypertension clinics.
Automatic non-invasive measurement of arterial blood pressure for ambulatory monitoring.
Studies of hypertension.
MRC Blood Pressure Unit, Glasgow
Clinical studies of diagnosis, treatment and incidence of hypertension using haemodynamic electrolyte corticosteroid ream peptide techniques and systems analysis.
Studies in animals of renal, malignant and doca induced hypertension using haemodynamic electrolyte corticosteroid, renin, angiotensin and vasopressin techniques.
MRC Neurological Prostheses Unit, London
Carotid sinus nerve stimulator.
Dr. G. J. Miller (External Scientific Staff)
Trinidad cardiovascular survey.
Dr. W. Z. Billewicz (External Scientific Staff)
Community studies in tropical and nontropical environments.
Professor Colley-National Survey (External Scientific Staff)
Medical studies using the cohort data including mental illness, respiratory and cardiovascular disease, obesity and physical disability.
MRC Grants, Professor S. M. Hilton, University of Birmingham
Central nervous control of the circulation.
Dr. E. Ayitey-Smith, University of Accra
Environmental influence on the development of experimental hypertension.
179WDr. A. P. A. Steptoe, St. George's Hospital Medical School, London
Regulation of blood pressure reactions to psychological stressors using biofeedback and relaxation.
Dr. P. J. Harris, University of Edinburgh
Role of angiotension in control of proximal tubular sodium reabsorption in normotensive and hypertensive rats.
Professor C. T. Dollery, Royal Postgraduate Medical School, London
Role of peripheral pre-synaptic alpha receptors in circulatory control.
Professor J. L. Reid, University of Glasgow
Peripheral sympathetic activity, circulating catechol amines and alpha adrenoceptors in experimental hypertension.
Professor J. M. Ledingharn, London Hospital Medical College
Effect of altering sodium and potassium intake in borderline essential hypertension.
Dr. I. Ostman-Smith, Radcliffe Infirmary, Oxford
Modification of pathological Cardiac hypertrophy.
Professor P. Sleight, University of Oxford
Relationship between non-invasive arterial blood velocity and intra-arterial blood pressure.
Dr. J. D. H. Slater, Middlesex Hospital Medical School
Angiotensin 1 converting enzyme activity in the control of aldosterone secretion and arterial pressure in man.
Professor I. H. Mills, University of Cambridge
Role of arterial pressure and prostaglandin or prostacyclin in the regulation of renal kallikrein release.
Dr. J. Alaghband-Zadeh, Charing Cross Hospital Medical School
A cytochemical bioassay for angiotensin 11.
Professor E. M. Symonds, University of Nottingham
Some determinants of activity and response in the renin-angiotensin system in normal and hypertensive pregnancy.
Professor E. M. Symonds, University of Nottingham
Renin production by the uteroplacentalfetal complex.
Dr. M. J. Brown, Royal Postgraduate Medical School
A quantitative analysis of sympathetic nervous activity and its application to the study of hypertension and depression.
Dr. C. R. W. Edwards, St. Bartholomew's Hospital, Medical College
Factors modulating the biosynthesis release and peripheral effects of renin and mineralocorticoid steroids (RFAS).
180WDr. M. C. Harris, University of Birmingham
Connections between chemoreceptor and baroceptor afferents and hypothalamic supra-optic neurones.
Dr. M. De Soviet, Cardiothoracic Institute, London
Can children who will develop essential hypertension as adults be identified?
Dr. J C. Mott (Nuffield Institute for Medical Research), University of Oxford
Development of high blood pressure in fetal lambs and its maternal consequences.
Dr. D. R. Mottram, Liverpool Polytechnic
Cardiovascular properties of alpha adrenoceptor antagonist WB 4101.
Dr. C. R. M. Prentice, Royal Infirmary, Glasgow
Coagulation tests in predicting intro-uterine growth retardation and pre-eclampsia, trial of anti-platelet drugs.
§ Mr. Heddleasked the Secretary of State for Social Services what is the annual cost of drugs prescribed under the National Health Service in connection with the complaint hypertension.
§ Sir George Young:In 1979 the total cost to the National Health Service—after deducting revenue from prescription charges—of prescriptions for drugs specifically classified as antihypertensive and dispensed by retail pharmacists, drug stores and appliance contractors in Great Britain was £35.829 million. Drugs in other categories, eg diuretic drugs, are also sometimes prescribed for the treatment of hypertension: but since the prescription form does not record a diagnosis it is not possible to say how much of the cost of those drugs relates to such treatment.
§ Mr. Heddleasked the Secretary of State for Social Services what is his estimate of the number of patients suffering from hypertension and categorised as needing prolonged continuous medication.
§ Sir George Young:I regret that statistics are not available from which a reliable estimate could be made.