University of Minnesota

Hypertension & Coronary Disease, WHO TR Series #168, Geneva 1959

This expert report was the first solid contribution and floor of the program built by the WHO/CVD Unit director, Zdenek Fejfar. It rested upon the foundation erected by the 1955 WHO Expert Committee on Atherosclerosis and Ischemic Heart Disease (#117) and dealt with the public health issue of CVD, their diagnosis and classification: “Agreement regarding these matters appeared necessary in order that epidemiological studies can be planned in such a way that they produce comparable data” (page 3). (1)

The report provided uniform criteria with details on apparatus and measurement, along with a summary of knowledge on “etiological factors” (not yet “risk factors”). An appendix included specific clinical and electrocardiographic criteria for “probable and possible myocardial infarction,” along with useful explanatory diagrams. [ed. The later Minnesota Code did not include these more qualitative ECG criteria, which presumably were created by Professor Pierre Duchosal, Geneva cardiologist, who nevertheless strongly supported Minnesota-London efforts at ECG classification for epidemiology.]

The recommendations in this seminal report were the base for the CVD Unit’s program and staffing, its future planning, the WHO coordination and training function, and for further expert meetings of workers in CVD epidemiology. The report is summarized:

  1. There is an urgent necessity to establish the true frequency of coronary heart disease, hypertension, and related conditions in countries at various stages of development through the study of representative and comparable samples of their populations.
  2. Minimal criteria are given for the diagnosis of CHD and hypertension.
  3. Progress will depend on standardization of clinical, laboratory, and electrocardiographic methods for field study, as well as assessment of diet, physical activity and psychosocial factors.
  4. Training of field experts is of great urgency.

This report led directly to preparation of the WHO Technical Report Series #56 on CVD Survey Methods, as well as, for the WHO fellowships to the training program of the London School HTM, and for the ISFC ten-day seminars in CVD epidemiology. (Henry Blackburn)

Footnote 1. Membership [ed. Note overlap with the 1955 WHO Expert Committee on Atherosclerosis and Ischemic Heart Disease]:


World Health Organization. 1955. Report of a study group on atherosclerosis and ischaemic heart disease. Technical report series 117. Geneva: World Health Organization.

Rose, G., and H. Blackburn. 1968. Cardiovascular survey methods: WHO technical report series no. 56. Geneva: World Health Organization.