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September 19, 1990

California Living II: Not-the-Big-One Had No Effect on Blood Pressure

JAMA. 1990;264(11):1411. doi:10.1001/jama.1990.03450110057024

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To the Editor. —  We report what may be the first instance of ambulatory blood pressure recording during a natural disaster.On October 17, 1989, a severe earthquake of magnitude 7.1 on the Richter Scale devastated the San Francisco Bay region. Before the earthquake, a 73year-old man with a 20-year history of essential hypertension (treated with enalapril and hydrochlorothiazide) and diet-controlled non-insulin-dependent diabetes mellitus had been recruited for participation in a study of a new angiotensin-converting enzyme inhibitor, quinapril (Accupril, Parke-Davis, Ann Arbor, Mich). The remainder of the medical history, physical examination, and laboratory data were unremarkable; there was no clinical evidence of diabetic neuropathy or thyroid dysfunction. During the course of a 4-week wash-out period, his morning blood pressures in the clinic rose from 130/78 to 190/110 mm Hg. Home blood pressure recording, with a digital sphygmomanometer, showed comparable morning readings. His afternoon readings remained consistently lower, even when