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THE DEVELOPING COUNTRIES AND MEDICAL RESEARCH

tension, the consequent challenges for research are obvious. There is need first to extend efforts to find modifiable causal factors, and second to seek nonpharmacological ways of controlling hypertension. Since causal factors undoubtedly include environmental ones, these goals should not be assumed to be unattainable. Different workers would advocate research along different lines. Dietary modification, including moderate control of sodium intake, long-discussed, is only beginning to be critically examined in mild hypertension in man.? The possible influence of factors associated with tribal or extended-family ways of life, which have been largely lost in our type of community, is a lead which is yet to be explored experimentally, but which perhaps remains in the "too difficult" basket. There is no shortage of hypotheses generated by physiological and experimental studies. Overall the prevention and control of hypertension have such large potential implications for the health of the community, for example by reducing the incidence of stroke and heart disease, that it is timely to consider whether a large proportion of current expenditure on health care should be dedicated to research in this relatively new field of preventive medicine. R. R. H. LOVELL.