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Official reply from Director-General Dr Gro Harlem Brundtland

Director-General Gro Harlem Brundtland
The World Health Organization
Headquarters Office in Geneva (HQ)
Avenue Appia 20
1211 Geneva 27
Switzerland

About the 1999 World Health Organization - International Society of Hypertension Guidelines for the Management of Hypertension

Dear Dr Brundtland,

This letter originated from a widespread discussion among family doctors on the Internet. A total of 888 colleagues from 58 nations have put their 'electronic signatures' on it. They are mostly family doctors, but also specialists, pharmacists, and scientists. Their names are included at the end.

We welcome the priority you have given to primary health care, and the emphasis you have put on research, solid facts, and cost-effective practice. We support your intention to put WHO in the forefront in setting high standards and appreciate the completeness of the new guidelines (Journal of Hypertension 1999; 17: 151-83).

However, we are concerned about one particular part of the guidelines. Under "Goals of treatment" the guidelines state: ".. the goal of antihypertensive therapy should be to restore blood pressure to levels defined as 'normal' or 'optimal'." Normal is defined as blood pressure below 130/85 mmHg, optimal below 120/80 mmHg. Later in the same section: "It would seem desirable to achieve optimal or normal blood pressures in young, middle-aged or diabetic subjects."

As far as we know, there is only one trial that has aimed to investigate the level of optimal target blood pressure, the Hypertension Optimal Treatment (HOT) study (Lancet 1998; 351: 1755-62). About the HOT study the guidelines state: "Comparison of outcomes between the three randomized blood pressure target groups in the HOT study (DBP <=90, 85 or 80 mmHg) was unable to detect significant differences in the risk of cardiovascular disease between adjacent target groups." We have also reviewed the HOT paper and found no evidence to recommend aiming for a blood pressure below 140/90 in non-diabetics.

The justification for the recommendation appears to be that the HOT study indicates that there is no increase in cardiovascular risk in patients randomized to the lowest target groups (<= 80 mmHg). In our view it is necessary to prove benefit, not lack of harm, when making such a recommendation.

We are also concerned that ASTRA, the industrial sponsor of the HOT study, is overly anxious to promote the new guidelines. In early February ASTRA embarrassed WHO by announcing the new guidelines ahead of schedule at a press conference in London. ASTRA has also been running advertising campaigns in medical journals, claiming that the HOT study shows the optimal target diastolic blood pressure to be 83 or 85 mmHg. We fear that the new recommendations will be used to encourage an increased use of antihypertensive drugs, at great expense, and for little benefit.

Family doctors are responsible for treating the majority of hypertensive patients. This is an important task, and we acknowledge that there is a potential for improvement in care. We look to WHO for leadership in the global effort to prevent unnecessary deaths and appreciate your efforts in developing the new guidelines. Regrettably, in this particular recommendation we are left with an impression that WHO has failed its responsibility. We believe a correction is possible and necessary and will look forward to hear from WHO on this issue which, if left unattended, may affect millions of people.

Copy to: President & CEO Håkan Mogren, ASTRA AB, SE-151 85 Södertälje, Sweden


This letter has been 'signed' by:

Argentina (3): Luis Malgor, Mabel Valsecia, Dario Cesar Bega-Rodriguez,

Australia (13): Gerard Gill, Jan Radford, Grant Russell, Daniel Byrne, Paul Glasziou, Sophia Couzos, Peter Mansfield, Hugh Nelson, John Togno, Malcolm Ireland, Michael Kidd, Mike Bennett, Teng Liaw,

Austria (2): Josef Schützenberger, Erwin Rebhandl,

Bangladesh (2): Mamunur Rahman, Ashoke K. Roy,

Belgium (6): Pierre Chevalier, Etienne Vermeire, Paul Van Royen, Michel de Jonghe, Marc Jamoulle, Thierry Christiaens,

Brazil (6): Fernando Luiz de Andrade Maia, Eduardo Costa, Bernardo Rangel Tura, Flávio Danni Fuchs, Angela Beatriz Papaleo Wagner, Hamilton Lima Wagner,

Canada (29): Peter Kirk, Ricardo A. Cartagena, Reiner Banken, Ian Arnold, James M Wright, Wayne Weston, Jim Thorsteinson, Sue Tatemichi, David Maxwell, Terryn Naumann, Alain Léger, Joel Lexchin, Barbara Mintzes, Catherine Clase, Cheryl Levitt, Ciprian Jauca, David Knox, G. Rick Mann, Gordon Mercer, John Forster, K.G. Elder, Lora Morrice, Michael Allen, David Ross, Stanley G. Smith, Tim Temple, W. John Mail, William V. Flexer, Zaheen Rhemtulla,

Colombia (2): Carlos A. Villalba, Ignacio Ceballos V,

Croatia (1): Stanko Uzelac,

Czech Republic (1): Bohumil Seifert,

Denmark (32): Kim Rønhof, Erik Haarløv, Jørgen Nexøe, Niels Bentzen, Esther Vad, Niels Damsbo, Henrik Schroll, Erik Falkoe, Lise Forsom, Hans Kallerup, Torsten Lauritzen, Hildburg Jørgensen, Erik Schiøttz-Christensen, Flemming Bro, Poul Brix Jensen, Hans Granlie, Hanne Hollnagel, Lotte Hvas, Anders Beich, Mikkel Vass, Antonino Caldara, Benny Ehrenreich Nielsen, Camilla Sachs, Henrik Hassing, Ivar Clemmesen, Jesper Lundh, John Brodersen, Lars Schriver, Mette Ulsø, Niels C. Heebøll-Nielsen, Ole Klitgaard, Sverre Barfod,

Estonia (1): Heidi-Ingrid Maaroos,

Finland (4): Erik Hagman, Folke Lampen, Hans Blomberg, Marjukka Mäkelä,

France (119): P Manet, Daniel Coutant, Patrick Ouvrard, Isabelle de Beco, Didier Seyler, Paul Lafontan, Pascal Chabbert, JP Ramon, Jean Luc Regis, Philippe Schilliger, Philippe Roux, Louis Levy, Jean-François Courgeon, Denis Boyer, Georges Magnier, Patrick Segaud, André Perrin, Bruno Assemat, B. Granier, Michel Leveque, Paul Le Meut, Patrick Poisson, Henri Rodriguez, Madeleine Favre, François Teyssier, J-P Aubert, Frédéric Gelber, Nicole Renaud, Isabelle Vanoni, Hector Falcoff, Denis Pouchain, Jean-Louis Bensoussan, Jean-Marc Pariente, Jean-Louis Falzon, Christian Bianchi, André Perrin, Philippe Thonat, Bernard Lacassin, Frédéric Pozzobon, Raymond Glantenet, Alain Kouffienat, Philippe Sopena, François Carniaux, Marie-Hélène Robineau, Patric Bastien, François Pelissier, Claude Bronner, Jean-Pascal Ramon, Pascal Bonnet, Eric Vidal, Alain Moreau, Jean de Butler, Cécile Payen Piffau, Bennoussu, Serge Baluy, Serge Marquet, Françoise Bacle, Philippe Boulanger, Richard Bouton, Marie-Thérèse Mattera, Bernard Clark, Bruno Daubin, Yvette Boudesseul, Lionel Lambert, François Michel, Gisèle Warlop, Jacques Lagarde, Alain Stiloer, Martial Olivier-Koehret, Pierre-Louis Druais, Rémy Sebat, Paul Duchez, Gérard Blanchet, Daniel Zamboni, Michèle de Villepin, Noël Wuithier, Francis Bonnefond, Bernard Lagarrigue, Stid Mavir, Jean-Jacques Ormieres, Muriel Rogier, Jean-Louis Rose, Sylvie Fontano, Jacques Malaval, Rami Jrad, Claude Rozenzweig, Eric Leroyer, Christian Delamare, Emmanuel Forichon, Joël Cogneau, François Angles, Bernard Gay, Gilles Clement, Raymond Rozan, Christophe Cazard, Robert Caduc, André Esnault, Ursula Proust, Pascal Bricmont, Chatel, Jean-Baptiste Sautron, Daniel Leonard, Brigitte Perez, Denis Lagarde, Gérard Andreotti, Luc Vergnes, Yves Gervais, Anne-Marie Chesnau, Meillon, Pierre Rosset-Cailler, Christophe Kopp, François Mennerat, Jacques Elkine, Jean François Brulet, Luc Beaumadier, Michel Roland, Pascal Charbonnel, Patrick Atlas, Patrick Ouvrard,

Germany (3): Dieter Borgers, Michael M. Kochen, Norbert Donner-Banzhoff,

Greece (1): Antonios K. Karotsis,

Hong Kong (1): Chiu Alexander,

Hungary (1): Fenyvesi Tamas,

Iceland (3): Gudmundur I Georgsson, Kristmundur Asmundsson, Johann Agust Sigurdsson,

India (4): Samiran Adhikari, S. Gopalakrishnan, Rajeev Gupta, R. Murali,

Ireland (4): Joe Moran, James McCormick, Craig Bishop, Truls Christiansen,

Israel (7): Eran Rapoport, Dan Michael, Gail Loon-Lustig, Yaacov Fogelma, John Kent, Finn Haas, Shlomo M Monnickendam,

Italy (161): Lorenzo Comini, Giancarlo Mariotti, Mariapia Perlot, Renato Granuzzo, Roberto Leone, Alessandra Maggioni, Giorgio Tresoldi, Anna Rita Mondazzi, Marina Botto Micca, Marina Musso, Elena Zanellato, Rosanna Marino, Rosanna Massaro, Pierluigi Franco, Edgardo Gribaldo, Mara Fanì, Evasio Montiglio, Roberto Redaelli, Mario Marte, Loretta Castellani, Albano Del Favero, Nicola Montanaro, Lorenzo Culzoni, Giovanni Vantaggi, Maurizio Medda, Carmine Ragano, Vincenzo Del Carlo, Massimo Bevilacqua, Marco Venuti, Guido Pastacaldi, Cosimo De Mola, Giuseppe Galli, Gesuino Mattana, Marzio Uberti, Stefano Galli, Assunta De Rosa, Marco Gaddi, Paolo Evangelista, Silvio Guidi, Luciano Caraceni, Francesco Gervasi, Pier Giuseppe Natta, Giancarlo Tricarico, Cosimo Guerra, Tullio Rapacciuolo, Luca Pejrolo, Josef Jorg, Luciano Bertolusso, Enzo Brizio, Pietro Marroni, Luigi Bozzini, Carlo Romaldo, Giorgio Vianello, Fabio Chesani, Laura Baraldini, Maria Rosa Visca, Salvatore Moretti, Fabio Suzzi, Sebastiano Marino, Adriana Gasparotto, Augusto Cavalli, Marco Marchetto, Mariapia Perlot, Paolo Congia, Angelo Campanini, Renzo Vannucci, Ezio Sizzano, Luigi Bertini, Marco Aschei, Davide Lauri, Vincenzo Biasini, Daniele Coen, Di Andrea Osvaldo, Alberto Aronica, Piermaria Zannier, Italo Siena, Norma Sartori, Fabrizio Giunco, Paolo Evangelista, Giustini Saffi-Ettore, Sebastiano Filetti, Maura Massimino, Mario Nejrotti, Dario Sinapi, Imbrici Fortunato, Adriana Novara, Marco Grassi, Carla Roncaglioni, Gianni Tognoni, Fausto Avanzini, Tiziano Cadioli, Vincenzo Landro, Fabrizio Valcanover, Daniele Spina, Pier Lorenzo Franceschi, Mario Nicolosi, Egidio Giordano, Anna Katharina Rieve, Maurizio Damiani, Amedeo Circosta, Tiziana Galopin, Simonetta Pagliani, Giovanni Pettenella, Giuseppe Parisi, Giampaolo Collecchia, Bianca Fossati, Maria Grazia Riva, Romeo Riundi, Maria Teresa Gabaglio, Paolo Longoni, Filippo Bianchetti, Fiorella Gazzetta, Giuseppe Montagna, Marina Bosisio, Franco Fornaciari, Annalisa Campomori, Anna Vittoria Ciardullo, Gianluigi Passerini, Francesco Rapetti, Guido Giustetto, Stefano Bertolissi, Paolo Malavasi, Erminio Tabaglio, Giorgio Crosio, Giuseppe D'Eredità, Giancarlo Gatta Michelet, Francesco Benincasa, Giuseppe Belleri, Ernesto Fumagalli, Ballari Ornella, Francesco Carelli, Alessandro Del Carlo, Giovanni Cataldi, Paolo Schianchi, Bruno Franco Novelletto, Roberto Galante, Amedeo Gasparin, Maria Milano, Lino Gambarelli, Giuseppe Greco, Francesco Cazzaniga, Bernardo Cannelli, Roberto Della Vedova, Maurizio Bonati, Sergio Bernabe, Guido Danti, Angelo Recusani, Andrea Bruschini, Claudio Cricelli, Edoardo Ceschini, Gilberto Lacchia, Giorgio Lazzari, Giorgio Visentin, Marco Ragazzini, Marco Visconti, Massimiliano Ferroni, Massimiliano Marinelli, Massimiliano Vassura, Massimo Tombesi, Nicola Tarallo, Vittorio Caimi,

Ivory Coast (1): Joseph Aka,

Japan (2): Hideki Nomura, Tsukasa Tsuda,

Jordan (1): Ghazi Mousa,

Korea (4): Seong-Choon Choe, Hong Jun Cho, Haeng Lee, Sang Yeoup Lee,

Kuwait (1): Bader Al-Zaid,

Lithuania (1): Vanda Zidoniene,

Macau (1): Carlos Canhota,

Malaysia (6): Yaacob Majezan, Tan Siong Lui, Chin Yooh Keing, Molly Cheah, Sharifah Sorayya Mahmood Jamalullail, Ruby Majeed,

Malta (1): Jean Karl Soler,

Mexico (2): Marité Acasuso Martínez, J. Gustavo Vega Gama,

Netherlands (12): B. D. Frijling, Meggy van Kruijsdijk, B. van der Bom, P.J.A. van Liere, Chris van Weel, F.P.M. Garnier, Arne Levin, B.J. Kral, M. Treub, Marc van Wijk, T.E.M. Aarns, Jan van Rooij,

New Zealand (26): Julie Kimber, Tony Dowell, Tom Farrar, Arlene Smyth, Helen Rodenberg, David Werry, Ian McArthur, Kenneth V. McIver, Ron Law, Anne Licol, Alexander Luft, David Hopcroft, Richard Medlicott, Sarath Gunatunga, Campbell Murdoch, Christopher Leathart, Stephen Murray, John Russell, Barry Gribben, Lindsay J. Strang, Svend Lynge Ottosen, Linda Bryant, Ashwin Patel, John Durham, Karen Flegg, Laurence Malcolm,

Nigeria (2): Zacharias Baridi Ebenezer, Inyang A Ukot,

Norway (99): Endre Sandvik, Richard J. Jacobsen, Roar Dyrkorn, Heidi Thornhill, Bjorn Erikstein, Jens Holm, Hanne Ellekjær, Aslak Bråtveit, Erik S. Weie, Petter Holen, Kjell Skare, Per Steinar Steinsvoll, Helge Søndenå, Aage Bjertnæs, Øyvind Bjerve, Morten Lindbæk, Merete Undeland, Bård Moe, Asta Meland Lysebo, Bente Bjørnhaug Pedersen, Alexander Wahl, Roar Johnsen, Toralf Hasvold, Anders Grimsmo, Satya Sharma, Kristina Hernborg Johannessen, Pål G. Nord, Mette Brekke, Kjell Kristoffersen, Harald G. Sunde, Tore Tobiassen, Per Stensland, Frank Thrana, Bjorn Bjorvatn, Siri Forsmo, Guri Rørtveit, Ole Frithjof Norheim, John-Arne Skolbekken, Sabine Ruths, Torill Christine Lindstrøm, Kari Klungsoyr Melve, Svein Steinert, Geir Thue, Edvin Schei, Kirsti Malterud, Aasmund Storebø, Petter Mathisen, Harald A. Nygaard, Ketil Aspevik, Janecke Thesen, Steven Crozier, Erling Dalen, Knut Holtedahl, Steinar Westin, Hilde Grimstad, Arild Bjorndal, Jon Hilmar Iversen, Bent A Larsen, Jan-Petter Lea, Torstein Gjerløw, Asgeir Haugedal, Karl-André Wian, Finn Johnsen, Olav Thorsen, Tor Anvik, Anders Baerheim, Anette Fosse, Anna Jørdre, Atle Klovning, Benedicte Eskeland, Bjørn Gjelsvik, Brigt Bovim, Dag Bruusgaard, Eivind Meland, Erik Langeland, Geir Jacobsen, Harald Borve, Harald Kamps, Hogne Sandvik, Irene Hetlevik, Jan Robert Grøndahl, John Leer, John Agnar Kvamme, Jostein Holmen, Jørund Straand, Kjell Johansen, Knut-Arne Wensaas, Knut Michelsen, Olav Inge Håskjold, Pål Gulbrandsen, Signe Flottorp, Steinar Hunskår, Stig E. Snoen, Svein Skjøtskift, Tor Claudi, Tor Wold, Trygve Aarflot, Vigleik Kolltveit, Øyvind Rømo,

Oman (2): Jawad A. Al-Lawati, Musbah Omar Tanira,

Pakistan (2): A.S. Cheema, Mehrulolah S. Hashmi,

Panama (2): Raquel de Mock, Cecilia Llorach,

Philippines (2): Bernadette A. Tumanan, Rodolfo T. Rafael,

Poland (3): Mariusz Kustosik, Maciej S. Kowalczyk, Marek Soltysiak,

Portugal (43): Amilcar Augusto, Maria Isabel Pereira dos Santos, Luis Rebel, Maria Leonor Magalhães Castro Quaresma, M Alexandra Abrunhosa, Maria da Glória Neto, Luís Filipe R.A. Gomes, Rui Eugénio Ferreira Lourenço, Vasco Maria, Maria da Conceição Margalha, Rui Medon, António Jorge Barroso Rodrigues de Almeida, Rosalvo Almeida, Brizida Maria Santos Diogo, Teresa Ventura, Tony Woolfson, Manuel Santos Janeiro, Luis Pisco, Maria Rosa Gallego, Henrique Botelho, Mário Santos, Jorge Silva, Jaime Correia de Sousa, Antonio Almeida, Jose A. Baptista Pereira, Fernando Ferreira, Mário Martins, António José da Silva Pimenta Marinho, José Pedro Portugal Moura Relvas, João Cunha, António Maria Trigueiros de Soua Alvim, Antonio Manuel Nuncio Faria Vaz, Armando Brito de Sá, Carlos Mendes Ripado, Carlos Manuel Costa Gonçalves, Carlos Nunes , Constantino L. Santos, Helena Baía, Jesus Perez Sanchez, Jose Antonio Miranda, Jose Augusto R. Simoes, Manuela Agostinho, Miguel Melo,

Romania (4): Alex. Dan Ciochina, Ildiko Branescu, Aurel Bacean, Marius Marginean,

Russia (1): Vladimir A. Timofeev,

Slovenia (3): Igor Svab, Jozica Maucec-Zakotnik, Mateja Bulc,

South Africa (4): Alex Nita, Andre Daniels, Garth Brink, Leon Geffen,

Spain (39): Jose Maria Paez Pinto, Rafael Molina Diaz, Juan Antonio Sánchez Sánchez, Josema Martinez Eizaguirre, Alex Escosa Farga, Fernando Asensio Garcìa, José María Vergeles Blanca, Gabriel Gonzalez Roa, Luis Otero Garcia, Consuelo Arranz Gaite, Victoria Gosalbes Soler, Javier Urraca Gª de Madinabeitia, Juan Enrique Cimas Hernando, Oscar Seoane Perez, Luis Garcia Ortiz, David Ezpeleta, Eduardo Molina, Juan M.Mendive, Mercedes Pérez Fernández, Juan Gérvas, Mª Elisa Morell Sixto, Francisco Luis Caceres Ruiz, Asunción Prieto Orzanco, Agustín Gómez de la Cámara, Carlos J. Cristos, Carlos Martin, Carme Jane Julio, Enric Sala Carbonell, Fco J. Jorge, José A. Pere, José Luis Quintana Gómez, Juan Henríquez Betancor, Manuel Gálvez, Pedro Schwartz, Pilar Gayoso, Rafael Bravo Toledo, Santiago Mola, Vicente Baos Vicente, Vicente M Asencio Garcia,

Sri Lanka (1): Kumara Mendis,

Sweden (94): Bertil Hagström, Nils-Åke Lindén, Lars-Urban Lindström, Jan Bergström, Sakari Oistamo, Calle Antti, Torbjorn Lindblom, Peter Moström, Maria Truedsson, Margaretha Lööf-Johanson, Patrik Midlöv, Hans-Christian Karlsborn, Eva Wahlgren, Inger Jakobsson, Ingalill Morén Hybbinette, Nils Rodhe, Bo Bergstad, Dagrun Lihnell, Staffan Rudholm, Gunnar Claësson, Anna Källkvist, Lena Hedendahl, Birgitta Hovelius, Monica Löfvander, Carsten Karkov, Tommy Schöller, Hans Hallberg, Sonja Modin, Mogens Hey, Lars Borgquist, Leif Persson, Margareta Troein, Charlotte Joborn, Eva Edström, Ulf Eriksson, Maria Ripl Sörensen, Anna-Karin Furhoff, Ulf Ch Théen, Stig Eriksson, Klas Ericsson, Christian Reinisch, Per Högfeldt, Martin Enander, Gert Persson, Rudi Klemme Nielsen, Kjell Johansson, Nisse Årman, Christer Petersson, Jan Hennix, Anders Lundqvist, Gunnar Alm, Sten Sundberg, Kenneth Widäng, Meta Wiborgh, Annette Friström, Staffan Skobe, Björn Nilsson, Charlotte Holst, Gösta Eliasson, Margareta Leonardsson-Hellgren, Ulf Lindblad, Jonas Ranstam, Gunnar Lindberg, Ingmarie Skoglund, Olle Persson, Thord Svanberg, Kristina Bröms, Ulf Måwe, Flemming H. Hansen, Arne Melander, Bengt Silfverhielm, Staffan Lindeberg, Rolf Wahlstrom, Ingemar Block, Agneta Lindskog, Ingvar Ovhed, Mats Eliasson, Lars-Olof Hensjö, Magnus Geirsson, Anders Hansson, Jonas Sjögreen, Björn Olsson, Karin Lindhagen, Agneta Bjorck Linné, Anders Hernborg, Christer Mjömark, Dimitri Edin Zylberstein, Gustaf Lilliehöök, Göran Sjönell, Hans Liedholm, Jan Håkansson, Jan Zadig, Peter Rosenberg, Ture Ålander,

Switzerland (61): W. Hanke, Jürg Wyrsch, Kurt Kaspar, Thomas Voegeli, Fredy Emch, Alfred Pfiffner, Bernhard Rüetschi, Christian Marti, Niklaus Hasler-Gloor, Luzius von Rechenberg, Urs Glenck, Jürg Rufener, Heinz Bhend, Daniel Siegrist, Hans-Werner Leibundgut, Bruno Bischof, Otto Frei, Raetzo, Ulrich Weisskopf, Willy Buss, Thomas Rumetsch, Jean Pierre Keller, Fiona Fröhlich Egli, Peter Christen, Rudolf Ludwig Meyer, Michael Gerber, Max Flückiger, Jean Huber, Reto Baechler, Markus Denger, Walter Rüger, Hans-Jörg Rytz, Balz Burri, Isolde Schmid, René Dietrich, Urs Willimann, Alfred Rösli, Benedikt Portmann, Marja-Leena Nikmo Schaffner, Rolf Schaffner, Heinz Matti, Thomas Walser, Bruno Loher, Urs Wicki, Marcus Grossenbacher-Villiger, Michel Marchev, Margot Enz Kuhn, Marty Franz, Andreas Brun, Beat Hollenstein, Bernhard K. Rindlisbacher, Bruno Kissling, Clemens Fehr, Daniel Ackermann, Monika Maritz Mosimann, Niklaus Egli, Paul Winzenried, Pierre Periat, Regli Donat, Reto Castelberg, Thomas Kissling,

Taiwan (2): Heng-Shuen Chen, Patrick Yuk-lun Ma,

Turkey (8): Turgay Ongel, Nafiz Bozdemir, Nezih Dagdeviren, Rusen Topalli, Suleyman Gorpelioglu, Efe Onganer, Hakan Yaman, Mahmut Satan,

UK (18): Joe Neary, Martin Dawes, Carol D. Singleton, Iona Heath, G Narayanan, Nick Mawby, Ron Wylie, David Ruben, Jon Matson, Lesley Kay, Richard Till, David Jobson, David Lewis, Gene Feder, Mary Hawking, Mike Bainbridge, Paul Kamill, Toby Lipman,

United Arab Emirates (1): P. Badrinath,

Uruguay (1): Manuel Silva-Barbosa,

USA (30): Brian Budenholze, Robert Lachance, Gary Morasca, Clayton Booth, Robert Rountre, Vicki Sue Frydryc, Manny Saltiel, Gwen Halaas, Kathleen A. Culhane-Per, Wayne A. Hale, Yusuf Harpe, Brian S. Alper, Jeffrey M. Feit, Richard Neill, Patricia Birchfield, Alan Rogers, Anne Kwasnik-Krawczyk, Barry Saver, Bill Cayley, David Adams, David Bedell, David Slawson, Lee Green, Mark K. Huntington, Matt Handley, Max A. Crocker, Neil Massoud, Rex Force, Robert Hartog, Stephen F. Rothemich,

Venezuela (2): Jose Donis, Fernando Molina,



Updated May 6, 1999
Hogne.Sandvik@isf.uib.no