1
|
Orenstein S, Yarnell J, Connors E, Bohnenkamp J, Hoover S, Lever N. The State School Mental Health Profile: Findings from 25 States. J Sch Health 2024; 94:443-452. [PMID: 38321623 DOI: 10.1111/josh.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND State-level leadership and conditions are instrumental to local and regional comprehensive school mental health system (CSMHS) quality, sustainability, and growth. However, systematic documentation of state-level school mental health (SMH) policy, infrastructure, funding, and practice is limited. METHODS Using a multi-phase, multi-method process, we developed the State School Mental Health Profile (State Profile) to offer a comprehensive landscape of state SMH efforts. State leaders in 25 states completed the State Profile once over a 3-year data collection period. Mixed methods results are reported in 8 domains. RESULTS State education agencies were reportedly most involved in SMH technical assistance, advocacy, leadership, funding, and service provision, with mental health agencies reported as second most involved. Nearly half of state respondents reported having a state-level SMH director or coordinator. Policies with the greatest perceived impact require implementation of and funding for SMH services and supports. Despite leveraging multiple sources of funding, most states emphasized lack of funding as a primary barrier to establishing CSMHSs. All states reported staffing shortages. CONCLUSION The State Profile can assist multi-agency state leadership teams to self-assess policy, infrastructure, and resources to support CSMHSs statewide. Findings point to areas of opportunity to advance equity across resource allocation, service provision, and policy development.
Collapse
Affiliation(s)
- Shawn Orenstein
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
| | - Jordy Yarnell
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
| | - Elizabeth Connors
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
- Department of Psychiatry, Yale University, 389 Whitney Avenue, Office 106, New Haven, CT, 06511
| | - Jill Bohnenkamp
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
| | - Sharon Hoover
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
| | - Nancy Lever
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201
| |
Collapse
|
2
|
Gnatiuc L, Herrington WG, Halsey J, Tuomilehto J, Fang X, Kim HC, De Bacquer D, Dobson AJ, Criqui MH, Jacobs DR, Leon DA, Peters SAE, Ueshima H, Sherliker P, Peto R, Collins R, Huxley RR, Emberson JR, Woodward M, Lewington S, Aoki N, Arima H, Arnesen E, Aromaa A, Assmann G, Bachman DL, Baigent C, Bartholomew H, Benetos A, Bengtsson C, Bennett D, Björkelund C, Blackburn H, Bonaa K, Boyle E, Broadhurst R, Carstensen J, Chambless L, Chen Z, Chew SK, Clarke R, Cox C, Curb JD, D'Agostino R, Date C, Davey Smith G, De Backer G, Dhaliwal SS, Duan XF, Ducimetiere P, Duffy S, Eliassen H, Elwood P, Empana J, Garcia-Palmieri MH, Gazes P, Giles GG, Gillis C, Goldbourt U, Gu DF, Guasch-Ferre M, Guize L, Haheim L, Hart C, Hashimoto S, Hashimoto T, Heng D, Hjermann I, Ho SC, Hobbs M, Hole D, Holme I, Horibe H, Hozawa A, Hu F, Hughes K, Iida M, Imai K, Imai Y, Iso H, Jackson R, Jamrozik K, Jee SH, Jensen G, Jiang CQ, Johansen NB, Jorgensen T, Jousilahti P, Kagaya M, Keil J, Keller J, Kim IS, Kita Y, Kitamura A, Kiyohara Y, Knekt P, Knuiman M, Kornitzer M, Kromhout D, Kronmal R, Lam TH, Law M, Lee J, Leren P, Levy D, Li YH, Lissner L, Luepker R, Luszcz M, MacMahon S, Maegawa H, Marmot M, Matsutani Y, Meade T, Morris J, Morris R, Murayama T, Naito Y, Nakachi K, Nakamura M, Nakayama T, Neaton J, Nietert PJ, Nishimoto Y, Norton R, Nozaki A, Ohkubo T, Okayama A, Pan WH, Puska P, Qizilbash N, Reunanen A, Rimm E, Rodgers A, Saitoh S, Sakata K, Sato S, Schnohr P, Schulte H, Selmer R, Sharp D, Shifu X, Shimamoto K, Shipley M, Silbershatz H, Sorlie P, Sritara P, Suh I, Sutherland SE, Sweetnam P, Tamakoshi A, Tanaka H, Thomsen T, Tominaga S, Tomita M, Törnberg S, Tunstall-Pedoe H, Tverdal A, Ueshima H, Vartiainen E, Wald N, Wannamethee SG, Welborn TA, Whincup P, Whitlock G, Willett W, Woo J, Wu ZL, Yao SX, Yarnell J, Yokoyama T, Yoshiike N, Zhang XH. Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies. Lancet Diabetes Endocrinol 2018; 6:538-546. [PMID: 29752194 PMCID: PMC6008496 DOI: 10.1016/s2213-8587(18)30079-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight. Data on causes of death were obtained from medical death certificates. We used Cox regression models to assess the relevance of diabetes (any type) to occlusive vascular mortality (ischaemic heart disease, ischaemic stroke, or other atherosclerotic deaths) by age, sex, and other major vascular risk factors, and to assess whether the associations of blood pressure, total cholesterol, and body-mass index (BMI) to occlusive vascular mortality are modified by diabetes. RESULTS Individual participant-level data were analysed from 980 793 adults. During 9·8 million person-years of follow-up, among participants aged between 35 and 89 years, 19 686 (25·6%) of 76 965 deaths were attributed to occlusive vascular disease. After controlling for major vascular risk factors, diabetes roughly doubled occlusive vascular mortality risk among men (death rate ratio [RR] 2·10, 95% CI 1·97-2·24) and tripled risk among women (3·00, 2·71-3·33; χ2 test for heterogeneity p<0·0001). For both sexes combined, the occlusive vascular death RRs were higher in younger individuals (aged 35-59 years: 2·60, 2·30-2·94) than in older individuals (aged 70-89 years: 2·01, 1·85-2·19; p=0·0001 for trend across age groups), and, across age groups, the death RRs were higher among women than among men. Therefore, women aged 35-59 years had the highest death RR across all age and sex groups (5·55, 4·15-7·44). However, since underlying confounder-adjusted occlusive vascular mortality rates at any age were higher in men than in women, the adjusted absolute excess occlusive vascular mortality associated with diabetes was similar for men and women. At ages 35-59 years, the excess absolute risk was 0·05% (95% CI 0·03-0·07) per year in women compared with 0·08% (0·05-0·10) per year in men; the corresponding excess at ages 70-89 years was 1·08% (0·84-1·32) per year in women and 0·91% (0·77-1·05) per year in men. Total cholesterol, blood pressure, and BMI each showed continuous log-linear associations with occlusive vascular mortality that were similar among individuals with and without diabetes across both sexes. INTERPRETATION Independent of other major vascular risk factors, diabetes substantially increased vascular risk in both men and women. Lifestyle changes to reduce smoking and obesity and use of cost-effective drugs that target major vascular risks (eg, statins and antihypertensive drugs) are important in both men and women with diabetes, but might not reduce the relative excess risk of occlusive vascular disease in women with diabetes, which remains unexplained. FUNDING UK Medical Research Council, British Heart Foundation, Cancer Research UK, European Union BIOMED programme, and National Institute on Aging (US National Institutes of Health).
Collapse
|
3
|
Poisson T, Dallongeville J, Evans A, Ducimetierre P, Amouyel P, Yarnell J, Bingham A, Kee F, Dauchet L. Fruit and vegetable intake and smoking cessation. Eur J Clin Nutr 2012; 66:1247-53. [DOI: 10.1038/ejcn.2012.70] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
4
|
Poisson T, Dallongeville J, Evans A, Yarnell J, Amouyel P, Kee F, Dauchet L. P031 Arrêt du tabac et consommation de fruits et légumes : une surestimation de l’association entre consommation de fruits et légumes et maladies cardiovasculaires. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70098-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
5
|
Canouï-Poitrine F, Luc G, Mallat Z, Machez E, Bingham A, Ferrieres J, Ruidavets JB, Montaye M, Yarnell J, Haas B, Arveiler D, Morange P, Kee F, Evans A, Amouyel P, Ducimetiere P, Empana JP. Systemic chemokine levels, coronary heart disease, and ischemic stroke events: the PRIME study. Neurology 2011; 77:1165-73. [PMID: 21849651 DOI: 10.1212/wnl.0b013e31822dc7c8] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To quantify the association between systemic levels of the chemokine regulated on activation normal T-cell expressed and secreted (RANTES/CCL5), interferon-γ-inducible protein-10 (IP-10/CXCL10), monocyte chemoattractant protein-1 (MCP-1/CCL2), and eotaxin-1 (CCL11) with future coronary heart disease (CHD) and ischemic stroke events and to assess their usefulness for CHD and ischemic stroke risk prediction in the PRIME Study. METHODS After 10 years of follow-up of 9,771 men, 2 nested case-control studies were built including 621 first CHD events and 1,242 matched controls and 95 first ischemic stroke events and 190 matched controls. Standardized hazard ratios (HRs) for each log-transformed chemokine were estimated by conditional logistic regression. RESULTS None of the 4 chemokines were independent predictors of CHD, either with respect to stable angina or to acute coronary syndrome. Conversely, RANTES (HR = 1.70; 95% confidence interval [CI] 1.05-2.74), IP-10 (HR = 1.53; 95% CI 1.06-2.20), and eotaxin-1 (HR = 1.59; 95% CI 1.02-2.46), but not MCP-1 (HR = 0.99; 95% CI 0.68-1.46), were associated with ischemic stroke independently of traditional cardiovascular risk factors, hs-CRP, and fibrinogen. When the first 3 chemokines were included in the same multivariate model, RANTES and IP-10 remained predictive of ischemic stroke. Their addition to a traditional risk factor model predicting ischemic stroke substantially improved the C-statistic from 0.6756 to 0.7425 (p = 0.004). CONCLUSIONS In asymptomatic men, higher systemic levels of RANTES and IP-10 are independent predictors of ischemic stroke but not of CHD events. RANTES and IP-10 may improve the accuracy of ischemic stroke risk prediction over traditional risk factors.
Collapse
Affiliation(s)
- F Canouï-Poitrine
- INSERM U970, The Paris Cardiovascular Research Centre (PARCC), 56 rue Leblanc, Paris, F-75015, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Blacher J, Evans A, Arveiler D, Amouyel P, Ferrières J, Bingham A, Yarnell J, Haas B, Montaye M, Ruidavets JB, Ducimetière P. Residual cardiovascular risk in treated hypertension and hyperlipidaemia: the PRIME Study. J Hum Hypertens 2009; 24:19-26. [DOI: 10.1038/jhh.2009.34] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
7
|
Canouï-Poitrine F, Bingham A, Luc G, Bard JM, Ferrieres J, Ruidavets JB, Montaye M, Yarnell J, Haas B, Arveiler D, Evans A, Amouyel P, Ducimetière P, Empana JP. Association différentielle des lipides circulants avec le risque d’évènement coronaire et d’accident vasculaire cérébral ischémique incident. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
8
|
Graham I, Ata D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, Backe GD, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Reime WSO, Weissberg P, Wood D, Yarnell J, Zamorano JL. EUROPEAN GUIDELINES ON CARDIOVASCULAR DISEASE PREVENTION IN CLINICAL PRACTICE (ENDING). FOURTH JOINT TASK FORCE OF THE EUROPEAN SOCIETY OF CARDIOLOGY AND OTHER SOCIETIES ON CARDIOVASCULAR DISEASE PREVENTION IN CLINICAL PRACTICE. Racionalʹnaâ farmakoterapiâ v kardiologii 2008. [DOI: 10.20996/1819-6446-2008-4-4-90-107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
9
|
Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, Backer GD, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Scholte op Reimer W, Weissberg P, Wood D, Yarnell J, Zamorano JL. EUROPEAN GUIDELINES ON CARDIOVASCULAR DISEASE PREVENTION IN CLINICAL PRACTICE FOURTH JOINT TASK FORCE OF THE EUROPEAN SOCIETY OF CARDIOLOGY AND OTHER SOCIETIES ON CARDIOVASCULAR DISEASE PREVENTION IN CLINICAL PRACTICE . Racionalʹnaâ farmakoterapiâ v kardiologii 2008. [DOI: 10.20996/1819-6446-2008-4-3-111-128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
10
|
Bataille V, Perret B, Dallongeville J, Arveiler D, Yarnell J, Ducimetière P, Ferrières J. Metabolic syndrome and coronary heart disease risk in a population-based study of middle-aged men from France and Northern Ireland. Diabetes & Metabolism 2006; 32:475-9. [PMID: 17110903 DOI: 10.1016/s1262-3636(07)70306-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Metabolic Syndrome (MetS) was found associated with an increased CHD risk in several studies but data about this relationship in Southern Europe are lacking. We studied the association of MetS according to three different indexes (the National Cholesterol Education Program's definition (NCEP), a modified World Health Organization's definition (WHO) and the recent International Diabetes Federation's definition (IDF)) with CHD risk in a case-control study nested within the PRIME cohort, composed of subjects from France (Southern Europe) and Belfast (Northern Europe). The PRIME prospective study is composed of 10 592 men, aged 50-59 at baseline and followed for 5 years. Subjects included in this nested case-control study were 296 cases of incident CHD and 540 controls, who remained free of CHD during the 5 years of follow-up of the PRIME cohort and matched for age, recruitment centre and recruitment date. All subjects had questionnaires and a medical examination at baseline, and a blood sample was taken. Using the IDF's, the WHO's and the NCEP's definitions respectively, the frequency of MetS was 38.9%, 35.5% and 29.7% in cases and 32.4%, 28.7% and 22.6% in controls. After adjustment for physical activity, smoking and drinking habits, MetS was associated with CHD risk whichever the definition used (ORIDF=1.41 [1.02-1.95], P<0.04, ORWHO=1.40 [1.01-1.94], P<0.05 and ORNCEP=1.46[1.04-2.04], P<0.04). These results were homogeneous in France (low risk of CHD) and Belfast (high risk of CHD). Our results add further evidence that MetS is predictive of CHD risk in middle-aged men from Northern and Southern Europe, and highlight differences between the three definitions studied.
Collapse
Affiliation(s)
- V Bataille
- INSERM U558, Department of Epidemiology, CHU-Toulouse, France
| | | | | | | | | | | | | |
Collapse
|
11
|
Yarnell J, Yu S, McCrum E, Arveiler D, Hass B, Dallongeville J, Montaye M, Amouyel P, Ferrières J, Ruidavets JB, Evans A, Bingham A, Ducimetière P. Education, socioeconomic and lifestyle factors, and risk of coronary heart disease: the PRIME Study. Int J Epidemiol 2004; 34:268-75. [PMID: 15319403 DOI: 10.1093/ije/dyh267] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Socioeconomic differentials have been described in the risk of coronary heart disease (CHD) but the extent to which these differentials are explained by lifestyle factors has been examined to a lesser degree. We have examined the contribution of socio-economic factors to risk of CHD in a large cohort study in France and Northern Ireland. METHODS In all, 10 593 men aged 50-59 years were examined between 1991 and 1994 in centres in Northern Ireland, Lille, Strasbourg, and Toulouse. Details were obtained for a number of socio-economic indicators from the men at the baseline examination. Men were also screened for evidence of CHD and followed annually by questionnaire for incident cases of coronary disease. Coronary events (coronary deaths, myocardial infarction, and angina) were documented by clinical records and were reviewed by an independent medical committee. RESULTS In all, 842 men (8%) showed some evidence of CHD at screening examination and these men were more likely to be living in poorer material circumstances, be unemployed, or have had less full-time education than men without CHD at screening in both France and Northern Ireland. These relationships persisted following adjustment for all known risk factors for CHD. Among men who were initially free of CHD there were clear socio-economic differentials (years of full-time education, unemployment, and educational level) in the distribution of several risk factors for CHD, notably smoking habit (which differs in France and Northern Ireland), systolic blood pressure, body mass index, and fibrinogen. Total cholesterol in contrast showed no socio-economic differential whilst those with a shorter period of full-time education and the unemployed tended to be high consumers of alcohol. In this cohort of men free of CHD at baseline few socio-economic indicators showed relationships with risk of CHD by 5 years of follow-up. Only years in full education, educational level, and unemployment status when adjusted only for age and country showed significant relationships with CHD risk, but these became non-significant following adjustment for major CHD risk factors. CONCLUSIONS Socio-economic differentials in long-term risk of CHD are apparent in both cohorts of men from France and Northern Ireland, particularly in men with evidence of CHD at baseline. Among men free of CHD at baseline, although there is strong evidence of socio-economic differentials in cardiovascular risk factors these do not contribute independently to risk of CHD at 5 years of follow-up in this large cohort of men from France and Northern Ireland.
Collapse
Affiliation(s)
- J Yarnell
- Belfast-MONICA, Department of Epidemiology and Public Health, Queen's University Belfast, Belfast, UK
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Empana JP, Ducimetière P, Arveiler D, Ferrières J, Evans A, Ruidavets JB, Haas B, Yarnell J, Bingham A, Amouyel P, Dallongeville J. Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? The PRIME Study. Eur Heart J 2003; 24:1903-11. [PMID: 14585248 DOI: 10.1016/j.ehj.2003.09.002] [Citation(s) in RCA: 173] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIMS To assess whether the Framingham and PROCAM risk functions were applicable to men in Belfast and France. METHODS AND RESULTS We performed an external validation study within the PRIME (Prospective Epidemiological Study of Myocardial Infarction) cohort study. It comprised men recruited in Belfast (2399) and France (7359) who were aged 50 to 59 years, free of CHD at baseline (1991 to 1993) and followed over 5 years for CHD events (coronary death, myocardial infarction, angina pectoris). We compared the relative risks of CHD associated with the classic risk factors in PRIME with those in Framingham and PROCAM cohorts. We then compared the number of predicted and observed 5-year CHD events (calibration). Finally, we estimated the ability of the risk functions to separate high risk from low risk subjects (discrimination). The relative risk of CHD calculated for the various factors in the PRIME population were not statistically different from those published in the Framingham and PROCAM risk functions. The number of CHD events predicted by these risk functions however clearly overestimated those observed in Belfast and France. The two risk functions had a similar ability to separate high risk from low risk subjects in Belfast and France (c-statistic range: 0.61-0.68). CONCLUSION The Framingham and PROCAM risk functions should not be used to estimate the absolute CHD risk of middle-aged men in Belfast and France without any CHD history because of a clear overestimation. Specific population risk functions are needed.
Collapse
Affiliation(s)
- J P Empana
- Lille MONICA Project, INSERM U508, Institut Pasteur de Lille, Lille, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
The stressed bleeding time is a simple 'global' test of haemostasis, dependent upon platelet function, rheology, thrombosis and intimal function. It could be of considerable value in clinical practice if it were shown to be predictive of vascular disease events. A stressed bleeding time test was done on 1319 men aged 55-69 years in the Caerphilly Cohort Study of Heart Disease, Stroke and Cognitive Decline. The men were followed-up and during the following 7-10 years 155 men had a myocardial infarction (MI) and 72 an ischaemic stroke. The mean bleeding time was 323 (SD 113)s. This was shorter in men who smoked by an average of 45 s, and lengthened in men who took aspirin daily by 40s. After making statistical adjustments for numerous possible confounding factors, the relative odds (ROs) of an MI within the third of men with the longest bleeding times, compared to the third with the shortest times, was 0.90 (0.40-2.03). For ischaemic stroke, the ROs in the third of men with the longest times were 1.42 (0.39-5.21). The stressed bleeding time does not predict either MI or ischaemic stroke. It has no place in health screening.
Collapse
Affiliation(s)
- P C Elwood
- University of Wales College of Medicine, Wales, UK.
| | | | | | | | | | | |
Collapse
|
14
|
Ebrahim S, May M, Ben Shlomo Y, McCarron P, Frankel S, Yarnell J, Davey Smith G. Sexual intercourse and risk of ischaemic stroke and coronary heart disease: the Caerphilly study. J Epidemiol Community Health 2002; 56:99-102. [PMID: 11812807 PMCID: PMC1732071 DOI: 10.1136/jech.56.2.99] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To examine the relation between frequency of sexual intercourse and risk of ischaemic stroke and coronary heart disease. DESIGN Cohort study with 20 year follow up. SETTING The town of Caerphilly, South Wales and five adjacent villages. SUBJECTS 914 men aged 45-59 years at time of recruitment in 1979 to 1983. MAIN OUTCOME MEASURES Ischaemic stroke and coronary heart disease, all first events and fatal events. RESULTS Of the 914 men studied, 197 (21.5%) reported sexual intercourse less often than once a month, 231 (25.3%) reported sexual intercourse twice or more a week, and the remaining 486 (53.2%) men fell into the intermediate category. Frequency of sexual intercourse was not associated with all first ischaemic stroke events: age adjusted odds ratios (95% CI) for intermediate and low frequency of sexual intercourse of 0.61 (0.32 to 1.16) and 0.71 (0.34 to 1.49) respectively compared with the reference category of high frequency. A graded relation with fatal coronary heart disease events was observed in events recorded up to 10 years. The age adjusted relative risk (95% CI) of fatal coronary heart disease contrasting low frequency of sexual intercourse (that is, less than monthly) with the highest group (at least twice a week) was 2.80 (1.13 to 6.96, test for trend, p=0.04) which was not attenuated by adjustment for a wide range of potential confounders. Longer follow up to 20 years showed attenuation of this risk with odds of 1.69 (95% CI 0.90 to 3.20), contrasting low frequency of sexual intercourse with the highest group. CONCLUSIONS The differential relation between frequency of sexual intercourse, stroke and coronary heart disease suggests that confounding is an unlikely explanation for the observed association with fatal coronary heart disease events. Middle aged men should be heartened to know that frequent sexual intercourse is not likely to result in a substantial increase in risk of strokes, and that some protection from fatal coronary events may be an added bonus.
Collapse
Affiliation(s)
- S Ebrahim
- Department of Social Medicine, University of Bristol, UK.
| | | | | | | | | | | | | |
Collapse
|
15
|
Smith GD, Greenwood R, Gunnell D, Sweetnam P, Yarnell J, Elwood P. Leg length, insulin resistance, and coronary heart disease risk: the Caerphilly Study. J Epidemiol Community Health 2001; 55:867-72. [PMID: 11707479 PMCID: PMC1731819 DOI: 10.1136/jech.55.12.867] [Citation(s) in RCA: 173] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Adult height has been inversely associated with coronary heart disease risk in several studies. The mechanism for this association is not well understood, however, and this was investigated by examining components of stature, cardiovascular disease risk factors and subsequent coronary heart disease in a prospective study. METHODS All men aged 45-59 years living in the town of Caerphilly, South Wales were approached, and 2512 (89%) responded and underwent a detailed examination, which included measurement of height and sitting height (from which an estimate of leg length was derived). Participants were followed up through repeat examinations and the cumulative incidence of coronary heart disease-both fatal and non-fatal-over a 15 year follow up period is the end point in this report. RESULTS Cross sectional associations between cardiovascular risk factors and components of stature (total height, leg length and trunk length) demonstrated that factors related to the insulin resistance syndrome-the homeostasis model assessment of insulin resistance, fasting triglyceride levels and total to HDL cholesterol ratio-were less favourable in men with shorter legs, while showing reverse or no associations with trunk length. Fibrinogen levels were inversely associated with leg length and showed a weaker association with trunk length. Forced expiratory volume in one second was unrelated to leg length but strongly positively associated to trunk length. Other risk factors showed little association with components of stature. The risk of coronary heart disease was inversely related to leg length but showed little association with trunk length. CONCLUSION Leg length is the component of stature related to insulin resistance and coronary heart disease risk. As leg length is unrelated to lung function measures it is unlikely that these can explain the association in this cohort. Factors that influence leg length in adulthood-including nutrition, other influences on growth in early life, genetic and epigenetic influences-merit further investigation in this regard. The reported associations suggest that pre-adult influences are important in the aetiology of coronary heart disease and insulin resistance.
Collapse
Affiliation(s)
- G D Smith
- Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
| | | | | | | | | | | |
Collapse
|
16
|
Ducimetière P, Ruidavets JB, Montaye M, Haas B, Yarnell J. Five-year incidence of angina pectoris and other forms of coronary heart disease in healthy men aged 50-59 in France and Northern Ireland: the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study. Int J Epidemiol 2001; 30:1057-62. [PMID: 11689522 DOI: 10.1093/ije/30.5.1057] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The North-South gradient in myocardial infarction and coronary death rates in various western European regions has been described by the WHO MONICA Project over the last decade. The results of the 5-year follow-up of the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study reported here give the opportunity of extending the comparison to the incidence of angina pectoris in men aged 50-59 living in four regions (Belfast, Lille, Strasbourg, Toulouse) which were covered by the MONICA Project. METHODS The PRIME Study is a multicentre cohort study with a common protocol and centralized event analysis. It included 10 600 men, of whom 9758 (7359 in France and 2399 in Belfast) were free of coronary disease at entry with 842 (496 in France and 346 in Belfast) having pre-existing coronary disease. RESULTS In France, subjects free of coronary heart disease at baseline developed 106 cases of myocardial infarction or coronary death (2.93/1000 subjects per year) and 94 cases of angina pectoris (2.61/1000). In Belfast, 61 developed myocardial infarction or coronary death (5.24/1000) and 60 angina pectoris (5.39/1000). Hazard rate ratios for Belfast in comparison to France were respectively 1.79 (95% CI : 1.30-2.47) and 2.07 (1.49-2.86) for each class of clinical complication. CONCLUSION Rate ratios for angina pectoris incidence between Northern Ireland and France in the PRIME Study are comparable to those for myocardial infarction or coronary death reported by the WHO MONICA Project and suggest that the North-South gradient in Europe applies to different manifestations of coronary disease.
Collapse
Affiliation(s)
- P Ducimetière
- INSERM U258, Hôpital Paul Brousse, Villejuif, France
| | | | | | | | | |
Collapse
|
17
|
Shickle D, Carlisle J, Fryers P, Wallace S, Suckling R, Cork M, Bowns I, Beyleveld D, McDonagh A, Sandvik L, Mowinckel P, Abdelnoor M, Erikssen G, Erikssen J, White R, Altmann DR, Nanchahal K, Oliver S, Donovan JL, Peters TJ, Frankel S, Hamdy FC, Neal DE, Whincup PH, Gilg J, Papacosta O, Miller GJ, Alberti KGMM, Cook D, Lawlor DA, Ebrahim S, Smith GD, Lampe F, Morris R, Whincup P, Walker M, Ebrahim S, Shaper A, Brunner E, Shipley M, Hemingway H, Juneja M, Page M, Stansfeld S, Kumari M, Walker B, Andrew R, Seckl J, Papadopoulos A, Checkley S, Marmot M, Wood D, Sheehan J, Reilly M, Twomey H, Collins M, Daly A, Loningsigh S, Dolan E, Smith GD, Ben-Shlomo Y, Perry I, Moher M, Yudkkin P, Wright L, Turner R, Fuller A, Schofield T, Mant D, Feder G, Lilford RJ, Dobbie F, Warren R, Braunholtz D, Boaden R, Nolte E, Scholz R, Shkolnikov V, McKee M, Neilson S, Gilthorpe MS, Wilson RC, Jenkinson C, Coulter A, Bruster S, Richards N, Chandola T, Cromwell DA, Griffiths DA, Campbell MJ, Mollison J, McIntosh E, Grimshaw J, Thomas R, Rovers MM, Straatman H, Zielhuis GA, Hemminki E, Hove SL, Veerus P, Hakama M, Tuimala R, Rahu M, Ukoumunne OC, Gulliford MC, Shepstone L, Spencer N, Araya R, Rojas G, Fritsch RE, Acuna J, Lewis G, Ajdacic-Gross V, Bopp M, Eich D, Rossler W, Gutzwiller F, Corcoran P, Brennan A, Reilly M, Perry IJ, Middleton N, Whitley E, Frankel S, Dorling D, Gunnell D, Stanistreet D, Paine K, Scherf C, Morison L, Walraven G, O'Cathain A, Sampson F, Nicholl J, Munro J, Chapple A, Ziebland S, McPherson A, Herxheimer A, Shepperd S, Miller R, Brindle L, Donovan JL, Peters TJ, Quine S, O'Reilly M, Cahill M, Perry IJ, Maconochie N, Doyle P, Prior S, Ego A, Subtil D, Cosson M, Legoueff F, Houfflin-Debarge V, Querleu D, Rasmussen F, Smith GD, Sterne JAC, Tynelius P, Leon DA, Doyle P, Roman E, Maconochie N, Smith P, Beral V, Macfarlane A, Shoham-Vardi I, Winer N, Weitzman D, Levcovich A, Lahelma E, Kivela K, Roos E, Tuominen T, Dahl E, Diderichsen F, Elstad J, Lissau I, Lundberg O, Rahkonen O, Rasmussen NK, Yngwe MA, Gilmore AB, McKee M, Rose R, Salmond C, Crampton P, Tobias M, Li L, Manor O, Power C, Bruster S, Coulter A, Jenkinson C, Osler M, Prescott E, Gronbak M, Andersen AN, Due P, Engholm G, Drury N, Bruce J, Poobalan AS, Smith WCS, Jeffrey RR, Chambers WA, Mueller JE, Doring A, Stieber J, Thorand B, Lowel H, Chen R, Tunstall-Pedoe H, Redpath A, Macintyre K, Stewart S, Chalmers JWT, Boyd AJ, Finlayson A, Pell JP, McMurray JJV, Capewell S, Chalmers JWT, Macintyre K, Stewart S, Boyd AJ, Finlayson A, Pell JP, Redpath, McMurray JJV, Capewell S, Critchley J, Capewell S, Stefoski-Mikeljevic J, Johnston C, Cartman M, Sainsbury R, Forman D, Haward R, Morris E, Haward R, Forman D, Cartman M, Johnston C, Moebus S, Lehmann N, Goodacre S, Calvert N, Montgomery AA, Fahey T, Ben-Shlomo Y, Harding J, Anderson W, Florin D, Gillam S, Ely M, Nath U, Ben-Shlomo Y, Thomson RG, Morris HR, Wood NW, Lees AJ, Burn DJ, West RR, Fielder HM, Palmer SR, Dunstan F, Fone D, Higgs G, Senior M, Moss N, Campbell R, Pound P, Pope C, Britten N, Pill R, Morgan M, Donovan J, Rottingen JA, Garnett GP, Jagger C, Robine JM, Clarke M, Tobiasz-Adamczyk B, Szafraniec K, Lall R, Campbell MJ, Walter SJ, McGrother C, Donaldson M, Dallosso H, Dineen BP, Bourne RR, Ali SM, Huq DMN, Johnson GJ, Stang A, Jockel KH, Karvonen S, Vikat A, Rimpela M, Borras JM, Schiaffino A, Fernandez E, Borrell C, Garcia M, Salto E, Jefferis B, Power C, Graham H, Manor O, Yudkin P, Hey K, Roberts S, Welch S, Johnstone E, Murphy M, Griffiths S, Jones L, Walton R, Rasul F, Stansfeld SA, Hart CL, Gillis C, Smith GD, Marks D, Lambert H, Thorogood M, Neil H, Humphries S, Wonderling D, Surman G, Newdick H, Johnson A, Pharoah P, Glinianaia SV, Wright C, Rankin J, Basso O, Christensen K, Olsen J, Love A, Cheung WY, Williams J, Jackson S, Maddocks A, Hutchings H, Gissler M, Pakkanen M, Olausson PO, Owen CG, Whincup PH, Odoki K, Gilg JA, Cook DG, Aveyard P, Markham WA, Sherratt E, Bullock A, Macarthur C, Cheng KK, Daniels H, Murphy S, Egger M, Grimsley M, Green G, Read C, Redgrave P, Suokas A, McCulloch A, Zagozdzon P, Zaborski L, Cardano M, Costa G, Demaria M, Gnavi R, Spadea T, Vannoni F, Batty D, Leon DA, Rahi J, Morton S, Leon D, Stavola BDE, Gunnell D, Fouskakis D, Rasmussen F, Tynelius P, Harrison G, Spadea T, Faggiano F, Armaroli P, Maina L, Costa G, Ellison GTH, Travis R, Phillips M, Dedman D, Upton M, McCarthy A, Elwood P, Davies D, Shlomo YB, Smith GD, Berrington A, Cramer DW, Kuper H, Harlow BL, Titus-Ernstoff L, McLeod A, Stockton D, Brown H, Leyland AH, Liratsopulos G, West CR, Williams EMI, Abrams K, Sharp L, Little J, Brockton N, Cotton SC, Haites NE, Cassidy J, Kamali A, Kinsman J, Kintu P, Quigley M, Carpenter L, Kengeya-Kayondo J, Whitworth. JAG, Porter K, Noah N, Rawson H, Crampin A, Smith WCS, Group CMSOBOTMS, Jahn A, Kudzala A, Kitundu H, Lyamuya E, Razum O, Thomas SL, Wheeler JG, Hall AJ, Moore L, Dennehy A, Shemilt I, Belderson P, Brandon M, Harvey I, Moffatt P, Mugford M, Norris N, O'Brien M, Reading R, Robinson J, Schofield G, Shepstone L, Thoburn J, Cliffe S, Leiva A, Tookey P, Hamers F, Nicoll A, Critchley J, Capewell S, Ness AR, Hughes J, Elwood PC, Whitley E, Smith GD, Burr ML, Chase D, Roderick P, Cooper K, Davies R, Raftery J, Martikainen P, Kauppinen TM, Valkonen T, Somerville M, Barton A, Foy C, Basham M, Thomson H, Petticrew M, Morrison D, Chandola T, Biddulph J, McCarthy M, Gallivan S, Utley M, Kinra S, Black ME, Murphy M, Hey K, Jones L, Brzezinski ZJ, Mazur J, Mierzejewska E, Evans JG, Clarke R, Sherliker P, Birks J, Wrieden WL, Connaghan JP, Tunstall-Pedoe H, Silva IDS, Mangtani P, McCormack V, Bhakta D, Sevak L, McMichael AJ, Sauvaget C, Nagano J, Ogilvie D, Raffle AE, Alden B, Brett M, Babb PJ, Quinn M, Banks E, Beral V, Bull D, Reeves G, Leung GM, Lam TH, Thach TQ, Hedley AJ, Roderick P, Davies R, Crabbe D, Patel P, Raftery J, Bhandari P, Pearce R, Thomas MC, Walker M, Lennon LT, Thomson AG, Lampe FC, Shaper AG, Whincup PH, Fallon UB, Ben-Shlomo Y, Laurence KM, Lancashire RJ, Pharoah POD, Nevin NC, Smith GD, Fear NT, Roman E, Ansell P, Bull D, Nilsen TIL, Vatten LJ, Lane JA, Harvey RF, Murray LJ, Harvey IM, Donovan JL, Egger M, Wright CM, Parker L, Lamont D, Craft AW, Hallqvist J, Lundberg M, Diderichsen F, Boniface DR, McNeilly E, Bromen K, Pohlabeln H, Ahrens W, Jahn I, Jockel KH, Darby S, Doll R, Whitley E, Key T, Silcocks P, Linos D, Markaki I, Ntalles K, Riza E, Linos A, Memon A, Darif M, AL-Saleh K, Suresh A, de Vries CS, Bromley SE, Williams TJ, Farmer RDT, Ruiz M, Nieto A, Boshuizen HC, Nagelkerke NJD, Schellekens JFP, Peeters MF, Den Boer JW, Van Vliet JA, Neppelenbroek SE, Spaendonck MAECV, Mazloomzadeh S, Woodman CBJ, Collins S, Winter H, Bailey A, Young LS, Rosenbauer J, Herzig P, Giani G, Olowokure B, Spencer NJ, Hawker JI, Blair I, Smith R, Olowokure B, White J, Rush M, Hawker JI, Ramsay M, Watkins J, Mayor S, Matthews I, Crilly M, Bundred P, Prosser H, Walley T, Walker ZAK, Oakley L, Townsend JL, Donovan C, Smith H, Bell J, Hurst Z, Marshall S, Wild S, Whyman C, Barter M, Wishart K, Macleod C, Marinko K, Malmstrom M, Johansson SE, Sundquist J, Crampton P, Salmond C, Tobias M, Lumley J, Small R, Brown S, Watson L, Gunn J, Hawe P, Shiell A, Langer M, Steiner G, Tiefenthaler M, Adamek S, Ronsmans C, Khlat M, Waterstone M, Bewley S, Wolfe C, Hooper R, Moore L, Campbell R, Whelan A, Winter H, Macarthur C, Bick D, Lancashire R, Knowles H, Henderson C, Belfield C, Gee H, Biggerstaff D, Lilford R, Olsen J, the EuroMap Group, Spencer EA, Davey GK, Appleby PN, Key TJ., Breeze E, Leon D, Clarke R, Fletcher A, Boniface DR, McNeilly E, Lam TH, Ho SY, Hedley AJ, Mak KH, Canoy D, Khaw KT, Thorogood M, Appleby PN, Mann JI, Key TJ, Bobak M, Pikhart H, Martikainen P, Rose R, Marmot M, Rooney CIF, Cook L, Uren Z, Watson MC, Bond CM, Grimshaw JM, Mollison J, Ludbrook A, Poobalan AS, Bruce J, King PM, Krukowksi ZH, Smith WCS, Chambers WA, Seagroatt V, Goldacre M, Purcell B, Majeed A, Mayor S, Watkins J, Matthews I, Morris RW, Whincup PH, Emberson J, Lampe FC, Walker M, Wannamethee G, Shaper AG, Ebrahim S, May M, McCarron P, Frankel S, Smith GD, Yarnell J, Ebrahim S, May M, McCarron P, Shlomo YB, Stansfeld S, Gallacher J, Smith GD, Taylor FC, Rees K, Ebrahim S, Angelini GD, Ascione R, Muller-Nordhorn J, Binting S, Kulig M, Voller H, Willich SN, Group FTPS, Whincup PH, Emberson J, Papacosta O, Walker M, Lennon L, Thomson A, Sturdy PM, Anderson HR, Butland BK, Bland JM, Victor CR, Wilman C, Gupta R, Anderson HR, Mindell J, Joffe M, Nikiforov B, Pattenden S, Armstrong B, Hedley AJ, Wong CM, Thach TQ, Chau P, Lam TH, Anderson HR, Whitley E, Darby S, Deo H, Doll R, Raleigh VS, Logie J, Macrae K, Lawrenson R, Villegas R, Nielson S, O'Halloran DJ, Perry IJ, Gallacher JEJ, Elwood PC, Yarnell JWG, Shlomo YB, Pickering J, Evans JMM, Morris AD, Sedgwick JEC, Pearce AJ, Gulliford MC, Walker M, Thomson A, Whincup P, Lyons RA, Jones S, Richmond P, McCarthy J, Fone D, Lester N, Johansen A, Saunders J, Palmer SR, Barnes I, Banks E, Beral V, Jones GT, Watson KD, Taylor S, Papageorgiou AC, Silman AJ, Symmons DPM, Macfarlane GJ, Pope D, Hunt I, Birrell F, Silman A, Macfarlane G, Thorpe L, Thomas K, Fitter M, Brazier J, Macpherson H, Campbell M, Nicholl J, Morgan A, Roman M, Allison T, Symmons D, Urwin M, Brammah T, Roxby M, Williams G, Primatesta P, Falaschetti E, Poulter NR, Knibb R, Armstrong SJ, Chilvers CED, Logan RFA, Woods KL, Bhavnani V, Clarke A, Dowie J, Kennedy A, Pell I, Goldacre MJ, Kurina L, Seagroatt V, Yeates D, Watson E, Clements A, Yudkin P, Rose P, Bukach C, Mackay J, Lucassen A, Austoker J, Guillemin M, Brown W, Tell GS, Nurk E, Vollset SE, Nygard O, Refsum H, Ueland PM, Villegas R, Nielson S, Creagh D, Hinchion R, Perry IJ, Allen NE, Key TJ, Vatten LJ, Odegard RA, Nilsen ST, Austgulen R, Harding AH, Khaw KT, Wareham NJ, Riza E, Silva IDS, De Stavola B, Bradlow HL, Sepkovic DW, Linos D, Linos A. Society for Social Medicine and the International Epidemiological Association European Group. Abstracts of oral presentations. Br J Soc Med 2001. [DOI: 10.1136/jech.55.suppl_1.a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
18
|
Marques-Vidal P, Montaye M, Haas B, Bingham A, Evans A, Juhan-Vague I, Ferrières J, Luc G, Amouyel P, Arveiler D, Yarnell J, Ruidavets JB, Scarabin PY, Ducimetière P. Relationships between alcoholic beverages and cardiovascular risk factor levels in middle-aged men, the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction Study. Atherosclerosis 2001; 157:431-40. [PMID: 11472744 DOI: 10.1016/s0021-9150(00)00734-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The relationships between alcoholic beverages and cardiovascular risk factors were assessed in 6730 men living in France or Northern Ireland. In France, all alcoholic beverages were significantly correlated with body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), high density lipoprotein (HDL) parameters, PAI-1 and Factor VII, whereas only wine was negatively related with fibrinogen levels. After adjusting for center, age, BMI, educational level, smoking and marital status, wine had a lesser effect on blood pressure, triglyceride, apo B and LpE:B levels than beer. Wine was associated with lower fibrinogen levels and beer with higher PAI-1 activity levels independent of the amount of alcohol consumed. In Northern Ireland, wine was negatively correlated with BMI, triglycerides, LpE:B and fibrinogen, whereas beer was positively correlated with SBP and DBP, triglycerides, HDL, apoprotein A-I and fibrinogen. Multivariate analysis showed wine to be positively associated with HDL parameters, and negatively with fibrinogen levels. Wine was also associated with higher LpA-I levels and lower fibrinogen levels independent of the amount of alcohol consumed. We conclude that alcohol consumption is related to lipid, lipoprotein and haemostatic variables, but the magnitude of the relationships depends on the type of alcoholic beverage. Also, some effects might be related to non-alcoholic components.
Collapse
Affiliation(s)
- P Marques-Vidal
- INSERM U518, Faculté de Médecine Purpan, Département d'Epidémiologie, 1er ét., 37, Allées Jules Guesde, 31073 Toulouse Cedex, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Wagner A, Simon C, Ducimetière P, Montaye M, Bongard V, Yarnell J, Bingham A, Hedelin G, Amouyel P, Ferrières J, Evans A, Arveiler D. Leisure-time physical activity and regular walking or cycling to work are associated with adiposity and 5 y weight gain in middle-aged men: the PRIME Study. Int J Obes (Lond) 2001; 25:940-8. [PMID: 11443490 DOI: 10.1038/sj.ijo.0801635] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2000] [Revised: 11/17/2000] [Accepted: 12/13/2000] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the influence of physical activity on body mass index (BMI), waist circumference (W) and body mass changes (DeltaBMI) in middle-aged men, with special regard to moderate-intensity activities. DESIGN Longitudinal study of adults who participated in the PRIME Study. SUBJECTS A cohort of 8865 men aged 50-59 y, free of coronary heart disease. MEASUREMENTS BMI and W at baseline, body mass changes over a 5 y period. Detailed baseline assessment of net energy expenditure due to physical activity (PAE) in the preceding year, according to category of activity, by means of the MOSPA Questionnaire. PAE was expressed in weekly metabolic equivalent scores (MET h/week). RESULTS After adjustment for confounders, the multiple regression analyses indicated that BMI, W and DeltaBMI were inversely associated with PAE spent in getting to work (P<10(-5), <10(-5) and 0.04, respectively) and practice of high-intensity (>or=6 MET) recreational activities (<0.01, <10(-5) and <0.01). Men who regularly spent more than 10 MET h/week in walking or cycling to work had a mean BMI, W and DeltaBMI respectively 0.3 kg/m(2), 1 cm and 0.06 kg/m(2) lower than those who did not expend energy in getting to work. In the subgroup of subjects who did not perform high-intensity activities, the level of recreational PAE was inversely associated with BMI and W but not with subsequent weight-gain. CONCLUSION These findings indicate that, in middle-aged men, physical activities of moderate-intensity, which are probably easier to promote than more vigorous activities and, in particular, a more current daily activity, walking or cycling to work, may have a favourable effect on body fat markers and body mass gain.
Collapse
Affiliation(s)
- A Wagner
- Laboratoire d'Epidémiologie et de Santé Publique, Faculté de Médecine, Strasbourg, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Beer-Borst S, Morabia A, Hercberg S, Vitek O, Bernstein MS, Galan P, Galasso R, Giampaoli S, Houterman S, McCrum E, Panico S, Pannozzo F, Preziosi P, Ribas L, Serra-Majem L, Verschuren WM, Yarnell J, Northridge ME. Obesity and other health determinants across Europe: the EURALIM project. J Epidemiol Community Health 2000; 54:424-30. [PMID: 10818117 PMCID: PMC1731700 DOI: 10.1136/jech.54.6.424] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
STUDY OBJECTIVE EURALIM (EURope ALIMentation), a European collaborative study, aimed to determine and describe the extent to which European data on risk factor distributions from different populations could be pooled and harmonised in a common database for international comparisons. SETTING Seven independent population-based surveys from six European countries (France, Italy, Northern Ireland/United Kingdom, Spain, Switzerland, the Netherlands). METHODS Data for 18 381 women and 12 908 men aged 40-59 were pooled in a common database. Central statistical analyses on major cardiovascular risk factors were conducted with careful consideration of methodological issues, including differences in study designs, data assessment tools, and analytic techniques used. MAIN RESULTS Because of the detected variability among methods used, direct comparisons of risk factor distributions and prevalences between studies were problematic. None the less, comparisons of within population contrasts by sex, age group, and other health determinants were considered to be meaningful and apt, as illustrated here for obesity. Results were targeted and disseminated to both the general public and public health professionals and framed in the context of a European information campaign. CONCLUSIONS International and national comparisons between existing locally run studies are feasible and useful, but harmonisation methods need improvement. Development of an international risk factor surveillance programme based on decentralised data collection is warranted. In the meantime, risk factor contrasts across populations can be used as a basis for targeting needed public health intervention programmes.
Collapse
Affiliation(s)
- S Beer-Borst
- Division of Clinical Epidemiology, University Hospitals of Geneva, 25, Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Marques-Vidal P, Arveiler D, Evans A, Montaye M, Ruidavets JB, Haas B, Yarnell J, Bingham A, Ferrières J, Amouyel P, Ducimetière P. Characteristics of male vitamin supplement users aged 50-59 years in France and Northern Ireland: the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction. INT J VITAM NUTR RES 2000; 70:102-9. [PMID: 10883403 DOI: 10.1024/0300-9831.70.3.102] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The prevalence and characteristics of vitamin supplement users were assessed in 7538 male subjects aged 50-59 from France and 2468 from Northern Ireland. In France, 15% of subjects used vitamin supplements; users were significantly younger, had a lower body mass index, a higher educational level, had more frequently a hard physical job, reported more frequently a personal history of disease and were less frequently retired or inactive than non-users. In Northern Ireland, 21% of subjects were vitamin supplement users; users had a lower body mass index, drank less alcohol, had a higher educational level, were more frequently non-smokers and professionally active, and reported a hard physical job and the practice of leisure sports more frequently than non-users. Finally, vitamin supplement users in Northern Ireland had a lower consumption of alcohol, smoked less, had a lower frequency of personal history of disease and were more frequently on dietary therapy for hypertension or dyslipidaemia than their French counterparts. We conclude that vitamin supplement use is associated with a healthier lifestyle and with dietary measures against hypertension and dyslipidaemia in Northern Ireland. The less favorable lifestyle observed for vitamin supplement users in France awaits further investigation.
Collapse
|
22
|
Beer-Borst S, Hercberg S, Morabia A, Bernstein MS, Galan P, Galasso R, Giampaoli S, McCrum E, Panico S, Preziosi P, Ribas L, Serra-Majem L, Vescio MF, Vitek O, Yarnell J, Northridge ME. Dietary patterns in six european populations: results from EURALIM, a collaborative European data harmonization and information campaign. Eur J Clin Nutr 2000; 54:253-62. [PMID: 10713749 DOI: 10.1038/sj.ejcn.1600934] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine and describe the extent to which European dietary data collected in disparate surveys can be meaningfully compared. DESIGN Seven independent population-based surveys from six European countries were initially included. Differences in study designs and methodological approaches were examined. Risk factor data for 31,289 adults aged 40-59 y were harmonized and pooled in a common, centralized database. RESULTS Direct comparisons of dietary measures across studies were not deemed appropriate due to methodological heterogeneity. Nonetheless, comparisons of intra-population contrasts by gender across sites were considered valid. Women consumed fruit and vegetables more often than men. Age-standardized gender differences in the prevalence of low fruit and vegetable consumption ranged from 7 to 18% and 5 to 15%, respectively. Data on energy intake showed good agreement across study populations. The proportion of total energy from macronutrients was similar for women and men. Gender differences for relative intakes of saturated fatty acids (percentage energy) were small and only in France were they significant. Dietary fibre density was significantly higher in women than in men. Overall, the participating Southern European populations from Italy and Spain exhibited more healthful food composition patterns. CONCLUSIONS Contrasts in dietary patterns by gender across populations may provide the basis for health promotion campaigns. The most favourable patterns observed may serve as attainable goals for other populations. An international risk factor surveillance programme based upon locally run, good quality studies has the potential to provide the needed data. SPONSORSHIP European Community (DG V), project 96CVVF3-446-0; Swiss Federal Office for Education and Science, OFES 96.0089.
Collapse
Affiliation(s)
- S Beer-Borst
- Division of Clinical Epidemiology, University Hospitals of Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Smith G, Frankel S, Yarnell J. Sex and Death: Are They Related? Findings From the Caerphilly Cohort Study. J Urol 1998. [DOI: 10.1016/s0022-5347(01)62990-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- G.D. Smith
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom, and Department of Epidemiology and Public Health, Queen's University of Belfast, Belfast, Ireland
| | - S. Frankel
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom, and Department of Epidemiology and Public Health, Queen's University of Belfast, Belfast, Ireland
| | - J. Yarnell
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom, and Department of Epidemiology and Public Health, Queen's University of Belfast, Belfast, Ireland
| |
Collapse
|
24
|
Sullivan PA, Murphy D, Sullivan PA, Keogh S, Sullivan PA, Nash P, Kaarisalo MM, Marttila J, Immonen-Raiha P, Salomaa V, Torppa J, Tuomilehto J, Siani A, Racone R, Ragone E, Stinga F, Strazzullol P, Cappuccio FP, Trevisan M, Farinaro E, Mellone C, Fox KF, Cowie MR, Wood DA, Coats AJ, Poole Wilson PA, Sutton GC, Yarnell J, Sweetnam P, Thomas H, Piwonski J, Piotrowski W, Pytlak A, Wannamethee SG, Shaper AG, Walker M, Sharpe PC, Young IS, Hasselwander O, McMaster D, Mercer C, McGrath LT, Evans AE, Thomas F, Guize L, Ducimetiere P, Benetos A, Rosolova H, Simon J, Mayer O, Sefrna F, Mayer O, Šimon J, Rosolova H, Racek J, Trefil L, Marin-Tarlea M, Carp C, Apetrei E, Ginghina C, Serban I, Florica N, Ceck C, Patrascoiu M, Ginghina C, Carp C, Apetrei E, Tarlea M, Cioranu R, Florica N, Ceck C, Vaduva M, Mihaescu D, Lapadat M, Ashton WD, Wood D, Nanchahahal K, Kelleher CC, Brennan PJ, Howarth D, Meade TW, Kelleher CC, Fallon UB, McCarthy U, O’Donnell MMK, Dineen B, Jousilahti P, Vartiainen E, Tuomilehto J, Puska P, Kastarinen M, Nissinen A, Salomaa V, Vartiainen E, Jousilahti P, Tuomilehto J, Puska P, Rosengren A, Wedel H, Wilhelmsen L, Liese AD, Hense HW, Keil U, Keil U, Liese AD, Hense HW, Filipiak B, Döring A, Stieber J, Lowel H, De Laet C, Brasseur D, Kahn A, Wautrecht JC, Decuyper J, Boeynaems JM, Jousilahti P, Vartiainen E, Tuomilehto J, Sundvall J, Puska P, Marques-Vidal P, Ferrières J, Haas B, Evans A, Amouyel P, Luc G, Ducimetiere P, Marques-Vidal P, Ferrieres J, Arveiler D, Montaye M, Evans A, Ducimetiere P, Fuentes R, Notkola IL, Shemeikka S, Tuomilehto J, Nissinen A, Mak R, De BacquerBacquer D, De Backer G, Stam M, Koyuncu R, de Smet P, Kornitzer M, Braeckman L, De Backer G, De Bacquer D, Claeys L, Delanghe J, De Bacquer D, Kornitzer M, De Backer G, Cífkova R, Pit’ha J, Červenka L, Šejda T, Lanska V, Škodová Z, Stavek P, Poledne R, Cífková R, Duskova A, Hauserová G, Hejl Z, Lánská V, Škodova Z, Pistulková H, Poledne R, Hubáček J, Pit’ha J, Stávek P, Lánská V, Cífková R, Faleiro LL, Rodrigues D, Fonseca A, Martins MC, Norris RM, Nyyssönen K, Seppänen K, Salonen R, Kantola M, Salonen JT, Parviainen MT, De Henauw S, Myny K, Doyen Z, Van Oyen H, Tafforeau J, Kornitzer M, De Backer G, Benetos A, Thomas F, Guize L, Immonen-Räihä P, Kaarisalo M, Marttila RJ, Torppa J, Tuomilehto J, Houterman S, Hofman B, Witteman JCM, Verschuren WMM, van de Vijver LPL, Kardinaal AFM, Grobbee DE, van Poppel G, Princen HMG, Kornitzer M, Doven M, Koyuncu R, De Bacquer D, Myny K, De Backer G, Tafforeau J, Van Oven H, Doyen M, Koyuncu R, Kornitzer M, De Bacquer D, Myny K, De Backer G, Tafforeau J, Van Oyen H, de Bree A, Verschuren WMM, Blom HJ, Mulder I, Smit HA, Menotti A, Kromhout D, Van den Hoogen PCW, Hofman A, Witteman JCM, Feskens EJM, Štika L, Bruthans J, Wierzbicka M, Bolinska H, Voutilainen S, Nyyssönen K, Salonen R, Lakka TA, Salonen JT, Lakka HM, Lakka TA, Salonen JT, Tuomainen TP, Nyyssonen K, Salonen JT, Punnonen K, Yarnell J, Patterson C, Thomas H, Sweetnam P, Smith WCS, Campbell SE, Cardy A, Phillips DO, Helms PJ, Squair J, Smith WCS, Cardy A, Phillips DO, Helms PJ, Squair J, Smith WCS, Cardy A, Phillips DO, Helms PJ, Squair J, Pytlak A, Piotrowski W, Rywik S, Waskiewicz A, Sygnowska E, Szczesniewska D, Sygnowska E, Waskiewicz A, Wagrowska H, Polakowska M, Rywik S, Broda G, Jasinski B, Piotrowski W, Elandt-Johnson RC, Wagrowska H, Kupsé W, Szczesniewska D, Platonov DY, Haapanen N, Miilunpalo S, Vuori I, Pasanen M, Oja P, Urponen H, Kopp MS, Skrabski A, Szedmák S, Boaz M, Biro A, Katzir Z, Matas T, Smetana S, Green M, Whincup PH, Morris R, Walker M, Lennon L, Thomson A, Ebrahim SJB, Refsum H, Ueland PM, Perry IJ, Boer JMA, Kuivenhoven JA, Feskens EJM, Schouten EG, Havekes LM, Seidell JC, Kastelein JJP, Kromhout D, Oomen CM, Feskens EJM, Rasanen L, Nissinen A, Fidanza F, Menotti A, Kok FJ, Kromhout D, Sileikiene L, Klambienne J, Milasauskiene Z, Cappuccio FP, Siani A, Barba G, Russo L, Ragone E, Strazzullo P, Farinaro E, Trevisan M, Schnohr P, Parner J, Lange P, Meleady R, Graham IM, Ueland PM, Refsum H, Blom H, Whitehead AS, Daly LE, Stefanovic B, Boskovic D, Mitrovic P, Perunicic J, Vukcevic V, Radovanovic N, Terzic B, Mrdovic I, Orilc D, Matic G, Vasiljevic Z, Mitrovic P, Boskovic D, Stefanovic B, Perunicic J, Vukcevic V, Mrdovic I, Radovanovic N, Orlic D, Matic G, Milentijevic B, Rajic D, Mitrovic N, Boskovic S, Vasiljevic Z, Marin-Tarlea M, Carp C, Apetrei E, Serban I, Ceck C, Patrascsoiu M, Florica N, Mihaescu D, Murphy C, Meleady R, Ingram S, Love J, Graham I, Graham IM, Meleady R, van Berkel TFM, Deckers JW, De Bacquer D. Working Group on Epidemiology and Prevention of the European Society of Cardiology. Shannon, May 14-17, 1998. Abstracts. Ir J Med Sci 1998; 167 Suppl 7:1-35. [PMID: 9827492 DOI: 10.1007/bf02937278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
25
|
Dobson AJ, Evans A, Ferrario M, Kuulasmaa KA, Moltchanov VA, Sans S, Tunstall-Pedoe H, Tuomilehto JO, Wedel H, Yarnell J. Changes in estimated coronary risk in the 1980s: data from 38 populations in the WHO MONICA Project. World Health Organization. Monitoring trends and determinants in cardiovascular diseases. Ann Med 1998; 30:199-205. [PMID: 9667799 DOI: 10.3109/07853899808999404] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The World Health Organization (WHO) MONICA Project is a 10-year study monitoring trends and determinants of cardiovascular disease in geographically defined populations. Data were collected from over 100,000 randomly selected participants in two risk factor surveys conducted approximately 5 years apart in 38 populations using standardized protocols. The net effects of changes in the risk factor levels were estimated using risk scores derived from longitudinal studies in the Nordic countries. The prevalence of cigarette smoking decreased among men in most populations, but the trends for women varied. The prevalence of hypertension declined in two-thirds of the populations. Changes in the prevalence of raised total cholesterol were small but highly correlated between the genders (r = 0.8). The prevalence of obesity increased in three-quarters of the populations for men and in more than half of the populations for women. In almost half of the populations there were statistically significant declines in the estimated coronary risk for both men and women, although for Beijing the risk score increased significantly for both genders. The net effect of the changes in the risk factor levels in the 1980s in most of the study populations of the WHO MONICA Project is that the rates of coronary disease are predicted to decline in the 1990s.
Collapse
|
26
|
Abstract
OBJECTIVE To examine the relation between frequency of orgasm and mortality. STUDY DESIGN Cohort study with a 10 year follow up. SETTING The town of Caerphilly, South Wales, and five adjacent villages. SUBJECTS 918 men aged 45-59 at time of recruitment between 1979 and 1983. MAIN OUTCOME MEASURES All deaths and deaths from coronary heart disease. RESULTS Mortality risk was 50% lower in the group with high orgasmic frequency than in the group with low orgasmic frequency, with evidence of a dose-response relation across the groups. Age adjusted odds ratio for all cause mortality was 2.0 for the group with low frequency of orgasm (95% confidence interval 1.1 to 3.5, test for trend P = 0.02). With adjustment for risk factors this became 1.9 (1.0 to 3.4, test for trend P = 0.04). Death from coronary heart disease and from other causes showed similar associations with frequency of orgasm, although the gradient was most marked for deaths from coronary heart disease. Analysed in terms of actual frequency of orgasm, the odds ratio for total mortality associated with an increase in 100 orgasms per year was 0.64 (0.44 to 0.95). CONCLUSION Sexual activity seems to have a protective effect on men's health.
Collapse
Affiliation(s)
- G Davey Smith
- Department of Social Medicine, University of Bristol
| | | | | |
Collapse
|
27
|
Ferrario M, Grafnetter D, Kuulasmaa K, Poledne R, Moltchanov V, Chatenoud M, Yarnell J. 1.P.331 Total cholesterol distributions and time trends in the populations of the WHO-MONICA project. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)88510-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
28
|
Abstract
BACKGROUND Several studies have shown a relation between fetal development, as shown by birthweight, and later coronary heart disease. This study investigated whether this relation is predominantly the consequence of early life exposures, or can best be explained in terms of an interaction between influences in early life and in adulthood. METHODS This prospective study in Caerphilly, South Wales, included 1258 men, aged 45-59 at initial screening, who were able to provide birthweight data. These men are from an initial cohort of 2512 men, from whom information has been obtained in a series of examinations since 1979 on health-related behaviours, incidence of coronary heart disease, and risk factors. The main outcome measure was fatal and non-fatal coronary heart disease during 10 years of follow-up. FINDINGS Higher birthweight was related to lower risk of coronary heart disease during the follow-up period: coronary heart disease occurred in 46 (11.6%) men in the lowest birthweight tertile, 44 (12.0%) of those in the middle tertile, and 38 (9.1%) of those in the highest tertile (p = 0.03). Stratification of the cohort by body-mass index (BMI) revealed a significant interaction such that the inverse association between birthweight and risk of coronary heart disease was restricted to men in the top tertile of BMI (interaction test p = 0.048 adjusted for age, and p = 0.012 fully adjusted). Within the top BMI tertile, coronary heart disease occurred in 19 (16.4%) of men in the lowest birthweight tertile, 13 (12.6%) of those in the middle tertile, and 13 (7.5%) of those in the highest tertile (p = 0.0005). These associations were not changed substantially by adjustment for age, father's social class, own social class, marital status, fibrinogen and cholesterol concentrations, systolic blood pressure, and smoking history. INTERPRETATION The association between birthweight and risk of coronary heart disease cannot be explained by associations with childhood or adulthood socioeconomic status. Nor do conventional risk factors for coronary heart disease in adulthood account for the association. However, there is an important interaction between birthweight and BMI such that the increased risk of coronary heart disease associated with low birthweight is restricted to people who have high BMI in adulthood. Risk of coronary heart disease seems to be defined by the combined effect of early-life and later-life exposures.
Collapse
Affiliation(s)
- S Frankel
- Department of Social Medicine, University of Bristol, UK
| | | | | | | | | |
Collapse
|
29
|
|
30
|
Abstract
OBJECTIVE To determine the relationships between birthweight, the incidence of coronary heart disease, and a range of coronary heart disease risk factors that operate during adult life. DESIGN Cohort study with a 10-year follow-up period. SETTING The town of Caerphilly, South Wales, and five adjacent villages. SUBJECTS 1,258 men aged 45-59 at time of recruitment between 1979 and 1983. MAIN OUTCOME MEASURES All deaths, coronary heart disease deaths, non-fatal CHD events. RESULTS The validity of the birthweight data was supported by the strong graded associations between birthweight and anthropometric measures in adulthood, particularly height, body mass index, triceps, skinfold thickness and percentage body fat. An inverse relationship was found between birthweight and incident fatal and non-fatal CHD, (P = 0.01), though no relationship was found between birthweight and all-cause mortality. Amongst the major CHD risk factors, only fibrinogen shows a statistically significant relationship with birthweight (P = 0.008), fibrinogen levels being lower among the men with lower birthweights. When social and biological variables are included in models relating incident CHD and birthweight, the relationship between birthweight and incident fatal and non-fatal CHD remains essentially unchanged. CONCLUSION A graded association between low birthweight and later CHD has been demonstrated in this cohort. This inverse association cannot be explained by the measured social or behavioural variables, or by other risk factors operating in adult life.
Collapse
Affiliation(s)
- S Frankel
- Department of Social Medicine, University of Bristol
| | | | | | | | | |
Collapse
|
31
|
|
32
|
Smith WC, Kenicer MB, Davis AM, Evans AE, Graham JM, Yarnell J. Development of coronary prevention strategies by health authorities in the United Kingdom. Community Med 1989; 11:108-15. [PMID: 2752719 DOI: 10.1093/oxfordjournals.pubmed.a042454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The United Kingdom has one of the highest coronary heart disease mortality rates in the world. However, over the last decade there has been a growing impetus in coronary prevention. In 1988 the Faculty of Community Medicine carried out a survey of all health authorities in the UK to assess the progress and problems with coronary prevention. This survey received a 92 per cent response rate and shows some interesting findings. The picture at present reveals a growing momentum in the last couple of years with half the health authorities at present claiming to have a programme. The main hindrances reported are lack of funding rather than lack of interest. The development and difficulties with nutrition and smoking policies, and with blood pressure screening are also described. The regional pattern of development of these programmes and policies is complex. Many authorities favour a general health promotion approach rather than a negative, disease oriented one; this conflict in approach requires further debate.
Collapse
|
33
|
Affiliation(s)
- W C Smith
- Working Group Cardiovascular Disease, Faculty of Community Medicine, Royal College of Physicians of the UK
| | | | | | | | | |
Collapse
|
34
|
Rajput-Williams J, Knott TJ, Wallis SC, Sweetnam P, Yarnell J, Cox N, Bell GI, Miller NE, Scott J. Variation of apolipoprotein-B gene is associated with obesity, high blood cholesterol levels, and increased risk of coronary heart disease. Lancet 1988; 2:1442-6. [PMID: 2904569 DOI: 10.1016/s0140-6736(88)90930-0] [Citation(s) in RCA: 96] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A random sample of 290 white men was examined for association between restriction fragment length polymorphism (RFLP) haplotypes (closely linked RFLPs on a single chromosome) of the apolipoprotein-B gene and serum levels of cholesterol, triglyceride, and high-density lipoprotein, obesity, smoking, alcohol consumption, and coronary heart disease. Haplotype or single RFLP frequencies differed significantly for obesity (p less than 0.005), serum cholesterol (p less than 0.005), and coronary heart disease (p less than 0.05), but for no other variable. Obesity was associated with haplotypes involving minimum PvuII and XbaI RFLPs are likely to be in linkage disequilibrium with nearby functional variation predisposing to obesity. Significant variation in serum cholesterol levels was associated with three functional alleles defined by MspI and EcoRI RFLP pairs (p less than 0.03). These RFLPs correspond to charged aminoacid variants at positions 3611 (arginine to glutamine) and 4154 (glutamic acid to lysine), which lie near the low-density-lipoprotein (LDL) receptor binding region of apolipoprotein-B. The three alleles showed stratification of serum cholesterol between low, normal, and high levels. Coronary heart disease was associated with minimum haplotypes involving XbaI and MspI RFLPs. Together these results suggest that inherited variations of the apolipoprotein-B gene, probably in the form of charged aminoacid substitutions, influence circulating cholesterol concentration, and that these and other functional variants of the apolipoprotein-B gene affect susceptibility to coronary heart disease and obesity.
Collapse
Affiliation(s)
- J Rajput-Williams
- Division of Molecular Medicine, Medical Research Council Clinical Research Centre, Harrow, Middlesex
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Yarnell J, Samways R. Gonorrhoea in women and exposure to risk. Br J Vener Dis 1976; 52:333-6. [PMID: 1033015 PMCID: PMC1045295 DOI: 10.1136/sti.52.5.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Data are presented on the characteristics of women with newly diagnosed gonorrhoea who attended Lydia Clinic, St. Thomas' Hospital, during a 6-month period. Although gonorrhoea in women is largely asymptomatic, there was strong circumstantial evidence to suggest that some women had attended because they had been exposed to risk. The proportion of women thus motivated was largest among those women who had attended a clinic for sexually transmitted diseases before--in which up to 40 per cent. of women had apparently attended entirely of their own accord. Women born in the West Indies differed from their counterparts born in the United Kingdom in three respects: they were younger, recorded fewer contacts, and referred themselves less frequently to the clinic for a first visit. Implications for health education and for future research are discussed.
Collapse
|
36
|
|