Cardiovascular diseases in the United States

Stamler, Jeremiah

doi:10.1016/0002-9149(62)90320-x

Cited by 90 publications

(12 citation statements)

References 50 publications

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“…Our blood pressure data are similar to those from studies in the U.S.A. (Stamler, 1962;United States National Center for Health Statistics, 1964a, b;Cassel, 1971) in showing higher levels in blacks than in whites. While, in spite of their higher blood pressure levels, blacks appear to be less prone to ischaemic heart disease than whites, there is little doubt that they experience a considerable excess over whites of hypertensive and cerebrovascular disease (Boyle, 1974).…”

Section: Discussionsupporting

confidence: 85%

Ethnic group comparisons of variables associated with ischaemic heart disease.

Meade¹,

Brozović²,

Chakrabarti³

et al. 1978

Heart

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SUMMARY Variables known or postulated as being associated with the onset of ischaemic heart disease have been measured in 553 male and female members, aged 18 to 49, of a working population in northwest London; 412 were white, and 141 were black. Cigarette and alcohol consumption were higher in white than in black men, and so were cholesterol, triglyceride, factor VII, carbon monoxide, and haemoglobin levels, and platelet and white cell counts; factor VIII and blood pressure levels, and fibrinolytic activity were lower. More white than black women smoked; the latter were more obese. Differences between black and white women in factor VIII, carbon monoxide, haemoglobin, and blood pressure levels, and in white cell count were similar to those seen in men; however, there were no significant differences in levels of cholesterol, triglycerides or factor VII, or in platelet count, or fibrinolytic activity. Though fibrinolytic activity was higher in the black men than in the white, the difference was not as distinct as in some other studies; the possibility that black men may be losing some of their natural protection against ischaemic heart disease should be borne in mind. On the basis of the ethnic group comparisons it is concluded that, in addition to variables already known to be associated with the onset of ischaemic heart disease, attention should be given to the possible effects ofhigh factor VII levels, poor fibrinolytic activity, and high platelet counts; other considerations suggest that further haemostatic variables, such as factor VIII and fibrinogen, should also receive attention.

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Section: Discussionsupporting

confidence: 85%

Ethnic group comparisons of variables associated with ischaemic heart disease.

Meade¹,

Brozović²,

Chakrabarti³

et al. 1978

Heart

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“…Therefore, men with favorable values for the foregoing three traits Age was included in these analyses. For the end point 15-vear death from all causes, the coefficients for serum cholesterol, systolic pressure, cigarettes/day and age were: men aged 25 compared to the whole cohort could expect to live on average 5 + 28 = 33 additional years, i.e. to age 83.…”

Section: Relationship O F Baseline Variables To 25-year Mortality Fromentioning

confidence: 99%

Relationship of Baseline Major Risk Factors to Coronary and All-Cause Mortality, and to Longevity: Findings from Long-Term Follow-Up of Chicago Cohorts

et al. 1993

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The focus here is on relationships between major risk factors and long-term mortality from coronary heart disease (CHD) and all causes, and on longevity, in Chicago cohorts: 25-year follow-up for Peoples Gas (PG) men aged 25-39 (n = 1,119), 30-year follow-up for PG men aged 40-59 (n = 1,235), 24-year follow-up for Western Electric (WE) men aged 40-55 (n = 1,882); also 15-year follow-up for five cohorts of the Chicago Heart Association (CHA) Study: men aged 25-39 (n = 7,873), 40-59 (n = 8,515), 60-74 (n = 1,490), and women aged 40-59 (n = 7,082) and 60-74 (n = 1,243); also 12-year findings for very low risk men (n = 11,098) and other men (n = 350,564) screened for the Multiple Risk Factor Intervention Trial (MRFIT). With a high degree of consistency, multivariate analyses showed independent positive relationships of baseline serum cholesterol, blood pressure and cigarette use to risk of death from CHD and all causes. For the WE cohort, with baseline nutrient data, dietary cholesterol was also independently related to these mortality risks. Combined risk factor impact was strong for both men and women of all baseline ages. Thus, for WE men, favorable compared to observed levels of serum cholesterol, blood pressure, cigarette use and dietary cholesterol were estimated to result in 24-year risk of CHD death 69% lower, all-cause death 42% lower and longevity 9 years greater. For CHA middle-aged and older women, favorable baseline levels of serum cholesterol, blood pressure and cigarette use were estimated to yield 15-year-CHD risk lower by about 60% and longevity greater by about 5 years. For MRFIT, very low risk men (serum cholesterol < 182 mg/dl, systolic/diastolic blood pressure < 120/ < 80), nonsmokers, nondiabetic, no previous heart attack), compared to all others, observed 12-year death rates were lower by 89% for CHD, 79% for stroke, 86% for all cardiovascular diseases, 30% for cancers, 21 % for other causes, 53% for all causes, and longevity was estimated to be more than 9 years longer. These findings indicate great potentials for prevention of the CHD epidemic and for increased longevity with health for men and women, through improved life-styles and consequent lower risk factor levels.

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“…Therefore, only apparently healthy women were included in the data analysis. Criteria for inclusion in the study group are presented in table 1. Of the 2854 women who received the complete physical examination, 1074 were excluded for health reasons, based on the criteria listed in table 1.…”

mentioning

confidence: 99%

Association between coronary heart disease risk factors and physical fitness in healthy adult women.

Gibbons¹,

Blair²,

Cooper³

et al. 1983

Circulation

135

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SUMMARY We examined associations between physical fitness and risk factors for coronary heart disease in healthy women ages 18-65 years. Physical fitness was objectively determined by the duration of a maximal treadmill exercise test. Six physical fitness categories (very poor to superior), specific within 10-year age increments, were established. Mean risk factor levels varied across categories, but so did potential confounders such as age and weight. Multiple linear regression modeling was used to control for the effects of age, weight and year of exam on coronary risk factors. After adjustment, physical fitness was independently associated with triglycerides (p < 0.001), high-density lipoprotein cholesterol (HDL-C) (p -0.001), total cholesterol/HDL-C ratio (p S 0.001), blood pressure (p si 0.001) and cigarette smoking (p -0.001).IT IS WELL ESTABLISHED that men have a higher incidence of cardiovascular disease than women. Nonetheless, coronary heart disease (CHD) is the leading cause of death in women (259 deaths/100,000 per year), with women in the United States having high rates compared with the rest of the world.' These statistics belie the relative paucity of research in CHD epidemiology in women. Available data, notably from the Framingham study, support the classic risk factor hypothesis for CHD in women. Women with higher levels of blood cholesterol, high blood pressure, and who smoke cigarettes are more likely to develop CHD than women without these risk factors. aware of any such studies in women. Although the precise role of physical activity in the prevention of CHD is not known, a tenable hypothesis is that more active persons have lower levels of established -risk factors. We previously showed that men who were more physically fit had lower levels of CHD risk than their less physically fit peers.6The purpose of this paper is to examine the association between physical fitness and CHD risk factors in women. We hypothesized that women with higher levels of physical fitness have a lower CHD risk. MethodsMore than 3900 adult women, ages 18-65 years, were examined from 1971 to 1980. Some women received only a treadmill test, but 2854 received a complete physical examination, including CHD risk factor measurements. Most of these women were self-referred for the purpose of physical fitness evaluation, periodic health examination or receiving preventive medical advice. These patients tended to be well educated and from middle to upper socioeconomic strata. More than 99% of the women were white. Data reported in this paper are from the first clinic visit for these

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Cardiovascular diseases in the United States

Cited by 90 publications

References 50 publications

Ethnic group comparisons of variables associated with ischaemic heart disease.

Ethnic group comparisons of variables associated with ischaemic heart disease.

Relationship of Baseline Major Risk Factors to Coronary and All-Cause Mortality, and to Longevity: Findings from Long-Term Follow-Up of Chicago Cohorts

Association between coronary heart disease risk factors and physical fitness in healthy adult women.

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