The epidemiology of atherosclerosis among a random sample of clothing workers of different ethnic origins in New York City: II. Associations between manifest atherosclerosis, serum lipid levels, blood pressure, overweight, and some other variables

Abstract

The prevalence of various manifestations of atherosclerosis was measured among a random sample of clothing workers, aged 40 and over, of Italian and Jewish extraction, who were comparable with regard to working conditions, socioeconomic status, and dietary intake of calories and fat. The over-all prevalence rate of coronary heart disease among Italian men appeared to be influenced by serum cholesterol, blood pressure, and body weight levels since the frequency of the disease was consistently greater at higher than at lower levels of these three variables. By contrast, among Jewish men who, as a group, showed evidence of coronary disease more frequently than Italian men, these variables exerted no appreciable effect upon the prevalence of the disease. The sample included too few women with coronary disease for a similar analysis. The prevalence of roentgenographic evidence of aortic calcifications appeared similarly more susceptible to the influence of the three variables in question among Italians than Jews in both sexes. Data relating the prevalence of manifest atherosclerosis to the serum cholesterol-phospholipid and ratio and serum acid levels were also presented. Aortic calcifications were more commonly seen in the presence than in the absence of manifest coronary disease; further interrelations between manifest coronary, aortic and peripheral arterial disease were also made. Comparison of Italian and Jewish men with and without coronary disease in terms of some more obvious possible atherogenic factors failed to delineate a “profile” which might help in characterizing the affected men. These findings indicated primarily that the predisposition to the development of coronary heart disease of Jewish, as compared with Italian, men in this population segment is largely unexplained by any of the factors studied in these investigations. Presently undefined factors appear to be of considerable quantitative importance in determining the prevalence of coronary disease among certain predisposed groups and require further study, particularly by epidemiologic methods.