Epidemiology Of Coronary Heart Disease Research Articles

Effects of traditional coronary risk factors on rates of incident coronary events in a low-risk population. The Adventist Health Study.

California Seventh-Day Adventists have lower mortality rates from coronary heart disease (CHD) than other Californians. Associations between traditional risk factor and CHD events have not been reported previously for Adventists. A cohort study allowed 6 years of follow-up of 27,658 male and female California Seventh-Day Adventists. Data collected included age, sex, physician-diagnosed hypertension and diabetes mellitus, body height, weight, previous and current cigarette smoking habits, and current exercise habits. Incident cases of definite myocardial infarction (MI) and definite fatal CHD were diagnosed according to recognized criteria. Both stratified and proportional hazards analyses demonstrated that in this low-risk population, the above traditional coronary risk factors exhibit their usual associations with risk of CHD events. It was noted that exercise had a strong negative association with fatal CHD events (relative risks [RR], 1.0, 0.66, and 0.50 with increasing exercise) but no association with risk of MI (either nonfatal or all cases). Conversely, obesity was much more clearly associated with MI (RR, 1.0, 1.18, and 1.83 with increasing tertiles of obesity) than with fatal events. The importance of the risk factors was similar in both sexes, except that the effect of cigarette smoking seemed more pronounced in women. The epidemiology of coronary heart disease in this low-risk California population appears to be at least qualitatively similar to that seen in other groups. There was evidence that the effects of exercise and obesity may differ depending on whether fatal CHD and MI (either all MI or nonfatal alone) is the end point.

N-3 fatty acids and coronary heart disease Epidemiology from Eskimos to Western populations.

Summary The original cross-cultural comparisons between Greenland Eskimos and Danes and between Japan and Western countries suggested that a high fish intake was associated with low mortality rates from coronary heart disease. More comprehensive cross-cultural studies, eg the Seven Countries Study showed that the saturated fat content of the diet is more important than the amount of fish in explaining differences in coronary heart disease mortality between countries. Cohort studies carried out in cultures with a low level of fish consumption showed that persons who eat fish once or twice a week had lower mortality rates from coronary heart disease than persons who did not eat fish. The results of the epidemiological studies carried out so far suggest that a diet low in saturated fat in combination with a low level of fish consumption may be of importance for coronary heart disease prevention.

Epidemiology of Coronary Heart Disease and Its Risk Factors in the USSR

Epidemiology of Coronary Heart Disease and Its Risk Factors in the USSR

HIGH DENSITY LIPOPROTEIN CHOLESTEROL AS A PREDICTOR OF CARDIOVASCULAR DISEASE MORTALITY IN MEN AND WOMEN: THE FOLLOW-UP STUDY OF THE LIPID RESEARCH CLINICS PREVALENCE STUDY

With data from the Lipid Research Clinics Prevalence Study used as a baseline, an average of 8.4 years of mortality follow-up has been completed for 8,825 male and female participants who were at least 30 years of age at the time of the study. The participants were examined at 10 North American sites during 1972-1976. Univariate findings for high density lipoprotein (HDL) cholesterol in the 7,569 persons initially free of coronary heart disease indicate an inverse relation with cardiovascular disease mortality for men and women. Controlling for age, low density lipoprotein (LDL) cholesterol, triglycerides, body mass index, systolic blood pressure, and smoking, multivariate analysis results indicate inverse relations between HDL cholesterol and cardiovascular disease mortality. In men, the cardiovascular disease mortality rate ratio for HDL cholesterol increments of 10 mg/dl was similar to the cardiovascular disease mortality rate ratio for LDL cholesterol increments of 30 mg/dl. In women, HDL cholesterol is more closely related to cardiovascular disease than is LDL cholesterol. HDL cholesterol is inversely related to both coronary heart disease and other cardiovascular disease mortality in both sexes, though the relation of HDL cholesterol with coronary heart disease mortality in women approached statistical significance only for the combined end point of suspect and definite cases. No relation was observed in either sex group between HDL cholesterol and noncardiovascular disease mortality. This study, only the second large prospective study evaluating the role of HDL cholesterol in women, confirms both the importance and the independence in both men and women of HDL cholesterol in the epidemiology of coronary heart disease and other cardiovascular disease mortality.

Metabolic changes induced by sugar in relation to coronary heart disease and diabetes.

The effects on the biochemistry and physiology of the human body of diets differing only in the ratio of the two major carbohydrates, starch and sugars are discussed and related to the epidemiology of coronary heart disease and diabetes.

Book Review: Genetic Epidemiology of Coronary Heart Disease: Past, Present and Future

Book Review: Genetic Epidemiology of Coronary Heart Disease: Past, Present and Future

Genetic epidemiology of coronary heart disease. Past, present, and future.

HomeArteriosclerosis: An Official Journal of the American Heart Association, Inc.Vol. 4, No. 5Genetic epidemiology of coronary heart disease. Past, present, and future. Free AccessAbstractPDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessAbstractPDF/EPUBGenetic epidemiology of coronary heart disease. Past, present, and future. C Carter, R Havlik, M Feinleib, L H Kuller, R Elston and D C Rao C CarterC Carter Search for more papers by this author , R HavlikR Havlik Search for more papers by this author , M FeinleibM Feinleib Search for more papers by this author , L H KullerL H Kuller Search for more papers by this author , R ElstonR Elston Search for more papers by this author and D C RaoD C Rao Search for more papers by this author Originally published1 Sep 1984https://doi.org/10.1161/01.ATV.4.5.510Arteriosclerosis: An Official Journal of the American Heart Association, Inc.. 1984;4:510–516 Previous Back to top Next FiguresReferencesRelatedDetailsCited By Templeton A, Clark A, Weiss K, Nickerson D, Boerwinkle E and Sing C (2000) Recombinational and Mutational Hotspots within the Human Lipoprotein Lipase Gene, The American Journal of Human Genetics, 10.1086/302699, 66:1, (69-83), Online publication date: 1-Jan-2000. September 1984Vol 4, Issue 5 Article InformationMetrics Copyright © 1984 by American Heart Associationhttps://doi.org/10.1161/01.ATV.4.5.510PMID: 6477301 Originally publishedSeptember 1, 1984 PDF download Advertisement

Epidemiology of coronary heart disease in black populations: Methodologic proposals

The Working Conference on Coronary Heart Disease in Black Populations should define an agenda for research to determine (1) the degree to which the persistent socioeconomic differences between U.S. blacks and whites are important environmental determinants of differeing risk factor distributions and (2) whether these differences have a differential impact on the natural history of coronary disease in these groups. In addition, research should be directed toward the resolution of existing controversies and to the testing of hypotheses suggested by earlier work. In the definition of this agenda, attention must be paid to the methodologic problems identified in this article. The resolution of the controversies and the testing of hypotheses suggested by ethnic comparisons are of intrinsic scientific importance for ischemic heart disease research and is likely to yield insights of value in diminishing the heart disease burden in all segments of the population.

Plasma Cholesterol

For two decades, the Framingham study has provided valuable information about plasma lipoproteins and the epidemiology of coronary heart disease (CHD). First, low-density lipoprotein (LDL) cholesterol (roughly equivalent to total plasma cholesterol) was found to be directly related to the risk of CHD; then, high-density lipoprotein (HDL) cholesterol was found to be inversely related. The most recent report (p 1128) examines illnesses other than CHD and uncovers a provocative finding: low levels of LDL predict high rates of stroke and cancer. What is the explanation for this association? There are several possibilities. It is due to chance. The tests of statistical significance show this is unlikely. Furthermore, similar results have been found in many,1-7 though not all,8 other epidemiologic studies. It is due to bias. The Framingham study has become a modern classic precisely because its prospective cohort design removes most of the usual biases. A special one that might

Epidemiology of coronary heart disease. Lessons from North and South Belgium.

AbstractDifferences in food intake, smoking and drinking habits in the North and the South of Belgium have been studied with the aid of household data gathered by the National Institute of Statistics, Brussels, 1973-74. Consumption of sugar, vegetables, fruits, crude fibre and meat was almost identical between the regions. Consumption of bread, fish and salt intake were slightly higher in the North and alcohol consumption higher in the South. The major differences were located in fat consumption. Saturated fat as a percentage of dietary energy amounted to 15·8% in the North v. 18·5% in the South; polyunsaturated fat was, respectively for the North and South, 7·9% and 5·5%. Dietary cholesterol intake was 320 mg/day in the North against 400 mg/day in the South. The difference in serum cholesterol, calculated with the Keys formula, was 11·9 mg%, a value totally consistent with the observed values.The difference in saturated fat intake between the regions was almost entirely due to the difference of butter intake, thereby explaining why butter correlated so perfectly with mortality in different parts of Belgium. Similar correlations were found in France and Western Europe.The mortality trends in both regions were compared with the available data on fat consumption over the last 15 years. Again a decreasing intake of saturated fat (less butter and less common (hard) margarine) was associated with a decreasing coronary, cardiovascular and total mortality in both the North and the South. The time-related decrease discussed in the second part was quantitatively similar to one obtained in the first part from geographical differences, making a spurious association extremely unlikely.Similar dietary changes with identical results in terms of mortality have also been observed in the U.S.A. and Finland.

Observations on the epidemiology of coronary heart disease from an industrial hospital.

Observations on the epidemiology of coronary heart disease from an industrial hospital.

Part I: Epidemiology of coronary heart disease in migrant Chinese populations

Abstract Proportional mortality rates from coronary heart disease (CHD) are compared among Chinese populations in Hawaii and New York City (N.Y.C.). Hawaii Chinese have a greater proportion of deaths due to CHD than N.Y.C. Chinese. Within the N.Y.C. Chinese population, United States (U.S.)‐born Chinese have a greater proportion of deaths due to CHD than foreign‐born Chinese. Deaths from CHD occur at younger ages among Chinese in Hawaii and U.S.‐born Chinese in N.Y.C. when compared with foreign‐born N.Y.C. Chinese. The results suggest that deaths from CHD increase and occur at earlier ages as Chinese migrant populations become assimilated with the host population.

Epidemiology of coronary heart disease among young army males of World War II

An epidemiologic study was carried out on 1,393 cases of CHD in World War II Army men, median age 39.6 years, by comparing these cases with representative age-matched Army controls using data from military records of both groups, particularly records of induction into service. Factors showing significant (P < 0.05) association with the development of angina pectoris, coronary insufficiency, myocardial infarction, and death from CHD at this young age were: higher systolic and diastolic blood pressure, higher weight and ratio of actual-to-standard weight, aspects of body build as measured by a greater chest circumference, a heavy frame, and being shorter than the matched controls. Other characteristics more prevalent among the coronary cases than among the matched controls and therefore associated with a higher risk of CHD were: geographical residence in the Middle Atlantic States, a higher socioeconomic score, some graduate education, being an officer, being of Jewish religion, and having a blood Group A. A significantly lower risk of CHD was found for rural birthplace and previous outdoor occupation requiring high physical activity. Men whose previous occupation was that of a farmer or farm laborer had a relative risk of 0.54 (P < 0.008) compared with other occupational groups. Stepwise multiple regression analysis revealed the successive contribution to risk of first myocardial infarction, coronary thrombosis, and coronary occlusion associated with size of chest circumference, level of diastolic blood pressure, urban-rural classification, height (negatively associated), occupational group, and ABO blood group. This analysis evaluates the contribution of each selected factor independent of the factors selected in previous steps. Similar multiple regression analysis applied to angina pectoris and coronary insufficiency cases identified occupational group, ABO blood group, size of chest circumference, height (negatively associated), and religion as independent contributors for risk of this manifestation of CHD at a young age.

Coffee and coronary disease.

Current assessment of the epidemiology of coronary heart disease indicates a major role of environment in the evolution of this disease. Environmental factors that contribute to the incidence of th...

Epidemiology of coronary heart disease and stroke in Japanese men living in Japan, Hawaii, and California: methodology for comparison of diet

Epidemiology of coronary heart disease and stroke in Japanese men living in Japan, Hawaii, and California: methodology for comparison of diet

Diet in the epidemiology of coronary heart disease.

Diet in the epidemiology of coronary heart disease.

Estimation of the probability of an event as a function of several independent variables

SUMMARY A method for estimating the probability of occurrence of an event from dichotomous or polychotomous data is developed, using a recursive approach. The method in the dichotomous case is applied to the data of a 10-year prospective study of coronary disease. Other areas of application are briefly indicated. The purpose of this paper is to develop a method for estimating from dichotomous (quantal) or polychotomous data, the probability of occurrence of an event as a function of a relatively large number of independent variables. A key feature of the method is a recursive approach based on Kalman's work (Kalman, 1960 and unpublished report) in linear dynamic filtering and prediction, derivable also from the work of Swerling (1959), which provides an example of many other possible uses of recursive techniques in nonlinear estimation and in related areas. The problem that motivated the investigation is a central one in the epidemiology of coronary heart disease, and it will be used to fix ideas and illustrate the method. Some indication of the range of applications will be given in the conclusion.

Epidemiology of Coronary Heart Disease in Middlesex County, Connecticut . Pilot Study of Dietary Assessment of Patients with Primary Myocardial Infarction

Epidemiology of Coronary Heart Disease in Middlesex County, Connecticut . Pilot Study of Dietary Assessment of Patients with Primary Myocardial Infarction

Crete: A study in the metabolic epidemiology of coronary heart disease

In addition to standard survey technics, a new procedure for aspiration of depot fat, the determination of urinary vanil mandelic acid, and radioelectrocardiography were utilized for the first time, to our knowledge, under field conditions to study the “metabolic epidemiology” of coronary heart disease. The study sample consisted of 280 men, aged 45 and over (mean, 62), most of whom were randomly selected from five geographic areas in which indigenous diet patterns of the populace could be distinguished. A 12-lead electrocardiographic survey of all subjects revealed 2 cases of residual myocardial infarction. The use of exercise radioelectrocardiography detected 2 cases of definite myocardial ischemia in which the standard electrocardiograms were normal. Thirty-one cases of cardiac arrhythmias were found, the vast majority considered to be due to arteriosclerotic heart disease. The nutritional status of the male Cretan was assessed by interview technics, 24 hour diet recall, clinical examination, hemoglobin, hematocrit and the determination of serum vitamin A and E. The mean level of hemoglobin was 14.1 gm.%; of hematocrit, 43.1%; serum vitamins E and A, 0.97 mg.% (range 0.32–1.8) and 92 μg.% (range 43–168), respectively. Two instances of petechial hemorrhages believed to be due to deficiency of ascorbic acid were found. Two other subjects had serum vitamin E levels below 0.5 mg.%; 8 cases of anemia were detected. With the exception of the cases cited, the mean serum vitamin and hemoglobin determinations were within normal limits; mean hematocrit levels were slightly below normal. Analysis of 200 depot fat samples revealed significant differences which could be associated with specific local dietary patterns. Oleic acid comprised 65 per cent of total depot fatty acids in subjects consuming the greatest quantity of olive oil. The Iracleion subjects ate the most meat and cheese, exhibited the highest mean weight, and showed the highest depot total saturated fatty acid content. When the depot fat composition pattern of all the Cretan subjects was compared to that of American men of the same age, a highly significant difference in depot saturated and monounsaturated fatty acids was revealed. The monounsaturated depot fatty acid content was 69 compared to 59 per cent in the American. Depot saturated fat was 19 per cent in the Cretan, 30 in the American. It was suggested that the populations having low incidence of coronary heart disease may be associated with relatively low depot saturated fat content and a proportionate increase in either depot monoenes or polyenes. In the subsample of 12 subjects a mean level of 24 hour urinary vanil mandelic acid was found to be 6.3 mg.%, an amount found in American subjects with evidence of coronary heart disease. It was postulated that though the urinary vanil mandelic acid excretion of Cretan men is high, reaction to stress is decisive and disassociated with anxiety-provoking behavioral patterns which characterize the coronary-prone subject. In determining the status of our study subjects relative to the risk factors defined by the Framingham study, the rural Cretan man can be said to be hypo- or normocholesteremic, normotensive and normal in weight. He eats little saturated fat, smokes moderately if at all, exercises considerably and tends to react to stress decisively. Thus, all factors of risk studied were found to be of low order, and this combination of findings appears to best explain the low incidence of coronary heart disease observed in the Cretan men.

A prospective study of the relationship between personality and coronary heart disease

As part of a prospective epidemiological study of coronary heart disease, the Minnesota Multiphasic Personality Inventory (MMPI) and the Sixteen Personality Factor Questionnaire (16PF) were used to obtain measures of personality from 1990 men who were 40–55 years of age and free of clinical coronary disease at the beginning of the study 4 1 2 years ago. With respect to the MMPI, data are presented for 48 men who have subsequently developed only the symptoms of angina pectoris, 37 men who have had myocardial infarctions, and 1771 men who have remained free of clinical coronary heart disease. For the 16PF, the number of cases in the angina, infarct, and non-coronary groups is 31, 18, and 1773, respectively. In all cases, the data on personality were obtained prior to the appearance of clinical coronary heart disease. Statistical analyses of these data indicate that the men who subsequently developed angina pectoris, in comparison to the subjects with myocardial infarction, scored significantly higher on the HsK and Hy scales of the MMPI and lower on Factor C of the 16PF. It was also found that the total coronary group (cases of angina plus cases of infarct) had significantly higher mean scores on Factors L and Q 2 than the men in the non-coronary group. These findings suggest that the men in the angina group, as compared to the men with myocardial infarction, were characterized before the clinical appearance of coronary heart disease by the following attributes: (1) a tendency to complain about somatic symptoms of all sorts and to be worried about the state of their health even in the absence of objective findings; (2) greater lability in cardiovascular functioning; and (3) greater emotional lability and suggestibility. With respect to the observed psychometric differences between the total coronary and non-coronary groups, it is inferred that the men who later developed coronary heart disease, as compared to those who did not, tended to be: (1) more independent in their social relationships; (2) more suspicious about the motives of other people; and (3) to have greater feelings of inner tension. It is emphasized that these results should not be taken as descriptions of ‘coronaryprone’ or ‘angina-prone’ personalities because these data do not by themselves demonstrate the existence of an etiological relationship between personality and coronary heart disease. This evidence supports the general hypothesis that patterns of behavior are significant in the epidemiology of coronary heart disease in man.