Biomedical subjects

A Bingham

Publications and source records attributed to A Bingham.

At least 37 records · Page 2Linked to original sources

PubMed1999

Influence of parental history of hypertension on blood pressure.

AIM: To assess the effect of parental history of hypertension on blood pressure in representative samples from three French populations (MONICA centres of Lille, Strasbourg, Toulouse). METHODS: We screened 1660 males and 1635 females, aged 35-64 years. Subjects were defined as hypertensive if systolic blood pressure >/=160 mm Hg or diastolic blood pressure >/=95 mm Hg or if they were treated by antihypertensive drugs. Four groups of parental history were determined: no parental history; at least one parent hypertensive before 60 years; hypertension was diagnosed after 60; and hypertension with unknown age of discovery. A logistic regression model was used separately for each sex. RESULTS: After adjustment for age, body mass index, physical exercise, educational level, tobacco consumption, alcohol consumption, high density lipoprotein cholesterol, centre, diabetes mellitus and hypercholesterolaemia, parental history before age 60 was related to offspring's hypertension: OR = 2.09 (95% CI: 1.42-3.09) in men, and OR = 2.77 (95% CI: 1.95-3.93) in women. This relationship was stronger when we compared two parental histories versus none (women: OR = 5.33, 95% CI: 1.30-21.94; men: OR = 7.78, 95% CI: 2.45-24.74). CONCLUSION: In this representative cross-sectional study, history of hypertension in at least one parent was associated with offspring's hypertension.

Adult↗

PubMed1999

Trends and geographical disparities in coronary heart disease in France: are results concordant when different definitions of events are used?

OBJECTIVES: To assess whether different definitions of acute coronary events yielded concordant results concerning trends and geographical disparities in coronary heart disease (CHD) mortality and morbidity in France. STUDY DESIGN: Data from three French CHD registries participating in the WHO MONICA Project during the period 1985-1992. SETTING: Three areas of about one million inhabitants each in the North, South and East of France. SUBJECTS: About 2,000 acute coronary events each year. MAIN OUTCOME MEASURES: Mortality, annual rate of fatal and non-fatal events, incidence of first and recurrent events, case-fatality rates. RESULTS: For incidence and mortality, the broader the broader the definition of the acute event, the higher the reported rates. The same tendency was not observed for case-fatality rates. Comparing between-registry rates for mortality, 28-day case-fatality and hospital case fatality yielded relatively concordant results whatever the definition of event. As a whole, the higher mortality rate in Lille and its intermediate rank in Strasbourg were related more to disparities in case-fatality rates, with only small variations in incidence rates, independently of the definition used. Comparing temporal trends in rates within and between regions, a consistent decrease in annual mortality rates and case-fatality rates was observed, whatever the definition. In contrast, the incidence of non-fatal probable myocardial infarction did not change during the period in any register. CONCLUSIONS: Although the absolute estimates of rates were variable with the definition of the event, major findings in relation to trends and geographical disparities were fairly consistent across the definitions: the North-South gradient in mortality observed in France was found to be much more pronounced for case fatality than for incidence. The proportion of milder acute myocardial infarction is currently increasing and this element should be taken into account when analysing CHD rates.

Adult↗

PubMed1998

Transdermal estrogen replacement therapy and plasma lipids in 693 French women.

OBJECTIVES: The cardiovascular effects of transdermal estrogen are not so well established than those induced by oral estrogen. In a representative sample of French postmenopausal women, we assessed plasma lipid changes induced by transdermal 17 beta-estradiol. METHODS: This cross-sectional study was carried out among the population sample of the third MONICA survey on cardiovascular risk factors. We selected 693 postmenopausal women according to the followed criteria; women with intact uterus and no menstruation for more than 12 months, women with bilateral oophorectomy, hysterectomized women older than 55 years and hysterectomized women who had followed hormone replacement therapy. We used multivariate linear regression models, taking into account confounding variables, to assess lipid changes induced by estrogen. RESULTS: We compared 192 women currently taking transdermal 17 beta-estradiol (27 unopposed estrogen and 165 estrogen plus progestin) with 501 women without any hormonal treatment. After adjustment for living area, education level, income tax, smoking, alcohol consumption, physical activity, age and body mass index, transdermal estrogen replacement therapy (ERT) was significantly associated with lower levels of serum total cholesterol [6.10 (S.E., 0.11) vs 6.35 (0.09) mmol/l, P < 0.01], triglycerides [1.06 (0.06) vs 1.23 (0.05) mmol/l, P < 0.001], LDL-cholesterol [3.93 (0.11) vs 4.13 (0.09) mmol/l, P < 0.05], VLDL-cholesterol [0.48 (0.03) vs 0.56 (0.02) mmol/l, P < 0.001] and apolipoprotein B [1.20 (0.03) vs 1.26 (0.02) g/l, P < 0.01]. Levels did not differ significantly for HDL-cholesterol [1.68 (0.05) vs 1.66 (0.04) mmol/l] and apolipoprotein A1 [1.79 (0.03) vs 1.81 (0.02) g/l]. CONCLUSION: Transdermal ERT may confer a cardiovascular protection by lowering atherogenic lipoproteins.

Administration, Cutaneous↗

PubMed1998

Influence of alcohol consumption and various beverages on waist girth and waist-to-hip ratio in a sample of French men and women.

OBJECTIVE: The goal of the present study was to assess the association between alcohol consumption and abdominal fat deposition in France, a country where wine is the most commonly consumed alcoholic beverage. METHODS: We analyzed the association between alcohol consumption and various markers of body weight, in a population sample recruited in three distinct geographical areas of France (MONICA centers). This sample included men (n = 1778) and women (n = 1730) aged 35- 64 y, randomly selected from electoral rolls. Alcohol consumption was assessed with a quantitative frequency questionnaire. RESULTS: Alcohol intake ranged from 0-1655 ml of alcohol per week. Wine was the main source of alcohol, representing 67% of total alcohol intake in both genders. In men, there was no association between alcohol intake and body mass index (BMI) or body weight, whereas in women, alcohol consumption was inversely correlated with BMI (P < 0.0001) and body weight (P < 0.0002). In men, total alcohol consumption was positively associated with waist-to-hip ratio (WHR, P < 0.0002) and waist girth (P < 0.004), independently of BMI. Similarly, in women, positive associations were found between alcohol intake and WHR (P < 0.0001) as well as waist girth (P < 0.0001), independently of BMI. In a linear regression model including types of beverages and usual confounders, reporting consumption of either wine, beer or spirit was poorly associated with WHR in men, whereas wine (P < 0.0008) and beer (P < 0.0001) consumptions were both positively associated with WHR in women. However, there was no evidence of a statistically significant heterogeneous effect of wine, beer and spirits on WHR in both genders. CONCLUSION: In a sample of representative French people, in whom wine is the most common alcoholic beverage, alcohol consumption is associated with greater WHR independently of BMI in both men and women.

Adult↗

PubMed1998

Is hospital care involved in inequalities in coronary heart disease mortality? Results from the French WHO-MONICA Project in men aged 30-64.

OBJECTIVES: The goal of the study was to assess whether possible disparities in coronary heart disease (CHD) management between occupational categories (OC) in men might be observed and contribute to the increasing inequalities in CHD morbidity and mortality reported in France. METHODS: The data from the three registers of the French MONICA Collaborative Centres (MCC-Lille, MCC-Strasbourg, and MCC-Toulouse) were analysed during two period: 1985-87 and 1989-91. Acute myocardial infarctions and coronary deaths concerning men, aged 30-64 years, were included. Non-professionally active and retired men were excluded. Results were adjusted for age and MCC, using a logistic regression analysis. RESULTS: 605 and 695 events were analysed for 1985-87 and 1989-91, respectively. Out of hospital cardiac arrests, with or without cardiac resuscitation, and 28 day case fatality rates were lower among upper executives in both periods. A coronarography before the acute event had been performed more frequently in men of this category and the proportion of events that could be hospitalised was higher among them. In both periods, the management of acute myocardial infarctions in hospital and prescriptions on discharge were similar among occupational categories. CONCLUSIONS: For patients who could be admitted to hospital, the management was found to be similar among OCs, as was the 28 day case fatality rate among the hospitalised patients. In contrast, lower prognosis and higher probability of being hospitalised after the event among some categories suggest that pre-hospital care and the patient's conditions before the event are the primary factors involved.

Adult↗

PubMed1997

Incidence, case fatality, risk factors of acute coronary heart disease and occupational categories in men aged 30-59 in France.

OBJECTIVES: To assess the incidence and case fatality rate (CFR) from acute coronary insufficiency in men among occupational categories and to analyse the relationship between these disparities and the distribution of cardiovascular risk factors in the French population. SETTING: Three registers of the WHO-MONICA project in France: the urban area of Lille and two French districts: Bas-Rhin and Haute-Garonne. METHODS: Two sets of data were used: 1) the incident cases collected by the three MONICA Collaborating Centres (MCC) of the French WHO-MONICA Project (Lille, Strasbourg and Toulouse), between 1985 and 1989; 2) a cross-sectional study on cardiovascular risk factor prevalence performed in 1985-1989 in the three areas corresponding to the MCC. SUBJECTS: The data concern 5133 new coronary events in men aged 30-59 and a sample of 1863 men aged 30-59. RESULTS: A strong relationship was observed between occupational categories and the incidence of acute myocardial infarction and coronary events as well as CFR. Both incidence and CFR were lower among senior executives. Incidence was higher among employees and workers. However, employees, as opposed to unskilled workers, did not have higher CFR. Using occupational category as a statistical unit, the incidence of first acute myocardial infarction and coronary events was associated with the prevalence of smokers in the population (r = 0.50, P = 0.06 and r = 0.61, P = 0.02). The CFR was associated with systolic blood pressure (r = 0.82, P = 0.002), and the prevalence of smokers (r = 0.65, P = 0.02). None of the measures of incidence or case fatality among categories was related to cholesterol, HDL-cholesterol or body mass index. CONCLUSIONS: Strong differences were observed between occupational categories and the incidence of acute myocardial infarction, coronary events and CFR. These differences were found to be closely related to the social distribution of two major cardiovascular risk factors: tobacco smoking and blood pressure.

Adult↗

PubMed1997

Awareness and control of hypertension and hypercholesterolaemia in France and Northern Ireland.

We assessed awareness and control of hypertension and hypercholesterolaemia in a cross-sectional study of 586 men from France and 189 from Northern Ireland, aged 35-55, without known coronary artery disease. Prevalence of hypertension was 28% in France and 31% in Northern Ireland (p < 0.42). In France, 70% of hypertensive subjects were aware of their status, vs. 58% in Northern Ireland (p < 0.10). Overall, 40% of subjects with a history of hypertension were untreated, and only 32% of the French and 12% of the Northern Irish subjects treated for hypertension (diet with/without drugs) were normotensive. The prevalence of hypercholesterolaemia was 46% in France and 48% in Northern Ireland (p < 0.62). In France, 59% of hypercholesterolaemic subjects were aware of their status, vs. only 17% in Northern Ireland (p < 0.0001). In both countries, half of those with a history of hypercholesterolaemia were untreated, and only 47% of the French and 43% of the Northern Irish patients treated for hypercholesterolaemia (diet with/without drugs) were controlled. While awareness of hypertension is comparable in France and Northern Ireland, awareness of hypercholesterolaemia is much lower in the latter. Control of hypertension and hypercholesterolaemia in both countries is poor and should be improved.

Adult↗

PubMed1997

Sex differences in awareness and control of hypertension in France.

OBJECTIVE: To assess the prevalence, awareness, treatment and control of hypertension for men and women living in three French regions. DESIGN: A cross-sectional population survey. SETTING: Subjects in the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease population surveys of Bas-Rhin, the urban community of Lille and Haute-Garonne, France. SUBJECTS: We studied 1924 men and 1874 women aged 35-64 years. MAIN OUTCOME MEASURES: Hypertension was defined as a systolic blood pressure > or = 160 mmHg, a diastolic blood pressure > or = 95 mmHg, being administered antihypertensive drug treatment or any combination of the foregoing. Treated hypertensive subjects were considered controlled if their systolic blood pressure was < 160 mmHg and their diastolic blood pressure was < 95 mmHg. RESULTS: The prevalence of hypertension was 40.2, 43.8 and 27.7% among men in Lille, Bas-Rhin and Haute-Garonne, respectively. For women, the corresponding values were 31.5, 33.8 and 18.9%. Among hypertensive men, 51.8% were aware of their condition, 30.0% were being administered drug treatment and 9.2% were controlled; the respective values for hypertensive women were 69.8, 51.2 and 25.3% (P < 0.001). Awareness of hypertension was associated with antihypertensive treatment more commonly in Haute-Garonne (81.0% for men and 84.7% for women). The percentages of treated subjects in whom adequate control of the blood pressure had been achieved were only 30.7% for men and 49.4% for women. CONCLUSION: Women have a better awareness of hypertension than do men and their hypertension is controlled better but the low rate of control for both sexes calls for further improvements.

Adult↗

PubMed1997

A novel mutation in the helix termination peptide of keratin 5 causing epidermolysis bullosa simplex Dowling-Meara.

Epidermolysis bullosa simplex Dowling-Meara (MIM# 1317600) is the most severe of the three common epidermolysis bullosa simplex subtypes. In addition to the palmoplantar distribution seen in other epidermolysis bullosa simplex subtypes, extensive herpetiform blistering spontaneously develops on the trunk and limbs and may lead to scarring or milia formation. The keratin 5 and keratin 14 genes encode proteins that form the primary structural components of the basal epidermal keratinocytes, mutations in either of these genes can cause epidermolysis bullosa simplex. In this study we sequenced these genes in a family with epidermolysis bullosa simplex Dowling-Meara. We report a novel T to C transition in the helix termination peptide of K5 that causes a nonconservative substitution of a highly conserved amino acid within this critical region (I466T). This mutation adds to those previously reported and provides further evidence of phenotype-genotype correlation in epidermolysis bullosa simplex.

Amino Acid Sequence↗

PubMed1997

Naevus lipomatosus cutaneous superficialis.

A young male presenting with cutaneous papules and plaques in a segmental distribution in the pelvic girdle area is reported. The clinical features were suggestive of naevus lipomatosus cutaneous superficialis, but diagnostic biopsy is essential to demonstrate the typical histopathological features and exclude important differential diagnoses such as segmental neurofibromatosis.

Adipose Tissue↗

PubMed1997

Computerized patient records benefit physician offices.

The use of computerized patient record systems in ambulatory settings is still a relatively new concept; however, such systems offer a variety of benefits to physician practices. Computerized patient record systems can help improve the quality of care provided, for example, by providing real-time patient status reports, test results as soon as they are available, and graphs and flowsheets of test trends. They can help reduce costs by eliminating many manual functions and the supply and staff expenses associated with these functions. Finally, they can provide practices the data necessary to attract and negotiate favorable managed care contracts. Because computerized patient record technology is still new, substantive empirical evidence upon which to base payback calculations is scarce. Time and motion studies were conducted at a model five-physician, primary care clinic to determine where efficiencies and cost savings could be realized through the use of a computerized patient record system. In addition, actual and anecdotal information from several clinics of comparable size that have such systems was used to reach some preliminary conclusions. Findings suggest that computerized patient record systems may return productivity gains and help physicians attain their patient care and financial goals.

Ambulatory Care Information Systems↗

PubMed1997

[Epidemiology of sudden coronary death in France (1985-1982)].

The physiopathology of sudden coronary death (SCD) is well known. However, its impact on the population of France has not been studied in depth. The MONICA project recenses all coronary events in subjects of 25 to 64 years of age in a given geographic area. The definition of SCD is coronary death occurring less than one hour after the onset of symptoms. Out of 4,004 coronary deaths recorded from 1985 to 1992 in the Bas-Rhin and Haute-Garonne departments, 48% in men and 43% in women were SCD. This event occurred outside hospital in 89% of men and 85% of women. SCD was the first ischaemic symptom in 61% of SCD in men and in 74% of women. Of the SCD occurring outside hospital, 2 to 6% of men and 6 to 7% of women. received emergency treatment in less than 5 minutes. The frequency of SCD increased with age and was highest in men. Between 1985 and 1992, standardised rates (35-64 years) in men fell from 62 to 48/100,000 in the Bas-Rhin (p < 0.01) and from 59 to 36/100,000 in the Haute-Garonne (p < 0.0001); in women, the frequency fell from 17 to 8/100,000 in the Bas-Rhin (p < 0.01) and remained stable in the Haute-Garonne (10/100,000 to 11/100,000). In conclusion, for the first time in France, accurate epidemiological data on SCD is presented, underlying its importance in terms of public health.

Adult↗

PubMed1996

[Cardiovascular risk factors trends in men from Haute-Garonne, 1985-87 and 1989-91. Results from the MONICA project].

Cardiovascular risk factors were assessed in two population surveys conducted in 1985-87 and 1989-91, in Haute-Garonne, among 675 and 590 middle-aged men, respectively. Relative to the first survey, the frequency of reported diabetes increased (9.7 vs 5.5%, p < 0.02), the frequency of hypertension decreased (27.6 vs 21.9%, p < 0.001), body mass index increased (26.3 vs 25.6 kg.m-2, p < 0.001), while the lipid levels did not change (total cholesterol: 2.25 vs 2.29 g/l; HDL-cholesterol: 0.51 +/- 0.13 vs 0.53 +/- 0.14 g/l). Although the frequency of smokers decreased slightly (42.0 vs 34.7%, p < 0.01), the cigarette consumption among smokers did not change (16.0 +/- 13.9 vs 15.7 +/- 12.1 cigarettes/day). These results show that cardiovascular risk factor levels did not improve significantly in Haute-Garonne.

Adult↗

PubMed1996

[Coronary disease in France: data from the MONICA registers (1985-1991)].

The MONICA Project is an international project co-ordinated by the World Health Organisation. The objective of this study is to assess fluctuations in coronary heart disease (CHD) mortality and morbidity. From 1985 to 1991 a continuous and exhaustive registration of acute coronary events (15,775 cases among which 12,789 men and 2,986 women) was carried out in the 3 French MONICA Centres Lille, Strasbourg and Toulouse. During this period, the average rate of CHD mortality according to the death certificates was higher for men in Lille (93/100,000 inh) and Strasbourg (84/100,000 inh) than in Toulouse (57/100,000 inh). The official rates are close to those found by the MONICA Registers if documented myocardial infarctions only are taken into account. If sudden deaths are included, these rates must be multiplied by 1.6. In terms of evolution, official statistics showed an improvement with a mortality decrease of 33%. For the MONICA Registers which include sudden deaths, the decrease was only 20%. Official statistics underestimate coronary death rate and overestimate the decrease tendency. Morbidity rates between the South and the North of France are close, and when compared to Northern Europe countries, France is in an area of moderate incidence. The favourable evolution of coronary disease frequency hides in fact a contrasted evolution: improvement in myocardial infarction recurrence and worsening of incidence. The example of CHD proves that registers provide relevant information for a prevention policy.

Adult↗

PubMed1996

[Therapeutic management of myocardial infarction: trends observed in the MONICA-France project between 1985 and 1991].

This paper describes the trends observed in the treatment of myocardial infarction within the three French MONICA registers between 1985 and 1991. Data, collected according to the WHO-MONICA Protocol, relate to the initial care of patients and the treatment they were prescribed. In this study 2974 cases are included. The time delays before hospitalization do not change in spite of an increasing use of mobile emergency care units. In all three centers there is a strong progression of thrombolysis, increasing from 12% to 41% in Strasbourg, from 21% to 47% in Toulouse and from 31% to 35% in Lille. Antiplatelet drugs rise from 11% to 76% in Strasbourg, from 39% to 85% in Toulouse and from 33% to 76% in Lille. Beta-blockers also progress in the three centers. Prescription of anticoagulants, nitrates and antiarrythmics is constant. In contrast calcium blockers are less prescribed. Duration of hospital stay is much longer in Strasbourg. In Toulouse the resort to coronary angiography (96%) and to angioplasty (51%) is much more frequent than in the two other centers. Similar trends in the three regions reflect the results of the secondary prevention trials conducted in the last years. Differences concern mainly treatments and procedures that were less studied before 1991. It will be interesting to study the trends in the following years in order to estimate the influence of the trials on the homogeneity of practice in the three centers.

Adult↗

PubMed1995

Cardiovascular risk factors and alcohol consumption in France and Northern Ireland.

The levels of different lipid, lipoprotein and haemostatic variables were assessed in 615 control subjects of the ECTIM Study, defined by five groups of alcohol consumption: non-drinkers, 0 < or = 15 g/day, 15 < . < or = 36 g/day, 36 < . < or = 66 g/day and > 66 g/day. After adjustment for age, body mass index, cigarette consumption and country, alcohol consumption was associated with an increase in HDL-cholesterol (0.47 +/- 0.02 to 0.59 +/- 0.01 g/l in non-drinkers and > 66 g/day consumers, mean +/- S.E.M., P < 0.0001), apolipoproteins A-I and A-II (1.37 +/- 0.03 to 1.60 +/- 0.03 g/l and 0.32 +/- 0.01 to 0.41 +/- 0.01 g/l, respectively, P < 0.0001), LpA-I, LpA-I:A-II (0.46 +/- 0.01 to 0.50 +/- 0.01 g/l and 0.75 +/- 0.02 to 0.91 +/- 0.02 g/l, respectively, P < 0.001) and PAi-1 activity (134 +/- 11 to 177 +/- 11 U/ml, P < 0.001). Conversely, no increases were found for total and LDL-cholesterol, triglycerides, apolipoproteins B and C-III, LpE:B, LpC-III:B, fibrinogen and factor VII. Hence, among the lipid and haemostatic variables studied, only HDL parameters and PAi-1 activity were increased by alcohol consumption.

Adult↗

PubMed1995

Medical treatment of myocardial infarction in France and Northern Ireland. Results from the ECTIM study. Enquête cas-Témoins de l'Infarctus du Myocarde.

As part of the ECTIM Study, the medical treatment given to male patients (25-64 years) 3 to 9 months after myocardial infarction (MI) were analysed in France and Northern Ireland. On univariate analysis, hypolipidaemic drugs, angiotensin-converting enzyme inhibitors and antiarrhythmic drugs were found to be prescribed more frequently in France, while beta-blockers were more common in Northern Ireland. No differences were found for diuretics, calcium channel blockers, antithrombotic and anti-anginal drugs, although the Northern Irish patients were mainly on antiplatelet drugs and nitrates, while the French patients received nitrates and non-nitrates, as well as oral anticoagulants and antiplatelet drugs in similar amounts. These differences remained after adjustment for personal history of diabetes, hyperlipidaemia, hypertension, and previous myocardial infarction, but the beta-blocker prescription was no longer significant. When the French centres were analysed, patients from Strasbourg were more frequently on oral anticoagulants and diuretics and less frequently on antiplatelet drugs, while patients from Toulouse had fewer anti-anginal drugs. Hence, although the current guidelines for secondary prevention of myocardial infarction are generally well applied in France and Northern Ireland, significant differences exist regarding the choice of the active drug.

Adult↗

PubMed1995

Autres pays, autres coeurs? Dietary patterns, risk factors and ischaemic heart disease in Belfast and Toulouse.

The WHO MONICA project monitors trends and determinants in cardiovascular disease to relate classical risk factor changes to trends in incidence rates. The Belfast and Toulouse MONICA centres have also collaborated in dietary studies. Both centres have validated incidence and attack rates for ischaemic heart disease using coronary event registration. These data confirm that the disease in middle-aged men is between three and four times as common in Belfast as in Toulouse. Risk factor surveys show some differences between the centres, but the overall risks assessed by two multiple logistic function scoring systems were identical. A weighed dietary survey revealed no important difference in macronutrient intake, although carbohydrate and saturated fat intake in Belfast was significantly higher. Protein, dietary cholesterol and polyunsaturated fat, particularly linoleic acid intake, was significantly higher in Toulouse, as was consumption of wine, cheese, fruit and vegetables, but not potatoes. The Northern Irish diet is typically Northern European, but although the diet in Toulouse has some features of the Mediterranean diet, it is not appreciably different from that in Belfast in terms of total fat intake. Major differences are present for several food items, and in general these differences add support to the antioxidant hypothesis.

Antioxidants↗