Search PubMed⌕ Search

Biomedical subjects

A Menotti

Publications and source records attributed to A Menotti.

At least 181 records · Page 10Linked to original sources
PubMed1988

Normotensive middle-aged men after 5-10 years: normal blood pressure or hypertension?

We evaluated the incidence of hypertension over 5-10 years of follow-up in middle-aged men, 40-59 years at entry, selected from the Italian section of the Seven Countries Study. Out of the 2480 subjects, 852 were normotensive at entry [systolic blood pressure (SBP) less than 140 mmHg and diastolic blood pressure (DBP) less than 90 mmHg)], alive after 10 years and had been evaluated repeatedly after 5 and 10 years. After 5 years, 31.3% had developed borderline hypertension (140 less than or equal to SBP less than 160 and 90 less than or equal to DBP less than or equal to 95 mmHg) and 14.6% had developed definite hypertension (SBP greater than or equal to 160 mmHg or DBP greater than or equal to 95 mmHg). During the next 5 years, out of the 267 borderline hypertensives, 28.5% became definite hypertensives, while 29.6% reverted to normal blood pressure. Out of the 124 definite hypertensives, 46% remained in this category, while 34.7% became borderline hypertensives and 19.4% became normotensive. In men aged 60-69 years, less than 2% of hypertensives were being effectively treated and changes in body weight were closely related to blood pressure. In addition, out of 461 normotensive subjects who remained normotensive at the 5-year examination, 63.6% remained normotensive in the next 5 years also, while 28% developed borderline hypertension and only 8.4% moved into the definite hypertensive class. These data suggest that a normotensive subject aged 40-59 years has a 34.4% probability of remaining normotensive in the next 10 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Follow-Up Studies↗
PubMed1988

Improved determination of selenium in serum by Zeeman atomic absorption spectrometry.

We have improved Zeeman atomic absorption spectrometric determination of selenium in serum by using an acidic solution of Ag + Cu + Mg as a matrix modifier and performing the charring step in flowing O2. Under these conditions, we could calibrate serum results with selenium standards in bovine albumin solutions. Mean analytical recovery was 98%, and the CV was 1.8% within runs, 2.9% between runs. Analysis of Reference Materials from the U.S. National Bureau of Standards (SRM 909 and RM 8419) yielded the values of 106 (SD 2.4) and 15 (SD 1.6) microgram/L, respectively, in good agreement with the expected values (106 and 16, respectively). The method--being reliable and relatively simple and rapid--is suitable for use in epidemiological screenings. Mean selenium concentrations in serum sampled from 274 adults in central Italy were 90 (SD 15) microgram/L. For 11-year-old children, these values were lower and showed a tendency to sex-related difference: 82 (SD 9.9) microgram/L for 97 boys, 78 (SD 9.3) microgram/L for 90 girls.

Adult↗
PubMed1988

Primary pulmonary hypertension: an Italian multicenter study. A retrospective epidemiological survey in the period 1975-1985.

An epidemiological retrospective survey on primary pulmonary hypertension was undertaken in Italy in 1985-6. The aim of the study was to obtain clinical and laboratory data on patients observed in the major cardiological Institutions, both Universities and Hospital Clinical Centers, in the period 1975-85. Forms were sent to 67 centers and twenty-three of them communicated their data on 124 cases of primary pulmonary hypertension. The diagnosis was considered certain or probable in 91 patients by the referring center. The mean age of patients was 38.5 years, with an overall female-to-male ratio of 2:1. Data were subjected to statistical analysis which confirmed the poor prognosis of the disease particularly for patients with high pulmonary resistances, low cardiac output and in class 3-4 of the NYHA. Half of the 124 cases were treated with calcium antagonists after 1980, but the results of therapy in modifying the clinical course of the disease could not be assessed by the study. Like all retrospective studies even the Italian Multicenter Study is biased but it can be considered as an useful preliminary investigation which can form the basis for a prospective registry of primary pulmonary hypertension cases.

Age Factors↗
PubMed1987

Coronary risk factors and survival probability from coronary and other causes of death.

The analysis concerns the two rural Italian cohorts of the Seven Countries Study and includes 1,712 men who, at the entry examination in 1960, were aged 40-59 years and whose 20-year follow-up examinations were complete for life status, dates, and causes of death. Excluded were 175 men because they lacked one or more of the risk factors selected for the study. A total of 517 deaths occurred in the remaining 1,537 men. The Cox proportional hazards regression model was applied with a forward procedure to include the entry risk factors in the model. First, total mortality was used as the endpoint. Then the risk factors identified as being related to total mortality were used to predict specific causes of death, i.e., coronary heart disease, stroke, cancer, violent death, and other causes. Blood pressure appeared as a nonspecific risk factor for all causes, including cancer and violence, forced expiratory volume and arm circumference appeared as nonspecific risk factors, smoking habits could not be easily classified, and cholesterol was definitely specific only for coronary deaths. Models for estimating survival probabilities from total mortality and from any of several causes of death are provided.

Adult↗
PubMed1987

Determinants of all causes of death in samples of Italian middle-aged men followed up for 25 years.

A total of 1712 men aged 40 to 59 years in two rural cohorts of northern and central Italy have been followed up for 25 years after an entry examination in 1960. Forty one individual characteristics have been considered as possible predictors of death in the next 25 years. After exclusion of 55 men with life threatening diseases (cardiovascular and cancer) and of 161 men because of missing measurements, 1495 men have been analysed for relation between entry factors and subsequent death (n = 670). Twelve factors eventually emerged as powerful predictors of future death: in hierarchical order, age, blood pressure, forced expiratory volume, cigarette smoking, xanthelasma, mother life-status, arm circumference, father life-status, shoulder-pelvis ratio, vital capacity, arcus senilis, and serum cholesterol. Discrimination as provided by logistic modelling placed 19.6% of all cases in the upper decile of the estimated risk, 36.8% in the upper quintile, 2.5% in the lowest decile, and 7.1% in the lowest quintile. Out of those located in the lowest decile of risk, 11.4% died within 25 years while the corresponding percentage in the upper decile was 87.3%. Use of the Cox model yielded slightly better coefficients than logistic function.

Adult↗
PubMed1987

Blood pressure, serum cholesterol and smoking habits predicting different manifestations of arteriosclerotic cardiovascular diseases.

1661 men aged 40-59 belonging to two rural communities in Italy were enrolled into a longitudinal study in 1960 and some risk factors were measured. In the next 25 years 779 died from all causes, 309 died from arteriosclerotic cardiovascular diseases, and, in particular, 201 from coronary heart disease (CHD), 96 from stroke (STR) and 12 from peripheral arteriosclerotic disease (PAD). The predictive power of mean blood pressure (MBP), of serum cholesterol (CHOL), of cigarette consumption (CIG) and of age (AGE) was evaluated by the multiple logistic model. Beyond AGE, which was always relevant to prediction, the three major risk factors were significant predictors of all cardiovascular diseases (ACVD) and of CHD; only MBP was a significant predictor of STR whereas the limited number of cases prevented from the possibility to obtain stable and significant coefficients for PAD. Within three different sub-categories of CHD only cases ending-up as sudden deaths were significantly related to the three factors including smoking habits, whereas those manifested as myocardial infarction (without sudden death) and those manifested as chronic coronary heart disease (atypical CHD) were related only to MBP and to CHOL.

Adult↗
PubMed1986

The prediction of future health in healthy middle-aged men.

Two cohorts of men aged 49-59 at entry, representing cluster samples of two rural areas in Northern and Central Italy, for a total of 1712 subjects have been followed-up for 20 years within an epidemiological study originally designed for cardiovascular disease. After 20 years, only 41 men have been judged to have remained substancially healthy throughout the observation period, i.e. free from a number of major diseases. Univariate and multivariate analyses trying to predict the maintenance of health status showed that among 21 selected characteristics only the following one had a significant power: age, cigarette smoking (adverse effect) and vital capacity (favourable effect). A minor role was also played by the body mass index (adverse effect) and forced expiratory volume (favourable effect). Those who did not remain healthy exibited a greater increase in blood pressure and body mass index.

Adult↗
PubMed1986

Age, period, cohort and geographical area effects on the relationship between risk factors and coronary heart disease mortality. 15-year follow-up of the European cohorts of the Seven Countries study.

The effects of three major risk factors (i.e. serum cholesterol, systolic blood pressure and smoking habits) on prediction of coronary heart disease (CHD) mortality in relation to three nuisance variables--i.e. geographical location, age of subject at examination and period of examination--are analyzed using data from three different 5-year apart examinations of the Seven Countries Study and observations on CHD mortality in the corresponding 15-year follow-up period. First, a cross-classification exploratory analysis including both CHD-free subjects at entry and prevalence subjects, by different geographical areas, age classes and examination times is presented. Secondly, a logistic regression including the three major risk factors and the three nuisance variables, regarded both as confounders and effect modifiers is discussed. The prevalence status of the subjects is also considered as a nuisance variable in this second analysis. Results showed that: (a) there is a highly significant (p less than 0.001) marked decrease in the association between cholesterol level and CHD mortality with increasing age of subject; (b) a decreasing association with coronary heart disease mortality as age increases also holds for smoking habits (p less than 0.05). This association, however, tends to be reinforced with time (p less than 0.05), i.e. the relative risk of heavy smokers vs non-smokers is four times bigger in the period 1970-75, than in the period 1960-65, age and all other factors being equal; (c) a possible dependence of the association between systolic blood pressure and CHD on geographical area is suggested, although this finding could be the result of chance with a 10% probability.

Adult↗
PubMed1986

Risk factors for definite hypertension: cross-sectional and prospective analyses of two Italian rural cohorts.

Risk factors for definite hypertension were examined using data from two Italian rural cohorts from the Seven Countries Study, originally composed of 1,712 men ages 40-59 at entry. Two approaches were used: cross-sectional examination of baseline exposure/outcome measurements; and prospective examination of data, correlating baseline measurements with subsequent definite hypertension, diagnosed at the 10-year follow-up exam. Hypertension was defined as diastolic blood pressure greater than or equal to 95 mm Hg or systolic blood pressure greater than or equal to 160 mm Hg. Included in the cross-sectional analysis were 1,437 subjects free from other cardiovascular diseases at baseline. Of these, 590 were included in the prospective analysis. Using a multiple logistic function that did not include baseline (normal) blood pressure, age, pulse rate, and weight were confirmed as risk factors for hypertension both cross-sectionally and prospectively, thus suggesting that bias cannot explain the relationship of hypertension to these factors. Although proteinuria and vital capacity were associated with hypertension in the cross-sectional analysis, no such relationships were detected prospectively, thus implying that these factors are effects, rather than determinants, of definite hypertension. Smoking had a negative prospective (but not cross-sectional) association with hypertension, which can probably be explained by survival bias at 10 years after ascertainment of smoking habits. When mean baseline blood pressure was added to the prospective multiple logistic function, it became the only factor significantly associated with hypertension (P less than 0.001), again confirming the importance of "tracking" in the determination of hypertension.

Age Factors↗
PubMed1986

The diet and 15-year death rate in the seven countries study.

In 15 cohorts of the Seven Countries Study, comprising 11,579 men aged 40-59 years and "healthy" at entry, 2,288 died in 15 years. Death rates differed among cohorts. Differences in mean age, blood pressure, serum cholesterol, and smoking habits "explained" 46% of variance in death rate from all causes, 80% from coronary heart disease, 35% from cancer, and 45% from stroke. Death rate differences were unrelated to cohort differences in mean relative body weight, fatness, and physical activity. The cohorts differed in average diets. Death rates were related positively to average percentage of dietary energy from saturated fatty acids, negatively to dietary energy percentage from monounsaturated fatty acids, and were unrelated to dietary energy percentage from polyunsaturated fatty acids, proteins, carbohydrates, and alcohol. All death rates were negatively related to the ratio of monounsaturated to saturated fatty acids. Inclusion of that ratio with age, blood pressure, serum cholesterol, and smoking habits as independent variables accounted for 85% of variance in rates of deaths from all causes, 96% coronary heart disease, 55% cancer, and 66% stroke. Oleic acid accounted for almost all differences in monounsaturates among cohorts. All-cause and coronary heart disease death rates were low in cohorts with olive oil as the main fat. Causal relationships are not claimed but consideration of characteristics of populations as well as of individuals within populations is urged in evaluating risks.

Adult↗
PubMed1985

Serum cholesterol and cancer mortality in the Seven Countries Study.

In the Seven Countries Study, carried out in Finland, Greece, Italy, Japan, The Netherlands, the United States, and Yugoslavia, among 11,325 "healthy" men aged 40-59 years in 15 years, there were 594 cancer deaths. Among 477 cancer deaths five years after cholesterol measurement, there was a significant excess of lung cancer deaths in the bottom 20% of the cholesterol distributions in the populations. Age, blood pressure, smoking habits, occupation, and relative body weight did not help explain this. A U-shaped relationship between cancer and cholesterol was not seen in any population. Trend analysis with various cutting points indicated increasing risk of lung cancer death at cholesterol levels under 170 mg/dl. The 45 men dead from cancer in the first two years had lower cholesterol levels than their compatriots who died from cancer later but they did not differ in relative weight or fatness. In contrast to relationships for individuals within populations, the highest cancer death rates were in northern Europe, where the general level of cholesterol was also highest. Other characteristics of the populations--age, relative weight, smoking habits, blood pressure, physical activity, and vitamin A and ascorbic acid in the diet--did not help in the attempt to understand the regional differences in cancer mortality. There is no evidence that any of the observed cancer-serum cholesterol relationships among or within the populations involve an effect of serum cholesterol concentration on oncogenesis or cancer mortality but the possibility of such an effect cannot be denied.

Adult↗