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Biomedical subjects

C M Suchindran

Publications and source records attributed to C M Suchindran.

At least 37 records · Page 2Linked to original sources
PubMed1989

Coronary heart disease morbidity and mortality in hypercholesterolemic men predicted from an exercise test: the Lipid Research Clinics Coronary Primary Prevention Trial.

A positive exercise electrocardiogram (ECG) has been proved to predict cardiovascular events in asymptomatic normolipidemic men. To study whether it is also predictive for hypercholesterolemic men, data from 3,806 asymptomatic hypercholesterolemic men in the Lipid Research Clinics Coronary Primary Prevention Trial were analyzed. All the men had performed a submaximal treadmill exercise test at baseline, before they were assigned to the cholestyramine or placebo treatment group. Because of missing or inconclusive data, 31 men were excluded from the analyses. A test was positive if the ST segment was displaced by greater than or equal to 1 mm (visual code) or there was greater than or equal to 10 microV-s change in the ST integral (computer code), or both. The prevalence of a positive test was 8.3%. During the 7 to 10 year (mean 7.4) follow-up period, the mortality rate from coronary heart disease was 6.7% (21 of 315) in men with a positive test and 1.3% (46 of 3,460) in men with a negative test (placebo and cholestyramine groups combined). The age-adjusted rate ratio for a positive test, compared with a negative test, was 6.7 in the placebo group and 4.8 in the cholestyramine group. With use of Cox's proportional hazards models, it was found that the risk of death from coronary heart disease associated with a positive test was 5.7 times higher in the placebo group and 4.9 times higher in the cholestyramine group after adjustment for age, smoking history, systolic blood pressure, high density lipoprotein cholesterol and low density lipoprotein cholesterol. A positive test was not significantly associated with nonfatal myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1989

Male infertility in inflammatory bowel disease.

We examined fertility in men with inflammatory bowel disease (IBD) to determine whether the reported deficit in pregnancies in their spouses was due to reduced reproductive capacity. The cases were 106 men with Crohn's disease and 62 with ulcerative colitis drawn from the rosters of North Carolina chapters of the National Foundation for Ileitis and Colitis. The 140 normal controls were neighbors identified by the cases. There were 186 pregnancies among the spouses of men with Crohn's disease, 110 among the ulcerative colitis group, and 300 among the controls. The mean number of pregnancies among the Crohn's disease patients (1.75 +/- 0.12) was significantly lower than the number for controls (2.14 +/- 0.11), p less than 0.02. The reduction in the mean number of pregnancies among patients with ulcerative colitis (1.77 +/- 0.18) was not significantly different from controls (p less than 0.07). Analysis of waiting time to conception showed that fecundability (the probability of pregnancy in a menstrual cycle) was not different in spouses of IBD patients and controls. We conclude that the overall reproductive capacity of men with IBD is not markedly diminished.

Adult↗
PubMed1989

Heterogeneous risk models.

"This paper briefly reviews the heterogeneous risk models in demography. With a specific model, it is shown that in a heterogeneous population, the marginal hazard need not be monotonic. Procedures described in the literature to recover individual hazards from marginal hazards without precise knowledge of structural parameters can lead to biased results. Strategies of parameter estimation and testing are discussed. The results are extended to [the] multistate life table."

Biology↗
PubMed1987

Cardiovascular mortality and noncontraceptive use of estrogen in women: results from the Lipid Research Clinics Program Follow-up Study.

A cohort of 2270 white women, aged 40-69 years at baseline, were followed for an average of 8.5 years in the Lipid Research Clinics Program Follow-up Study. There were 44 deaths due to cardiovascular disease among the 1677 nonusers of estrogens and six cardiovascular disease deaths among the 593 estrogen users. The age-adjusted relative risk (RR) of cardiovascular disease deaths in users compared with nonusers was 0.34 (95% confidence limits 0.12 to 0.81). After multivariable adjustment for potential confounding factors (age, blood pressure, and smoking), the estimated RR for estrogen use was 0.37 (95% confidence limits 0.16 to 0.88). Analyses were done to explore whether these results could be due to selection bias for estrogen use. However, the prevalence of cardiovascular disease at baseline was slightly higher in estrogen users (12%) than in nonusers (10%); furthermore, the exclusion of all women with prevalent cardiovascular disease at baseline did not alter the apparent protective effect of estrogen use on cardiovascular disease mortality (RR = 0.42, 95% confidence limits 0.13 to 1.10). Additional analyses examining the complex association between estrogen use, lipoprotein levels, and cardiovascular disease mortality suggest that the protective effect of estrogen is substantially mediated through increased high-density lipoprotein levels.

Adult↗
PubMed1986

Dyslipoproteinemia in black participants. The Lipid Research Clinics Program Prevalence Study.

A comparison of blacks and whites 6 to 49 years old revealed striking differences between races with respect to the prevalence of various dyslipoproteinemias and mean plasma lipid levels. Compared with whites, juvenile and adult blacks of both sexes had higher mean levels of high-density lipoprotein cholesterol (HDL-C), with correspondingly higher prevalences of the hyperHDL and hypoLDL (low-density lipoprotein) phenotypes. In contrast, whites showed a much higher prevalence of type IV hyperlipoproteinemia and higher mean triglyceride levels in most age-sex groups. Although juvenile blacks had higher mean levels of LDL-C than did whites, this race difference was reversed in men, while women showed inconsistent differences between races. Adult black men and juvenile blacks of both sexes had a somewhat higher prevalence of the type IIA phenotype than whites. The distribution of major HDL-C predictors in this population could not account for the difference in prevalence of hyperHDL between races. These findings suggest that health professionals may find differences in plasma lipid and lipoprotein patterns between their black and white patients, but additional research is needed to ascertain the disease risks associated with dyslipoproteinemia among blacks.

Adolescent↗
PubMed1986

Progeny's lipid and lipoprotein levels by parental mortality. The Lipid Research Clinics Program Prevalence Study.

Using data from Lipid Research Clinics study participants at visit 2 (3972 and 2346 adult men and women), we examined the hypothesis that parental mortality from cardiovascular disease (CVD) or cancer before age 60 predicts their adult progeny's lipid and lipoprotein levels. Weighted regression analysis was used to control for the potential effect of progeny's other CVD risk factors (age, systolic blood pressure, Quetelet index, cigarette smoking, and alcohol consumption), and to assess for the effect of progeny's parental cause-specific mortality status on progeny's lipids and lipoproteins. Nearly all of the statistically significant parent-progeny predictions were for sons. Paternal death from CVD before age 60 years was associated with significantly higher plasma total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels in sons and (at marginal significance) in daughters, when compared with those in reference progeny with paternal survival over age 60 or over age 75. Maternal death from CVD before 60 was associated with lower levels of high-density lipoprotein cholesterol (HDL-C) in sons. Paternal and maternal death from cancer before age 60 years were associated with higher triglyceride levels in adult sons than in sons whose parents had lived beyond ages 60 and 75. Paternal all-cause mortality before age 60 was associated with higher cholesterol and triglycerides in sons; maternal all-cause mortality before age 60 was associated with depression of HDL-C in sons. Familial aggregation of lipids and lipoproteins may account, in part, for familial aggregation of CVD. Knowledge of family history facilitates identification of progeny at higher risk for CVD by virtue of elevated cholesterol or LDL-C, or reduced HDL-C.

Adult↗
PubMed1986

Customary diet, anthropometry, and dyslipoproteinemia in selected North American populations. The Lipid Research Clinics Program Prevalence Study.

The intake of nutrients, determined by 24 hr diet recall, and body measurements were obtained in 8250 free-living white study participants divided into 20 to 49 and 50 + age groups for males and female nonusers and users of gonadal hormones. They were classified into dyslipoproteinemia (DLP) phenotypes: hyperHDL, hypoHDL, IIA, hpypoLDL, IV, and normal. The dyslipoproteinemia DLP phenotypes, compared with the normal, had biologically meaningful differences in nutrient intake and indexes of obesity that were most marked for males aged 20 to 49 years as shown in the table (below). Those with the hyperHDL phenotype were thinner and ingested more energy and more alcohol and less carbohydrate as percent kilocalories (%kcal). Individuals classified as hypoHDL were fatter and tended to ingest less energy and less alcohol as %kcal. Persons with the type II phenotype were fatter and ingested less energy. Those with hypoLDL tended to be thinner and ingested more energy. Individuals with the type IV phenotype were fatter, ingested less energy and carbohydrate and more alcohol as %kcal. Similar trends were observed in female nonusers of hormones aged 20 to 49 and to a lesser extent in the 50 + age groups and in female users of hormones. Dietary protein, cholesterol, total fat, and polyunsaturated and saturated fatty acids had no consistent associations with DLP phenotype, and sucrose and starch had no association independent of total carbohydrate. This is the first evidence of an association of customary diet and DLP phenotypes in the free-living population. Equating energy intake with energy expenditure, persons with the high-risk phenotypes, IIA, IV, and hypoHDL, compared with the normal, had decreased energy expenditure and were fatter, whereas those with the low-risk phenotypes, hyperHDL and hypoLDL, had increased energy expenditure and were thinner.

Adult↗
PubMed1981

A randomized prospective study of the use-effectiveness of two methods of natural family planning.

The final results of a prospective comparative study of two methods of natural family planning indicate a significant difference in the 12 month net cumulative pregnancy rates between the ovulation and symptothermal methods. These differences are on the order of two to one in favor of the symptothermal method. Pearl pregnancy rates confirm similar differentials between the two methods. Dropout rates for both methods were high. Lack of interest or dissatisfaction with the method was the major reason for dropout training while pregnancy or desire for pregnancy were the major reasons for dropout during the formal phase of the study.

Adult↗
PubMed1975

Estimates of fecundability from a truncated distribution of conception times.

A population consisting of women who have conceived before a time t ignores all women whose conception time exceeds t. Such a population is considered as a truncated population, and the samples are called truncated samples. Under the assumption that fecundability among women varies according to a Beta distribution (with parameters a and b), the distribution of conception times in a truncated population can be considered as truncated Type I geometric. This paper presents an algorithm to obtain the moment and maximum likelihood estimates of a and b from the truncated samples. Large sample properties of the estimators are also studied. Examples using the Hutterite and the Princeton Fertility Survey data are given.

Female↗