Biomedical subjects

D M Reed

Publications and source records attributed to D M Reed.

At least 55 records · Page 3Linked to original sources

PubMed1988

A prospective study of mortality and morbidity among carpenters in the Honolulu Heart Program Cohort.

The relationship of occupation as a carpenter to the development of definite coronary heart disease, stroke, cancer and total mortality was examined in men of Japanese ancestry participating in the Honolulu Heart Program. After 18 years of follow-up those men who indicated that their present and usual occupation was carpentry had a significantly lower age-adjusted rate of definite coronary heart disease and a significantly lower mortality rate compared to participants who were never occupied as carpenters. There were no significant differences for age-adjusted rates for stroke and cancer nor any differences for those whose usual occupation was carpentry but present occupation was not carpentry. These results were unchanged when controlling for several cardiovascular risk factors and potentially confounding variables. Unlike earlier observations, these findings are not affected by the "healthy worker bias" and support the relationship that carpentry is associated with lower rates of cardiovascular disease.

Cerebrovascular Disorders↗

PubMed1988

Predictive value of resting electrocardiograms for 12-year incidence of stroke in the Honolulu Heart Program.

The importance of electrocardiographic (ECG) abnormalities at baseline examination for subsequent risk of stroke was analyzed in a 12-year follow-up of 7,560 men in the Honolulu Heart Program, aged 45-68 years, who were free of coronary heart disease and stroke at baseline. Age-adjusted univariate analysis showed that men with major ST depression, left ventricular strain, left ventricular hypertrophy, major T wave inversion, and overall major ECG abnormalities had considerably higher (2.5-5.4 times) incidence rates of both thromboembolic and hemorrhagic stroke than those with normal baseline ECG. When blood pressure, age, cigarette smoking, alcohol consumption, fat intake, serum glucose concentration, serum uric acid concentration, years of education, and years lived in Japan were taken into consideration through multivariate analysis, the ECG abnormalities retained a significant relation with stroke. Our study demonstrates that resting ECG abnormalities are independent predictors of both thromboembolic and hemorrhagic stroke.

Aged↗

PubMed1988

A prospective study of cerebral artery atherosclerosis.

Atherosclerosis in the circle of Willis and its major branches was studied prospectively in 198 men in the Honolulu Heart Program who were free of cardiovascular disease at the entry examination. The level of atherosclerosis was greater in the large arteries of the circle of Willis than in the small arteries, and autopsy-verified cerebral infarction was strongly associated with increasing severity of atherosclerosis in both. Analyses of the association of atherosclerosis scores with biologic and lifestyle characteristics measured at entry into the study indicated that atherosclerosis in the large arteries was consistently related to age, diastolic blood pressure, serum cholesterol, and height (inversely). Weak trends of association were also found with increasing serum glucose concentration, increasing cigarette use, and decreasing alcohol intake. Atherosclerosis scores in the small arteries were associated with diastolic blood pressure and serum triglyceride concentration. Analysis of dietary intake indicated that atherosclerosis scores were higher for men who reported low intakes of fat and animal protein and high intakes of vegetable protein and total carbohydrates. These patterns were consistent with similar findings on the incidence of clinical stroke in this cohort. Age-adjusted and -specific atherosclerosis scores from both the large and small arteries declined significantly during the period 1965-1983.

Age Factors↗

PubMed1988

Correlates of FEV1 and prevalence of pulmonary conditions in Japanese-American men.

Correlates of forced expiratory volume in one second (FEV1) and the prevalence of pulmonary disease and symptoms were examined in 6,346 Japanese-American men 45 to 68 yr of age. There was a significant inverse dose-response relationship between FEV1 and cigarette smoking measured as pack-years, number of cigarettes, or number of years smoked. Ex-smokers had FEV1 values that were intermediate to the higher values for nonsmokers and the lower values for current smokers. Among current smokers, inhaling and starting to smoke at a younger age were associated with lower values of FEV1, independent of pack-years. FEV1 was also correlated with a variety of other biologic and sociobehavioral variables, even after removing the effects of smoking. These variables included skinfold thickness, dynamometry, hematocrit, triglycerides, and systolic blood pressure. When compared with Caucasian populations, these Japanese-American men had low prevalence rates of airflow obstruction and pulmonary disease symptoms.

Aged↗

PubMed1988

Physical activity and coronary heart disease in middle-aged and elderly men: the Honolulu Heart Program.

The relationship of physical activity to the development of definite coronary heart disease was examined separately in middle-aged (45-64 years) and elderly men (65-69 years) participating in the Honolulu Heart Program. After 12 years of follow-up, results indicate that increased levels of physical activity reported at study entry were inversely related to the risk of definite coronary heart disease in both age groups. In particular, among those aged 45 to 64 years, the rate of definite coronary heart disease in men who led active life styles was 30 per cent lower than the rate experienced by those who were less active (relative risk, 0.69; 95% confidence interval, 0.53, 0.88). In those older than 64 years, the rate of definite coronary heart disease in active men was less than half the rate experienced by those who led more sedentary life styles (relative risk, 0.43; 95% CI, 0.19, 0.99). These results continued to hold up when controlling for several cardiovascular risk factors and potentially confounding variables, supporting earlier observations that physical activity is beneficial in middle-age, and further suggesting that benefits may extend to the elderly male population as well.

Aged↗

PubMed1988

Blood pressure, nephrosclerosis, and age autopsy findings from the Honolulu Heart Program.

The aspect of nephrosclerosis reflected by fibrous intimal thickening of small arteries (arteriosclerosis) was measured by a newly introduced morphometric procedure in 154 autopsies of Japanese-American men in Honolulu. These men were subjects of the Honolulu Heart Program and had previously been assessed for blood pressure and other clinical characteristics in a prospective study. In periodic acid-Schiff (PAS)-stained sections of renal cortex, measurements were made of interlobular artery diameters and intimal thicknesses. Vessels of outer diameter 80 to 130 microns and 160 to 300 microns were examined separately and are called the "remote" and "close" levels of the interlobular arteries, respectively, defined in relation to the heart. Nephrosclerosis thus quantified, together with age, could be used to predict the levels of blood pressure (BP) to be found in retrospective review of past records. The mathematical function obtained in a former study to make these predictions was found to predict the observed levels of blood pressure to an acceptable degree in the groupings that involved 92% of the subjects. Verification of that formerly obtained predictive function is now claimed. Correlation coefficients relating BP to close and remote measures were about of equal magnitude (r = 0.34 and 0.40, respectively). Subjects with cardiovascular-renal causes of death differed in both nephrosclerosis and blood pressure from subjects whose cause of death was unrelated to cardiovascular-renal diseases; the two factors taken together each contributed significantly to the cause of death difference. Correlations between nephrosclerosis and aortic atherosclerosis were stronger than could be explained solely by a linkage to observed values of blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1987

Central obesity and coronary heart disease in men.

The relation between central body fat distribution, determined by measurement of subscapular skinfold thickness (SSF), and the development of definite coronary heart disease (CHD) was examined after 12 years of follow-up in a cohort of 7692 men who participated in the Honolulu Heart Program. The risk of incident coronary events was directly related to SSF. Compared with men in the lowest tertile of SSF, those in the middle tertile experienced a 70% excess of definite CHD. For those in the highest tertile, the excess more than doubled. For a given level of body mass index (BMI), SSF remains a significant and independent predictor of definite CHD, even after adjustment for age, total cholesterol, glucose, triglycerides, hypertensive status, and cigarette smoking. In contrast, the independent effect of BMI was not significant after adjustment for SSF. Thus centrally obese individuals are at increased risk of CHD, independent of BMI.

Body Height↗

PubMed1987

Diabetes and the risk of stroke. The Honolulu Heart Program.

From 1965 to 1968, the Honolulu Heart Program began following up a cohort of men in a prospective study of cardiovascular disease. For this report, we examined the 12-year risk of stroke in 690 diabetic and 6908 nondiabetic subjects free of coronary heart disease and a history of stroke at study entry. In 12 years of follow-up, 62.3 per 1000 diabetic men and 32.7 per 1000 nondiabetic men experienced a stroke. The relative risk of thromboembolic stroke for those with diabetes compared with those without diabetes was 2.0 (95% confidence limits, 1.4 to 3.0). Although diabetes was usually associated with an atherogenic risk profile, control of hypertension, complicating myocardial infarction, and other risk factors failed to diminish the effect of diabetes on stroke. Among those without diabetes, the relative risk of thromboembolic stroke for those at the 80th percentile of serum glucose level compared with those at the 20th percentile (199 vs 115 mg/dL [11.0 vs 6.4 mmol/L]) was 1.4 (95% confidence limits, 1.1 to 1.8). In the nondiabetic sample, the relative risk of thromboembolic stroke for those with glucosuria compared with those without glucosuria was 2.7 (95% confidence limits, 1.6 to 4.5). There was no association between diabetes, or measures of glucose intolerance, and hemorrhagic stroke. We conclude that diabetes, even in a possibly undiagnosed subset of hyperglycemic individuals, imparts an additional independent risk of stroke unexplained by clinically measured risk factors.

Blood Glucose↗

PubMed1987

Postmortem findings in sudden and non-sudden deaths among Japanese-American men in Hawaii.

Analyses were made of the cause of death and major pathologic findings among 1,085 autopsied Japanese-American men in Hawaii to determine the differences between the 167 men who experienced sudden death within 24 hours of being well and the 918 men with non-sudden death. Sudden deaths were further divided into three subgroups according to the interval from the onset of symptoms to death: (less than one hour; one to six hours; more than six hours). Nearly 90 percent of sudden deaths and 25 percent of non-sudden deaths were attributed to cardiovascular disease. The proportion of deaths due to coronary heart disease was highest in sudden deaths less than one hour (72 percent) and lowest in sudden deaths more than six hours (49 percent), whereas the proportion of stroke deaths was highest in sudden deaths more than six hours (37 percent) and lowest in sudden deaths less than one hour (9 percent). The prevalence of myocardial infarction and the grade of coronary atherosclerosis were also significantly greater for sudden deaths (especially sudden deaths less than one hour) than for non-sudden deaths.

Aged↗

PubMed1987

Relationship of magnesium intake and other dietary factors to blood pressure: the Honolulu heart study.

Associations between blood pressure and intakes of 61 dietary variables assessed by 24-h recall method were investigated in 615 men of Japanese ancestry living in Hawaii who had no history of cardiovascular disease or treated hypertension. Magnesium, calcium, phosphorus, potassium, fiber, vegetable protein, starch, vitamin C, and vitamin D intakes were significant variables that showed inverse associations with blood pressure in univariate and a multivariate analyses. Magnesium had the strongest association with blood pressure, which supports recent interest in its relation to blood pressure. Nevertheless, it was not possible to separate the effect of magnesium from that of other variables because of the problem of high intercorrelation among many nutrients. While recommendations based upon cross-sectional studies must be viewed cautiously, these results suggest that foods such as vegetables, fruits, whole grains, and low-fat dairy items are major sources of nutrients that may be protective against hypertension.

Aged↗

PubMed1987

Predictors of atherosclerosis in the Honolulu Heart Program. I. Biologic, dietary, and lifestyle characteristics.

Of 8,006 men of Japanese ancestry living in Hawaii who were followed from 1966 to 1983 for incident cardiovascular disease, 1,381 died and 290 had a protocol autopsy which included determination of the extent of atherosclerosis in the coronary arteries and aorta. More than 50 biologic, lifestyle, and dietary characteristics, measured in 258 of the men who did not have existing evidence of definite coronary disease or stroke at the baseline examination, were examined for association with the measures of atherosclerosis using models which did and did not include adjustments for autopsy selection bias. Blood pressure and serum cholesterol were the strongest and most consistent predictors of atherosclerosis in both the coronary arteries and aortas. Cigarette smoking was also consistently associated with aortic atherosclerosis and inconsistently with coronary atherosclerosis. Several other variables often associated with clinical coronary artery disease in this cohort were not found to be independently associated with atherosclerosis. These included alcohol use, physical activity, serum glucose, triglyceride, and uric acid levels. None of more than 25 measures of dietary patterns and 24-hour dietary intake was associated with atherosclerosis in any statistical model. Examination of age-adjusted and age-specific levels of atherosclerosis over time from 1966 to 1983 showed a slight decrease in coronary atherosclerosis and a slight increase in aortic atherosclerosis; however, these trends were not significant. Both myocardial scars measured at autopsy and clinical evidence of myocardial infarction were significantly associated with the coronary atherosclerosis scores.

Aged↗

PubMed1987

Predictors of atherosclerosis in the Honolulu Heart Program. II. Adjustment for autopsy bias.

Although autopsy is considered the final word on many medical questions, there has long been concern over possible bias in inference about a living population from analysis of autopsy material. Focus of the present paper is on the relationship between results obtainable only at autopsy and risk factors recorded as part of a prospective study of the entire "target population." Since pathologies are sure to be overrepresented in an autopsy sample compared to the target population, the dependence of autopsy scores upon risk factors may be distorted in the autopsy sample. The present paper proposes a method of adjustment for this bias. When both autopsy sample and target population can be stratified by major disease categories, under certain assumptions of equal effect, adjustment similar to the direct method for age adjustment may be applied. If, in addition, dependence can be characterized accurately by linear regression of both autopsy score and disease category frequency onto risk factors, then a very convenient calculation produces adjusted regression coefficients. This "parametric" method usually provides the most convenient results, with the greatest statistical power.

Analysis of Variance↗

PubMed1987

Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program.

Since 1965, the Honolulu Heart Program has followed 8006 men of Japanese ancestry, aged 45-70 yr at study entry, for the development of cardiovascular disease. To investigate the role of glucose concentration 1 h after a 50-g challenge on the risk of fatal coronary heart disease (CHD) and nonfatal myocardial infarction (MI), 6394 nondiabetic men were followed for 12 yr for the first development of CHD. The rate of fatal CHD increased linearly with amount of glucose. Men in the fourth quintile of postchallenge glucose (157-189 mg/dl) had twice the age-adjusted risk of fatal CHD of those in the lowest quintile (P less than .05). Relative risk increased to threefold among those in the top quintile and remained statistically significant after adjustment for other risk factors including body mass, total cholesterol, hypertension, left ventricular hypertrophy, and hematocrit (P less than .001). When glucose was considered as a linear term in the proportional hazards model, a highly significant relation was noted with fatal CHD alone and when combined with nonfatal MI (P less than .001). We conclude that a continuously increasing risk gradient exists between postchallenge glucose and subsequent CHD that is independent of other known risk factors.

Aged↗

PubMed1986

Risk of stroke in male cigarette smokers.

From 1965 to 1968, the Honolulu Heart Program began following 8006 men of Japanese ancestry in a prospective study of cardiovascular disease. Of the subjects who had not had a stroke by the time of study entry, 3435 were cigarette smokers and 4437 were nonsmokers. In 12 years of follow-up, 171 smokers and 117 nonsmokers had a stroke. As compared with nonsmokers, cigarette smokers had two to three times the risk of thromboembolic or hemorrhagic stroke, after control for age, diastolic blood pressure, coronary heart disease, and other risk factors (P less than 0.001). Subjects who continued to smoke in the course of follow-up had the highest risk of stroke. When these subjects were compared with those who never smoked, their risk of hemorrhagic events was increased four- to six-fold (P less than 0.001). Subjects who were smokers at study entry but stopped smoking in the course of follow-up had a slight excess risk of stroke. When these subjects were compared with those who continued to smoke, however, their risk was reduced by more than half after adjustment for risk factors (P less than 0.05), indicating that stopping smoking had significant benefits.

Age Factors↗

PubMed1986

Alcohol and hemorrhagic stroke. The Honolulu Heart Program.

Since 1965, the Honolulu Heart Program has followed up 8,006 men in a prospective study of cardiovascular disease. Of those subjects free of stroke at the time of study entry, 2,916 were classified as nondrinkers of alcohol and 4,962 as drinkers. In 12 years of follow-up, 197 drinkers and 93 nondrinkers experienced a stroke. No significant relationships were noted between alcohol and thromboembolic stroke. When compared with nondrinkers, however, the risk of hemorrhagic stroke more than doubled for light drinkers and nearly tripled for those considered to be heavy drinkers. These findings are statistically significant and independent of hypertensive status and other risk factors. Results further indicate that alcohol has a greater effect on hemorrhagic strokes that are subarachnoid in origin, conferring a threefold to fourfold increased risk for moderate and heavy drinkers compared with nondrinkers.

Age Factors↗

PubMed1986

Coffee, caffeine, and serum cholesterol in Japanese men in Hawaii.

The relationship between coffee consumption and serum cholesterol was investigated in a cohort of 5,858 Japanese males born in 1900-1919 and living in Hawaii in 1965 who are currently followed by the Honolulu Heart Program. Data on coffee consumption, other dietary variables from a 24-hour dietary recall, and other potentially confounding variables collected in 1965 were correlated with serum cholesterol at that examination and at examination six years later. The mean coffee and tea consumption was 3.4 and 1.8 cups/day, respectively. Those consuming no coffee had a mean serum cholesterol of 210 mg/dl, while that of those drinking 9+ cups/day was 220 mg/dl (no such relationship was apparent with tea or cola). The relationship of coffee consumption and serum cholesterol with potentially confounding variables including body mass index, cigarette smoking, diastolic blood pressure, alcohol consumption, physical activity index, serum glucose, serum uric acid, education, age, and fat consumption was examined. When these variables were entered into a multiple regression equation with coffee consumption, a significant relationship between coffee consumption and serum cholesterol (p less than 0.001) persisted, as did that between baseline coffee consumption and serum cholesterol six years later (p less than 0.001). There was no significant relationship between tea or cola, the other major caffeine contributors to the diet, and baseline serum cholesterol. Thus, this analysis indicates a significant positive relationship between coffee consumption and serum cholesterol which is not present with other sources of caffeine.

Aged↗

PubMed1986

Plasma lipids and lipoproteins in elderly Japanese-American men.

Knowledge about blood lipids in older individuals is limited. In the Lipoprotein Study of the Honolulu Heart Program, plasma cholesterol, triglyceride, and high-density lipoprotein (HDL) were measured during 1980 and 1981 in Japanese-American men over 60 years of age. In addition, low-density lipoprotein cholesterol (LDL-C) was estimated via a regression model. Age-related differences in mean lipid levels between the youngest (60 to 64 years) and the oldest (75 years and older) groups included a decrease in total cholesterol from 214 to 207 mg/dL and plasma triglyceride from 188 to 144 mg/dL. High density lipoprotein cholesterol rose from 47 to 49 mg/dL and LDL was relatively stable (137 and 135 mg/dL, respectively). Age-adjusted total cholesterol tended to significantly increase with increasing body mass index and hematocrit but was not significantly related with systolic blood pressure, physical activity index, cigarettes per day, or alcohol intake. Among those variables HDL-C decreased significantly with increasing body mass index and hematocrit and increased significantly with increasing alcohol intake. Compared with elderly white men in the Lipid Research Clinic Program, total cholesterol values tended to be slightly higher and triglyceride values were substantially higher, whereas HDL and LDL values were appreciably lower. Both cholesterol and triglyceride values were substantially higher than values reported from Japan from men in these age groups.

Aged↗

PubMed1985

Sodium-losing nephropathy and nephrocalcinosis after transplantation.

Severe, prolonged sodium-wasting (up to 38% FENa) occurred in a man after he received a cadaveric-donor kidney. Posttransplantation supplementation with large amounts of saline and/or salt tablets was mandatory. Fludrocortisone had no clinically apparent effect. Plasma renin activity and plasma aldosterone concentration were markedly increased. As chronic rejection progressed, the syndrome ameliorated. Renal biopsy showed cellular rejection and nephrocalcinosis.

Adult↗