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Biomedical subjects

E Barrett-Connor

Publications and source records attributed to E Barrett-Connor.

At least 235 records · Page 13Linked to original sources
PubMed1990

Increasing sensitivity of blood pressure to dietary sodium and potassium with increasing age. A population study using casual urine specimens.

In a population of 887 men and 1159 women aged 40 to 89 years in southern California, age adjusted systolic and diastolic blood pressures correlated significantly with sodium/potassium ratios estimated from casual urine samples. The relationship was apparent over the whole range of blood pressures and urinary electrolyte excretions. An age gradient was apparent for systolic pressure in both men and women, the regression slope for blood pressure versus sodium/potassium ratio being steeper with increasing age. The regression slope overall was approximately 4 mm Hg systolic and 1 mm Hg diastolic pressure increase per unit increase in sodium/potassium (mmol/mmol) ratio. The use of casual urine samples in assessing the blood pressure and sodium/potassium relationship should not be prematurely dismissed. Evidence from this and other studies suggests the relationship between blood pressure and electrolyte intake in the population may be more dynamic than previously believed, and also more marked in the old, who are at the greatest risk for cardiovascular disease. A reduction in the age-related increase in blood pressure has considerable implications for the prevention of cardiovascular disease.

Adult↗
PubMed1990

Cardiovascular disease risk factors prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in a community of older adults.

Cardiovascular disease risk factors were measured 10-15 years (mean, 11.9 years) prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in Rancho Bernardo, California. There were 1,847 men and women aged 40-79 years who had no known diabetes or fasting hyperglycemia at baseline (1972-1974). At the follow-up examination (1984-1987), 1,115 men and women (60.4%) had normal glucose tolerance, 513 (27.8%) had impaired glucose tolerance, and 219 (11.9%) had non-insulin-dependent diabetes mellitus as defined by World Health Organization criteria. Rates of impaired glucose tolerance and non-insulin-dependent diabetes mellitus increased with age, and impaired glucose tolerance was approximately twice as common as non-insulin-dependent diabetes mellitus. Those with non-insulin-dependent diabetes mellitus were older and more overweight and had higher levels of blood pressure, fasting plasma glucose, and triglyceride at baseline than those whose glucose tolerance remained normal; those with impaired glucose tolerance generally had intermediate levels of the same risk factors. When it was examined in a prospective fashion, in general, the age-adjusted risk of non-insulin-dependent diabetes mellitus increased with increasing quartile of each risk factor, and the risk of non-insulin-dependent diabetes mellitus in a given quartile was greater than that for impaired glucose tolerance. Logistic regression analyses showed these factors to be positively associated with a subsequent diagnosis of impaired glucose tolerance as well as non-insulin-dependent diabetes mellitus in women, and to a lesser degree in men, independent of baseline age and body mass index (weight (kg)/height (m)2). These data illustrate that a less favorable cardiovascular risk factor profile precedes the diagnosis of both non-insulin-dependent diabetes mellitus and impaired glucose tolerance.

Adult↗
PubMed1990

Cancer mortality and lipid and lipoprotein levels. Lipid Research Clinics Program Mortality Follow-up Study.

The associations of serum lipid and lipoprotein levels with the risk of cancer mortality were assessed in 2,753 men and 2,476 women aged 40-79 years at baseline (1972-1976) who participated in the Lipid Research Clinics Program Mortality Follow-up Study through 1984. Seventy-nine cancer deaths occurred in men and 65 occurred in women during an average follow-up time of 8.4 years. Total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly inversely associated with overall cancer mortality in men, but no relation was observed in women. Neither high-density lipoprotein (HDL) cholesterol nor triglycerides were significantly related to total cancer mortality in either sex, although in women. HDL cholesterol was positively associated with risk of death from gynecologic cancers. Compared with men with higher cholesterol levels, the relative risk of death from colon cancer, adjusted for age, body mass, cigarette smoking, and alcohol consumption, was 5.20 (95 percent confidence interval (Cl) 1.61-16.8) in men with total cholesterol levels less than or equal to 187 mg/dl and 4.79 (95 percent CI 1.37-16.8) in those with LDL cholesterol levels less than or equal to 119 mg/dl. Death from smoking-related cancers was inversely related to baseline total cholesterol but not to LDL cholesterol. The absence of an association with HDL cholesterol, which has been shown to be lower in persons with clinically manifest malignancy, and evidence from survival curves suggest that the inverse relation in men is not due to preexisting disease.

Adult↗
PubMed1990

Endogenous sex hormone levels in older adult men with diabetes mellitus.

In a Southern California population-based cohort of 985 men aged 40-79 years in 1972-1974, 110 men with diabetes had significantly lower mean levels of endogenous plasma testosterone and sex hormone-binding globulin than did 875 nondiabetic men. Mean androstenedione, estrone, and estradiol levels did not differ significantly by diabetic status. The testosterone and sex hormone-binding globulin differences were reduced but not eliminated after adjustment for age and body mass index (weight (kg)/height (m)2). Twenty-one percent of diabetic men compared with 13% of nondiabetic men had testosterone levels below a categorically defined normal level of 3,500 pg/ml. Testosterone was inversely related to degree of glycemia in the whole cohort. Throughout the whole range of plasma glucose, there was a stepwise decrease in mean testosterone levels per categorical increase in fasting plasma glucose, apparent in both diabetics and nondiabetics. The clinical and physiologic implications of the reduced testosterone levels in diabetic men merit further investigation.

Adult↗
PubMed1990

A prospective population-based study of alcohol use and non-insulin-dependent diabetes mellitus.

The effect of alcohol use on risk of non-insulin-dependent diabetes mellitus was assessed in a defined population. A 24-hour recall of alcohol intake and past-week alcohol intake were obtained by separate interviewers between 1973 and 1975, and responses were coded by the Nutrition Coordinating Center, University of Minnesota. Of the 524 adults aged 30-79 years without diabetes at baseline, 31 men and 44 women were identified as diabetic by means of a glucose tolerance test (World Health Organization criteria) between 1984 and 1987. Men, but not women, who developed diabetes reported significantly more alcohol intake in the past week and in the past 24 hours. The highest rate of diabetes among alcohol users was in heavy drinkers--statistically significant only in men. Alcohol use remained a significant predictor of diabetes in men after adjustment for baseline age, body mass index (weight (kg)/height (m)2), cigarette smoking, family history of diabetes, and systolic blood pressure with a logistic regression model. The relative risk associated with past-week alcohol intake was 1.5 per 137.8 g; for past-24-hour alcohol intake, it was 1.5 per 24.5 g. Adjustment for baseline fasting plasma glucose and triglycerides did not change the results. Alcohol intake appears to be associated with risk of non-insulin-dependent diabetes mellitus in men.

Adult↗
PubMed1990

Resting electrocardiographic abnormalities suggestive of asymptomatic ischemic heart disease associated with non-insulin-dependent diabetes mellitus in a defined population.

The prevalence of ischemic heart disease (IHD) in older adults by glucose tolerance status was evaluated in 2,223 white men and women, aged 50-89 years, in the Rancho Bernardo cohort who were studied between 1984 and 1987. Impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) were classified according to World Health Organization criteria. End points of ischemic heart disease were defined by Rose Questionnaire and resting electrocardiogram (ECG) according to the Minnesota Code. IHD by electrocardiographic changes was classified as asymptomatic (without history of chest pain or overt IHD) or symptomatic (with history). IHD by all criteria combined was significantly more common in men and women with NIDDM, and in women with IGT, than in those with normal glucose tolerance. The prevalence of myocardial infarction, defined by major Q wave, Rose Questionnaire chest pain criteria, or personal history, was higher in persons with NIDDM than in persons without; the difference was highly significant in women (odds ratio, 2.08 [1.22, 3.56]; p = 0.009). Angina pectoris was not significantly related to NIDDM or IGT in either sex. Electrocardiographic evidence of asymptomatic IHD was significantly more prevalent in both men and women with NIDDM as compared with those with normal glucose tolerance (odds ratios, 1.75 [1.10, 2.81] for men and 1.80 [1.07, 3.01] for women; p less than 0.05). This significant association persisted after excluding persons on digitlis or diuretic therapy and, in women, was also independent of the effect of major known IHD risk factors. These population-based data are consistent with clinical reports suggesting an association of diabetes with silent myocardial infarction or ischemia. The presence of ischemic resting electrocardiographic abnormalities in the asymptomatic diabetic patient is likely to have prognostic and therapeutic implications.

Aged↗
PubMed1990

Nursing home utilization in adults: a prospective population-based study.

Rates of nursing home utilization between 1972 and 1986 were determined for 1,302 men and women living in an upper-middle-class community in Southern California. Leading diagnostic reasons for admission were dementia, cancer, and stroke, and the leading nondiagnostic reason for admission was an inability to carry out activities of daily living. In this cohort, rates of nursing home utilization increased with age. Women at all ages used nursing homes at a higher rate than men, although their probability of survival once admitted was greater. Admission rates were higher over time or prior to death than when observed cross-sectionally. Rates were highest in the year prior to death but declined at time of death.

Adult↗
PubMed1990

Clustering of atherogenic behaviors in coffee drinkers.

We studied the clustering of coffee consumption and selected atherogenic behaviors in older adults living in a southern California community. Men were somewhat more likely to drink caffeinated coffee while women were more likely to drink decaffeinated coffee. In men, but not women, caffeinated coffee drinking decreased with age and decaffeinated coffee drinking increased. Caffeinated coffee drinkers drank more alcohol, consumed more dietary saturated fats and cholesterol, were more likely to be current smokers and less likely to be current exercisers than were non-coffee drinkers. Smoking and exercise also showed a dose-response relationship to the amount of caffeinated coffee consumed. Risk factor levels among drinkers of decaffeinated coffee were more like those of caffeinated coffee than non-drinkers. These data illustrate the clustering of atherogenic behaviors with coffee drinking and highlight their potential importance in interpreting the growing body of literature about coffee and health.

Age Factors↗
PubMed1990

Behavioral covariates of waist-to-hip ratio in Rancho Bernardo.

We examined lifestyle and dietary habits in 685 men and 943 women (mean age 67 years) who completed an interview, examination, and food frequency questionnaire in 1984-87. Waist-to-hip ratio increased with age and body mass index in both men and women. In multiple regression, waist-to-hip ratio was independently associated with smoking, alcohol consumption, and exercise in men, and with smoking and alcohol consumption in women. The data suggest that waist-to-hip ratio is affected, at least in part, by behavioral, and potentially modifiable, factors.

Aged↗
PubMed1990

Obesity, hypertension and stroke.

Central fat distribution may be more closely associated with stroke risk than relative weight or body mass index, although both are associated with hypertension. Some of this association may reflect the fact that central obesity reflects adult weight gain, which may be more relevant to stroke risk than weight in old age. Three attributes associated with central obesity, hypertension and stroke risk deserve further exploration as a possible explanatory variables for the central obesity-stroke risk association. They are cigarette smoking, heavy alcohol intake and diabetes. Prevention of smoking and excess alcohol intake would be consistent with general public health guidelines and might be more relevant to stroke prevention than caloric reduction and management of general overweight.

Adult↗
PubMed1990

Sex-specific vs. unisex body mass indices as predictors of non-insulin dependent diabetes mellitus in older adults.

In order to examine sex differences in the association of obesity with the risk of non-insulin dependent diabetes mellitus (NIDDM) when using the body mass index (BMI), we compared unisex body mass index classifications with sex-specific categories, as defined by the Metropolitan Life Tables, based on their utility in predicting the 12-year incidence of NIDDM in men and women. The present analysis included all 747 men and 969 women from a defined older caucasian population in Rancho Bernardo, California, who were 40 years of age or older at the baseline examination in 1972-1974 and who had complete diabetes-related data available then and between 1984-1987. The 12-year age-adjusted incidence rates for NIDDM increased with increasing BMI among women (all steps significant), but was significantly increased only in the most obese category of men (relative risk (RR) = 2.3, P less than 0.05 for men; RR = 3.8, P less than 0.001 for women). Men and women had nearly identical rates of NIDDM in this obese category. When identical (unisex) BMI cutpoints were used, results were the same; (RR = 2.4, P less than 0.05 for men; RR = 3.1, P less than 0.01 for women). These data indicate that unisex and sex-specific cutpoints for BMI identify the same sex-specific patterns of association between obesity and risk of NIDDM.

Adult↗
PubMed1990

Intestinal parasites in Central American immigrants in the United States.

We describe the results of ova and parasite examinations of 216 Central Americans who were seen at a Los Angeles, Calif, clinic during an 8-month period. Among the 125 immigrants from Central America, intestinal parasitic prevalence was 53%. Pathogens were found in 45% and multiple pathogens in 21%. Of the 91 US born Central American children, parasite prevalence was 14%. Pathogens were found in 12%. The most common pathogens were Trichuris trichiura, Giardia lamblia, and Ascaris lumbricoides. Giardia lamblia was more prevalent in the younger than 5-year-old age group, and helminths were more prevalent in the 6- to 10-year-old age group. No helminths were found in immigrants who had been in the US for more than 3 years. Gastrointestinal symptoms did not correlate with prevalence of parasites. The high prevalence of intestinal parasites supports previous recommendations for screening; decisions for screening should be based on morbidity (probably low), efficacy and safety of treatment (good), and costs.

Adolescent↗
PubMed1989

Cigarette smoking and increased central adiposity.

STUDY OBJECTIVE: To determine whether cigarette smoking is associated with central obesity in men and women. DESIGN: A cross-sectional survey. SETTING: A geographically defined population of older white adults. PARTICIPANTS: Men (836) and women (1112) ages 50 to 79. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Waist-hip circumference ratio and body mass index (weight in kg/height in m2) were measured in participants wearing light clothing without shoes. Past and current cigarette smoking habits were ascertained by a standard self-administered questionnaire. Cigarette smokers had higher waist-hip ratios than non-smokers. We observed a dose-response relation of increasing waist-hip ratio with increasing number of cigarettes smoked. Although smokers were leaner than nonsmokers, the increased waist-hip ratio in smokers was independent of body mass index and was consistent within body-mass index tertiles. The associations, seen in both sexes, were stronger in women. CONCLUSIONS: Cigarette smokers have more central obesity than nonsmokers. These results suggest that body fat distribution can be modified by behavioral factors such as smoking.

Abdomen↗
PubMed1989

The effect of parity on the later development of non-insulin-dependent diabetes mellitus or impaired glucose tolerance.

To determine the effect of parity on the later development of non-insulin-dependent diabetes mellitus or impaired glucose tolerance, we studied a population-based sample of 1186 women at least 40 years of age; those who had been given a diagnosis of diabetes mellitus before the age of 40 or who had insulin-dependent diabetes mellitus were excluded from the study. On the basis of the World Health Organization's criteria, 714 had normal glucose tolerance, 326 had impaired glucose tolerance, and 146 had non-insulin-dependent diabetes mellitus (NIDDM). After adjustment for age, obesity, and family history of diabetes, increased parity was associated with a significantly increased risk of both NIDDM (odds ratio, 1.16 [95 percent confidence interval, 1.04 to 1.29] per pregnancy) and impaired glucose tolerance (odds ratio 1.10 [95 percent confidence interval, 1.01 to 1.19] per pregnancy). Obesity, whether estimated by means of the body-mass index or the waist-hip ratio, was significantly associated with an increased risk of both NIDDM and impaired glucose tolerance, but this factor did not explain the association between parity and diabetes or impaired glucose tolerance; neither the maximal lifetime body-mass index nor the waist-hip ratio was significantly associated with parity in this cohort. We conclude that there is a slight increase in the risk of NIDDM or impaired glucose tolerance with increasing parity many years after childbearing and that this association is not explained by obesity.

Adult↗
PubMed1989

Postmenopausal estrogen use and heart disease risk factors in the 1980s. Rancho Bernardo, Calif, revisited.

Postmenopausal estrogen use and risk factors for heart disease were assessed in 1057 women, aged 50 to 79 years, who were enrolled in an ongoing study of residents of an upper-middle-class community. From 1984 through 1987, thirty-one percent of the women reported current estrogen use, a rate equivalent to that determined in one survey of the same population done from 1972 through 1974. Compared with nonusers, current users did not have a more favorable cardiac risk factor profile before use, but users were more likely to have had a surgically induced menopause and to have been estrogen users during the survey done from 1972 through 1974. Similar to our earlier findings, current estrogen use was associated with lower weight, diastolic blood pressure, and fasting plasma glucose level than nonuse. Levels of low-density lipoprotein cholesterol were inversely related to estrogen dose; levels of high-density lipoprotein cholesterol were positively related to the duration of use. In this cross-sectional study, blood pressure and lipoprotein and plasma glucose levels were similar in women receiving estrogen alone and in women receiving combination estrogen and progestin therapy.

Age Factors↗