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Biomedical subjects

E Barrett-Connor

Publications and source records attributed to E Barrett-Connor.

At least 307 records · Page 17Linked to original sources
PubMed1984

Natural history of intestinal parasites in asymptomatic adults.

The need to treat asymptomatic adults who have intestinal parasites should be based on considerations of potential pathogenicity and transmission risk, but such data are sparse in general and unavailable for countries such as the United States, where reinfection is rare. Opinions of North American physicians about the natural history and treatment of 12 parasites detectable by stool examination were assessed using the Delphi technique. In response to the first questionnaire, majority agreement on pathogenic potential was achieved for only 3 of 12 parasites. When the more expert group was queried a second time, majority agreement was achieved for 8 of 12 parasites. Nevertheless, the predicted risk of subsequent disease still varied widely, from 1:10 to 1:1,000 for most parasites, and was unrelated to the perceived need for treatment. Almost all respondents thought asymptomatic adults with any intestinal parasites should always be treated. Transmission risk was judged to be low and was generally appropriate to the life cycle of the parasite.

Adult↗
PubMed1983

Estrogen use and all-cause mortality. Preliminary results from the Lipid Research Clinics Program Follow-Up Study.

The association of exogenous estrogen use and hysterectomy status with all-cause mortality was examined in 2,269 white women, aged 40 to 69 years, who had been followed up for an average of 5.6 years in the Lipid Research Clinics Program Follow-up Study. A total of 72 deaths occurred during this period. The relative risk of death in estrogen users compared with nonusers was 0.54 in gynecologically intact women, 0.34 in hysterectomized women, and 0.12 in bilaterally oophorectomized women. The risk of death in estrogen users, irrespective of hysterectomy status, was 0.37 times that in nonusers (3.4/1,000 v 9.3/1,000). The significant negative association of estrogen use with mortality persisted after multivariate adjustment for confounding factors. Hysterectomy status alone was not a significant predictor of death. Some, but not all, of the lower risk of mortality in estrogen users can be accounted for by increased levels of high-density lipoprotein cholesterol.

Adult↗
PubMed1983

Dairy products, calcium, and blood pressure.

The previously reported inverse association of dietary calcium intake and blood pressure levels was examined in a Southern California community, in order to determine whether this association was independent of age, obesity, and alcohol consumption. In the total population significantly less calcium intake from milk was reported in hypertensive versus normotensive men (but not women) and the association was independent of age and obesity. In a 23% subsample of men from this cohort the effect of total dietary calcium intake from all dairy products was estimated from a 24-h dietary recall. Again hypertensive men consumed significantly less calcium than normotensives. In men, both systolic and diastolic blood pressure levels were inversely associated with calcium intake from dairy products. After controlling for age, obesity, and alcohol, diastolic blood pressure was negatively and significantly associated with total calcium intake from dairy products, while systolic blood pressure was similarly associated with whole milk calcium alone. Although these data are cross-sectional, they suggest that some component of dairy products, probably calcium, exerts a protective effect against hypertension, and are compatible with the protective effect of calcium reported in hypertension-prone rats.

Adult↗
PubMed1983

Clustering of heart disease risk factors in diabetic compared to nondiabetic adults.

In a population-based study conducted by the Lipid Research Clinic between 1972 and 1974, the authors investigated the frequency and clustering of five heart disease risk factors--cholesterol, triglycerides, systolic blood pressure, obesity, and cigarette smoking--in 347 diabetic and 2285 euglycemic nondiabetic adults aged 35 to 79 years. Diabetics were more likely than nondiabetics to have high risk factor levels, although excesses for cholesterol and cigarette smoking were not statistically significant. Subjects at or above the 70th or 90th percentiles for one risk factor were more likely to be at or above these percentiles for other risk factors, and this clustering of heart disease risk factors was more common among diabetics than nondiabetics. Excess clustering in diabetics persisted after controlling for obesity and when only cholesterol, blood pressure, and cigarette smoking were analyzed. Clustering was more marked in women than in men. This may explain some of the excess risk of heart disease in female compared to male diabetics, which has been reported by others.

Adult↗
PubMed1983

The sex differential in mortality from all causes and ischemic heart disease.

The sex differential in mortality from all causes and ischemic heart disease is examined in an upper-middle class Caucasian community of 3516 adults in southern California, who were followed for a minimum of seven years. The influence of several demographic, behavioral, and biologic risk factors is simultaneously controlled for by means of a multiple logistic analysis. Risk factors include age, marital status, education, cigarette smoking, cholesterol, systolic blood pressure, fasting plasma glucose, and obesity. Both the prevalence and relative mortality risk associated with several risk factors differ by sex. Adjustment decreases the sex differential for mortality from 1.7 to 1.3 for all causes and from 4.8 to 2.4 for ischemic heart disease. When analysis is limited to healthy men and women, the adjusted sex differential in mortality is 1.2 for all causes and 2.0 for ischemic heart disease. Findings of this study are compared with two other population-based studies.

Adult↗
PubMed1983

A community study of high density lipoproteins in adult noninsulin-dependent diabetics.

It is generally accepted that high density lipoprotein cholesterol (HDL-C) is protective against cardiovascular disease, and that diabetics are at a significant excess risk of cardiovascular disease. Previous studies of HDL-C levels in noninsulin-dependent diabetics have reported divergent results, possibly due to case selection or failure to adjust for covariables known to effect HDL-C, such as obesity, cigarette smoking, alcohol intake, exercise, or exogenous estrogen use. The authors compared 97 adult noninsulin-dependent diabetics identified by history or fasting hyperglycemia from a population survey in southern California with 194 age- and sex-matched euglycemic controls from the same community. HDL-C levels were significantly lower in noninsulin-dependent diabetics of both sexes, and these differences persisted after adjustment for obesity, cigarette smoking, alcohol, exercise, and estrogen use in women. These data support the concept that reduced levels of HDL-C may be one mechanism whereby diabetics experience an excess risk of cardiovascular disease. In contrast to the published literature, HDL-C levels were not significantly different in diabetics treated with tolbutamide vs. diet therapy. This finding does not support the suggestion that the excess risk of cardiovascular disease mortality in diabetics assigned to tolbutamide reported from the University Group Diabetes Program was a consequence of tolbutamide-induced reductions in HDL-C.

Aged↗
PubMed1983

Change and correlates of change in high and low density lipoprotein cholesterol after six years: a prospective study.

Change and correlates of change in high and low density lipoprotein cholesterol (HDL and LDL) were studied in a prospective population-based study of 614 men and women in Rancho Bernardo, CA, 1972-1980. Correlations between baseline and follow-up examination an average of six years later were 0.72 for HDL and 0.68 for LDL, and 86% of HDL and 89% of LDL values were within +/- 30% of their original values. Predictions of HDL and LDL change were determined by multivariate analysis. Regression to the mean was the strongest single predictor of lipoprotein change and was more important than behavioral change. Among the behavioral variables, HDL change was positively associated with change in alcohol use in both sexes and with change in postmenopausal estrogen use in women and was inversely associated with change in obesity index in men. LDL change correlated positively with change in obesity index in both sexes. Change in reported cigarette use or exercise was unrelated to changes in HDL and LDL in this analysis. The similarity of lipoprotein values at baseline and follow-up suggests reasonable reliability and prognostic validity for a single HDL or LDL measurement. The multivariate analysis results generally confirm current cross-sectionally derived concepts about behavioral correlates of lipoproteins. However, the degree of regression to the mean indicates the wisdom of repeat measurements, particularly for persons with extreme values.

Adult↗
PubMed1983

Spouse concordance for systolic and diastolic blood pressure.

Eighty-two per cent of all adult residents of Rancho Bernardo, California, participated in a study of the prevalence of heart disease risk factors in 1972-1974. Spouse correlations for systolic and diastolic blood pressure were examined in 1702 spouse pairs including 403 spouse pairs married 40 or more years. Both systolic and diastolic blood pressure showed significant spouse correlation after adjustment for spouse similarities in age and relative weight (r = 0.102 for systolic, r = 0.114 for diastolic, p less than or equal to 0.05). An examination of blood pressure correlations by duration of marriage and age of wife showed correlations to be influenced by age of wife rather than duration of marriage. Spouse correlations were lowest when the wife was aged 40-49 years and highest when the wife was 50-59 years of age. The differential concordance by wife's age is compatible with different degrees of shared behaviors for couples at different ages.

Adult↗
PubMed1983

Isolated systolic hypertension and mortality after age 60 years. A prospective population-based study.

A total of 165 out of 2636 adults aged 60 years or older (6.3 per cent) in Rancho Bernardo, California, had isolated systolic hypertension with a systolic blood pressure greater than or equal to 160 mmHg and a diastolic blood pressure less than 90 mmHg when studied in 1972-1974. A 6.4-year follow-up of this cohort showed isolated systolic hypertension to be as important a risk factor for all-cause mortality as other types of hypertension in both men and women (adjusted relative risk = 1.5, p greater than 0.10). After adjustment for age and other covariates, male but not female subjects with isolated systolic hypertension experienced an excess risk of death from stroke (relative risk = 4.0, p less than 0.10), a relative risk exceeding that seen in men with treated hypertension. Isolated systolic hypertension was unassociated with an excess risk of fatal ischemic heart disease in subjects of either sex in this population. The excess risk of death and stroke is consistent with results published elsewhere, and supports the concept that isolated systolic hypertension is not a benign condition of the elderly. The efficacy and safety of therapeutic intervention in older adults with isolated systolic hypertension remain to be determined.

Aged↗
PubMed1983

Sex differential in ischemic heart disease mortality in diabetics: a prospective population-based study.

Two previous population-based US studies that examined the sex differential for heart disease mortality in diabetics showed an independent effect of diabetes on fatal heart disease only in women. This paper reports sex-specific ischemic heart disease mortality rates and relative risks for a geographically defined population in southern California of men and women aged 40-79 years, 99.5 per cent of whom were followed prospectively for seven years. When the 212 men and 131 women who had diabetes defined by personal history and/or fasting hyperglycemia were compared with 2104 nondiabetics defined by fasting euglycemia and a negative personal and family history of diabetes, the age-adjusted relative risk of death in diabetics attributed to ischemic heart disease was 2.5 for diabetic men and 3.4 for diabetic women. The sex difference increased only minimally after adjustment for heart disease risk factors when the Cox regression model was used: the adjusted risk ratio was 2.4 for diabetic men and 3.5 for diabetic women. In both men and women, diabetes, along with age and plasma cholesterol, was a statistically significant independent predictor of ischemic heart disease mortality. Among diabetics, male sex made a significant independent contribution to the prediction of fatal ischemic heart disease.

Adult↗
PubMed1982

Controlled trial of oral acyclovir in the therapy of recurrent herpes simplex genitalis. A preliminary report.

A randomized, placebo-controlled, double-blind study was performed to evaluate the efficacy and toxicity of orally administered acyclovir in the treatment of patients with recurrent herpes simplex genitalis (HSG). A total of 107 patients from centers in Burlington, Vermont, and San Diego, California, were entered into the study within 48 hours of the onset of lesions. Patients who received acyclovir shed virus for 1.8 +/- 0.6 days (mean +/- SEM) compared with 2.8 +/- 1.2 days for those who received placebo. The duration of shedding from genital lesions of patients in the acyclovir-treated group was significantly less than from lesions of patients who received placebo (p = 0.016 by a logrank test). An analysis of the toxicity of the drug was performed in 52 of the study participants. Acyclovir was well-tolerated and no alterations were observed in measurements of bone marrow, liver, or kidney function. Orally administered acyclovir is a promising antiviral compound for the treatment of recurrent HSG.

Acyclovir↗
PubMed1982

Seasonal variation in fasting plasma glucose levels in man.

A Southern California community study of 4,541 men and women (aged 20-79 years) showed significant seasonal variation in fasting plasma glucose. There was a mean 0.6 mmol/l difference between highest levels in winter and lowest levels in spring. This difference was consistent over a two-year period, similar at all ages and seen in both men and women. Fasting plasma glucose levels correlated directly with percentage possible sunshine (p = 0.03) and inversely with temperature (p = 0.04). Adjustment for the level of measured obesity did not alter the observed association, but a history of recent weight gain corresponded to the season of maximum fasting plasma glucose level.

Adult↗
PubMed1982

Impact of a heart disease risk factor screening survey on an upper-middle class community.

The impact of a community-based heart disease risk factor screening program was evaluated after three years. The study population was predominantly white, older, and upper-middle class. Rescreening of the 211 study subjects showed improvements in both health-related behaviors and in risk factor distributions to a degree which would be expected to reduce the risk of heart disease. Although some changes were attributable to secular trends and regression to the mean, direct impact of the survey itself was also demonstrated.

Adult↗
PubMed1982

Spouse concordance of plasma cholesterol and triglyceride.

Spouse concordance for plasma cholesterol and triglyceride was studied in 1971 spouse pairs including 545 spouse pairs married 40 or more years. Both lipids showed modest but statistically significant age corrected Kendall Tau-B correlations; 0.046 (P = 0.005) for cholesterol and 0.070 (P = 0.0001) for triglycerides. Concordance was not explained by season of sampling or by selective mortality. Relative weight was positively correlated in spouse pairs and appeared to explain much of the observed correlations in cholesterol and triglycerides. Spouse pairs also showed positive correlations for cigarette smoking and egg and milk consumption, though these behavioral variables explained little of the concordance for cholesterol and triglycerides. Lipid concordance was highest in marriages of the shortest (1-9 yr) and longest (40 + yr) durations, as was relative weight concordance, suggesting an interaction between duration of marriage and environmental and/or selective factors affecting plasma lipids.

Animals↗
PubMed1982

Alteration in blood pressures associated with combined alcohol and oral contraceptive use-the lipid research clinics prevalence study.

Alterations in systolic and diastolic blood pressure levels associated with combined oral contraceptive (OC) and alcohol use were investigated in white women 20-49 years of age from 10 North American Lipid Research Clinics study populations. OC users had systolic pressures 2-3 mm Hg higher than non-users, but no difference was noted for diastolic pressures. Among non-OC users, both systolic and diastolic blood pressures were positively associated with reported alcohol consumption, though participants reporting no alcohol use had blood pressures slightly higher than those reporting minimal intake. The blood pressure correlates of OC's and alcohol appeared to be independent, and systolic pressures levels were over 8 mm Hg higher in those reporting heavier alcohol intake and OC use than among those reporting minimal alcohol intake and no OC use.

Adult↗