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Biomedical subjects

G D Friedman

Publications and source records attributed to G D Friedman.

At least 91 records · Page 5Linked to original sources
PubMed1991

The leukocyte count and cancer mortality.

A previous report that the leukocyte count was related to mortality from cancer was evaluated in two large groups of multiphasic health examinees in the San Francisco Bay area, California--a cohort of about 25,000 persons followed up for mortality and a cohort of about 160,000 persons followed up for cancer incidence between 1964 and 1980. The leukocyte count was related to mortality from all cancers, smoking-related cancers, and cancers that were not smoking-related, but it was not related to cancer mortality in nonsmokers. The leukocyte count showed an association with the incidence of smoking-related cancers that was only partially removed by analytical control for smoking. It was only slightly, if at all, related to the incidence of not-smoking-related cancers and to the incidence of all cancers among nonsmokers. The relation of the leukocyte count to cancer mortality appears to be due to its close association with cigarette smoking, which raises the incidence of certain cancers and can hasten death attributed to cancer.

Cause of Death↗
PubMed1991

Alcohol drinking and cigarette smoking: an exploration of the association in middle-aged men and women.

The association of alcohol and cigarette consumption was explored among 13,673 black or white persons aged 40-49 years, who received check-ups from mid-1979 to 1985. Alcohol use was strongly associated with number of cigarettes smoked per day, but not with tar-yield, mentholation and presence of filters. Duration of cigarette use, frequency and depth of inhalation, proportion of cigarette smoked and greater time from arising to first cigarette were significantly related to alcohol use in some but not all race-sex groups. Among smokers who consumed alcohol, liquor drinkers smoked the most cigarettes per day and wine drinkers the least. Thus, the association between alcohol drinking and cigarette smoking is strong in middle-aged persons but there are race- and sex-related disparities when specific aspects of smoking behaviour are considered.

Black or African American↗
PubMed1991

Racial differences in cerebrovascular disease hospitalizations.

We studied the relationship of race to incidence of hospitalization for cerebrovascular disease among 74,096 white and 33,041 black persons who took health examinations in a prepaid health care program. Analyses were controlled for age, sex, body mass index, coffee use, smoking, alcohol use, systolic blood pressure, and baseline disease. Blacks were at higher hospitalization risk than whites for hemorrhagic cerebrovascular disease (relative risk = 2.4, 95% confidence interval = 1.3-5.8), cerebral thrombosis (relative risk = 1.9, 95% confidence interval = 1.2-2.9), and nonspecific cerebrovascular disease (relative risk = 1.6, 95% confidence interval = 1.2-2.2) but at lower hospitalization risk for extracranial occlusive disease (relative risk = 0.4, 95% confidence interval = 0.2-0.7). Blood pressure had a similar relation to all types of cerebrovascular disease in both races, but there were disparities in the relations of other atherosclerosis risk factors to different types of cerebrovascular disease. Educational attainment had little relation to hospitalization for extracranial occlusive disease, a finding that reduces the likelihood that selection bias explains the racial disparity. These data show unexplained racial differences in the type and location of cerebrovascular disease. The differences are important in understanding the pathogenesis of cerebrovascular disease and have practical clinical implications.

Alcohol Drinking↗
PubMed1990

Appendectomy, appendicitis, and large bowel cancer.

A cohort of 167,561 persons who received multiphasic health checkups were followed up for cancer development. A history of appendectomy showed slightly negative nonsignificant associations with the development of cancer of the colon, rectum, and all sites combined. By inference, the relation of appendicitis with these cancers was also inverse. Upper 95% confidence limits were compatible only with small positive associations of appendectomy and appendicitis with these cancers. These data do not support the view that removing the appendix increases cancer risk by diminishing immunocompetency. A link between appendicitis and large bowel cancer has been noted in intersociety correlations and has been hypothesized to be due to prevention of both by a high-fiber diet. However, appendicitis does not appear to be a useful predictor of large bowel cancer within a developed society.

Adolescent↗
PubMed1990

Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and nondrinkers.

Lower cardiovascular mortality rates in lighter drinkers (versus abstainers or heavier drinkers) in population studies have been substantially due to lower coronary artery disease (CAD) mortality. Controversy about this U-shaped curve focuses on whether alcohol protects against CAD or, because of other traits, whether abstainers are at increased risk. Inclusion of ex-drinkers among abstainers in some studies has led to speculation that this might be the trait increasing the risk of abstainers. This new prospective study among 123,840 persons with 1,002 cardiovascular (600 CAD) deaths showed that ex-drinkers had higher cardiovascular and CAD mortality risks than lifelong abstainers in unadjusted analyses, but not in analyses adjusted for age, gender, race, body mass index, marital status and education. Use of alcohol was associated with higher risk of mortality from hypertension, hemorrhagic stroke and cardiomyopathy, but with lower risk from CAD, occlusive stroke and nonspecific cardiovascular syndromes. Subsets free of baseline cardiovascular or CAD risk had U-shaped alcohol-CAD curves similar to subsets with baseline risk. Among ex-drinkers, maximal past intake and reasons for quitting (medical versus non-medical) were unrelated to cardiovascular or CAD mortality. These data show that: (1) alcohol has disparate relations to cardiovascular conditions; (2) higher cardiovascular mortality rates among ex-drinkers are due to confounding traits related to past alcohol use; and (3) the U-shaped alcohol-CAD relation is not due to selective abstinence by persons at higher risk. The findings indirectly support a protective effect of lighter drinking against CAD.

Adult↗
PubMed1990

Epidemiological screening for potentially carcinogenic drugs.

This paper describes a unique program for the systematic screening of commonly used prescription drugs for possible carcinogenic effects, by following up a large cohort of patients with computer-stored pharmacy data for incidence of cancer. Among the most interesting findings in recent analyses are an association of several antibiotics with subsequent lung cancer, and negative associations of prescribed vitamin E and diazepam with certain cancers. Analyses of additional data do not clearly indicate that these represent causal relationships to the drugs themselves. Also of interest is our continuing negative evidence regarding reserpine and metronidazole. The planned computerization of all pharmacies in our medical care program now serving over 2.2 million subscribers, should greatly increase our drug surveillance capabilities.

Barbiturates↗
PubMed1990

How often does metronidazole induce pancreatitis?

Two case reports of metronidazole-induced pancreatitis raised the question of how often this reaction occurs. Of 6485 patients who received 7704 computer-recorded prescriptions for metronidazole from a health maintenance organization, none were hospitalized for pancreatitis while taking the drug or within the following month. Accordingly, the upper 95% confidence limit for the occurrence rate of metronidazole-induced pancreatitis requiring hospitalization is 3.9/10,000 prescriptions and 4.6/10,000 recipients; the true rates are probably lower. Severe pancreatitis appears to be a rare adverse reaction to metronidazole.

Adult↗
PubMed1990

Cigarette smoking behavior is strongly related to educational status: the CARDIA study.

The prevalence and correlates of cigarette smoking were examined in 5,116 men and women ages 18-30 years including both blacks and whites of varied educational levels. Prevalence of smoking was approximately 30% in each race by gender subgroup after adjusting for age and education. The prevalence decreased with increasing education, from 54% among participants with less than a high school education to 12% among those with graduate degrees (P less than 0.001). Cessation rates followed a similar pattern, with former smokers twice as common among those with more education. Differences in smoking prevalence across occupational groups were largely explained by differences in educational achievement. More educated individuals smoked fewer cigarettes per day and chose brands with lower nicotine yield. Race and gender were not strongly related to smoking prevalence. However, among smokers, whites reported smoking 50% more cigarettes per day than blacks but the average nicotine and tar content of the cigarette was nearly three times higher among blacks than whites. The strong inverse relationship between education and cigarette smoking patterns has important implications for public health efforts directed at the prevention of cigarette smoking.

Adolescent↗
PubMed1990

Eye color and hypertension.

We searched for predictors of essential hypertension in 1,031 persons aged 30-49 who were observed to progress from normotension to hypertension, as compared to an equal number of matched subjects who remained normotensive. Blood pressure status was well documented in both multiphasic screenings and clinical records. Compared to persons with each lighter eye color, those with brown eyes were more prone to develop hypertension, with relative risk of 1.5 (95% confidence interval 1.18-1.96) compared to all persons with nonbrown eyes. The association persisted after control for race, sex, body mass index, alcohol use, educational level, parental history of hypertension, and among whites, for ethnic origin as crudely estimated by last name. Partial confirmation was obtained in three largely independent study groups: 1) 25 pairs of eye-color-discordant dizygotic twins; 2) 894 pairs of incident hypertensives and controls selected only with multiphasic screening blood pressure measurements; and 3) cross-sectional analysis of 152,018 multiphasic screenees. The weak association of eye color with hypertension clearly requires further confirmation. Although it has little potential for use in screening or clinical care, it may have implications regarding etiology. Areas for further exploration include the close metabolic relation of melanins to catecholamines, both derived from the amino acid tyrosine, and the possibility that dark-eyed persons react more quickly and strongly to stimuli than light-eyed persons.

Adult↗
PubMed1990

Alcohol intake and blood pressure in young adults: the CARDIA Study.

Associations between self-reported average daily alcohol intake and blood pressure were assessed in 5031 black and white men and women ages 18-30 from the Coronary Artery Risk Development in Young Adults Study (CARDIA). In general, intake was positively but weakly related to both systolic and diastolic blood pressure. Associations with systolic pressure were generally stronger than those with diastolic pressure. With average daily alcohol intake categorized as none, 0.1-9.9 ml, 10.0-19.9 ml, 20.0-29.9 ml, and 30.0+ ml, mean systolic pressure, adjusted for age, body mass index, education, smoking, and physical activity, increased progressively with increasing intake in black and white men and in white women. Mean diastolic pressure increased progressively with increasing intake only in white men and women, but was highest for those averaging 30.0+ ml per day in black women as well as white men and women. Mean pressures were also compared for those averaging 75.0+ ml per day (men) or 50.0+ ml per day (women) vs those reporting no intake. Differences in adjusted mean pressures for white men were 3.2 mmHg (95% confidence limits (CL) -0.3, 6.8) for systolic pressure and 1.7 mmHg (-1.6, 5.0) for diastolic pressure. In black men differences were 4.4 mmHg (1.4, 7.4) and 3.4 mmHg (0.6, 6.3), respectively. Differences in white women were 1.4 mmHg (-2.5, 5.3) for systolic pressure and 0.9 mmHg (-2.7, 4.5) for diastolic pressure and for black women, -0.2 mmHg (-4.3, 3.8) and 1.9 mmHg (-1.9, 5.8). Separate analyses in smokers and nonsmokers of the associations between alcohol intake and blood pressure suggested that associations may differ by smoking status in some sex-race groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

The leukocyte count: a predictor of hypertension.

In an exploratory study of 1031 persons observed to progress from normotension to essential hypertension and 1031 matched subjects who remained normotensive, the initial leukocyte count (WBC) was found to be related to the development of hypertension, with risk increased 40% (95% confidence interval 12-82%) in persons in the highest as compared to the lowest quartile of WBC. This relationship proved to be largely independent of body mass index, body fat distribution, alcohol and tobacco consumption, and parental history of hypertension. An increased WBC may reflect greater sympathetic tone or may directly increase peripheral vascular resistance by impeding circulation through small blood vessels. If confirmed, this study adds another condition to the growing list for which the WBC is predictive. This simple, cheap test should be considered for inclusion in prospective epidemiological studies of many different diseases.

Adult↗
PubMed1990

The leucocyte count: correlates and relationship to coronary risk factors: the CARDIA study.

Correlates of the leucocyte count (WBC) and its relationships to other coronary heart disease (CHD) risk factors were assessed in 4981 black and white young adults. Mean WBC was higher in women than men, higher in whites than blacks, and higher in those aged 18-24 than aged 25-30 years. It also varied by season with the highest levels in the autumn. Other characteristics with persistent statistically significant direct associations with the WBC after multivariate adjustments were cigarette smoking, marijuana use, geographical location (possibly an inter-laboratory artifact), use of birth control pills, body mass index, pulse rate, and systolic blood pressure; height, physical fitness and high density lipoprotein cholesterol (HDL-C) level were inversely associated with the WBC. The negative association of WBC with HDL-C was too small to explain the association of WBC with CHD found elsewhere. The WBC is a commonly performed clinical test; yet much remains to be learned about its variation in the general population and its value as a predictor rather than merely an indicator of disease.

Adolescent↗
PubMed1990

Precursors of essential hypertension: pulmonary function, heart rate, uric acid, serum cholesterol, and other serum chemistries.

Exploratory analyses were conducted in a nested case-control study of 1,031 incident cases of essential hypertension and 1,031 persistently normotensive controls from the Kaiser Permanente Multiphasic Health Checkup cohort in Northern California. Previous analyses have confirmed hypotheses that baseline weight, subsequent weight gain, alcohol consumption, parental history of hypertension, excessive use of salt, and centralized body fat distribution are predictive of developing hypertension. In the present study, pulmonary function tests, several serum chemistries, and heart rate were strongly predictive in univariate analyses. Adjusting for the risk factors mentioned above, forced vital capacity (p less than 0.001), serum uric acid (p = 0.003), serum cholesterol (p = 0.012), and heart rate (p = 0.014) remained independently predictive. Further adjustment for baseline blood pressure completely explained the association of heart rate with hypertension, and reduced the association with serum cholesterol to borderline significance. Forced vital capacity remained a strong, inverse predictor (odds ratio, fifth vs. first quintile = 0.22, 95% confidence interval (Cl) 0.11-0.46). Uric acid remained positively related to risk (odds ratio, fifth vs. first quintile = 2.19, 95% Cl 1.20-3.98). Although neither association is presently understood, both forced vital capacity and serum uric acid are closely linked to development of hypertension and may be markers of susceptibility or intermediate steps in pathways leading to hypertension.

Adult↗
PubMed1990

Coffee use prior to myocardial infarction restudied: heavier intake may increase the risk.

Because of conflicting evidence about the relation of coffee use to coronary artery disease, the authors conducted a new cohort study of hospitalizations among 101,774 white persons and black persons admitted to Kaiser Permanente hospitals in northern California in 1978-1986. In analyses controlled for eight covariates, use of coffee was associated with higher risk of myocardial infarction (p = 0.0002). Compared with nondrinkers of coffee, the following relative risks (RRs) were found: at 1-3 cups/day, RR = 1.14 (95% confidence interval (CI) 0.91-1.42); at 4-6 cups/day, RR = 1.42 (CI 1.10-1.84), p = 0.007; and at greater than 6 cups/day, RR = 1.41 (CI 1.00-1.99), p = 0.05. The relation remained significant when also controlled for blood cholesterol, blood glucose, blood pressure, and adiposity, singly or combined. Tea use was unrelated to myocardial infarction; neither coffee nor tea was related to other coronary diagnoses. Although causality remains unestablished and uncertainty remains, the authors conclude that 1) these data suggest a weak independent relation of coffee use to acute myocardial infarction, not mediated by an effect on blood cholesterol; and 2) persons at risk of myocardial infarction should consider limitation of coffee intake to less than 4 cups/day.

Aged↗