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Biomedical subjects

G De Backer

Publications and source records attributed to G De Backer.

At least 145 records · Page 8Linked to original sources

Serum lipids and apoproteins in students whose parents suffered prematurely from a myocardial infarction.

Lipids and apoproteins as well as other coronary risk factors were measured in offspring of patients who suffered from a myocardial infarction before the age of 50 years; the results are compared with the results of a control group matched for age and sex. Significant differences were observed in the apoprotein A1 level, in the protein/fat ratios of high- and low-density lipoproteins, and in smoking habits. In a multivariate analysis, the offspring group was found to be different from the control group in nonhigh-density lipoprotein cholesterol/apoprotein B ratio, high-density lipoprotein cholesterol/apoprotein A1 ratio, smoking habits, apoprotein A1, and apoprotein A2. By means of these variables a total of 85% of all subjects could be correctly classified. We conclude that as early as age 21 years the offspring of patients with premature coronary heart disease differ from matched control subjects in lipoprotein measurements and in smoking habits.

Adult↗

Pilot project for registering acute myocardial infarctions in Belgium.

In order to prepare Belgian participation in the International Study "Monitoring of trends and determinants in cardiovascular disease (MONICA)", a pilot project for registration of acute myocardial infarctions was organized in the Flemish city of Ghent and the Walloon city of Charleroi. Thanks to the collaboration of 449 general practitioners and 17 hospitals, 790 acute coronary events (fatal and non-fatal) were registrated during one year among the 251 000, 25 to 69 year old, inhabitants of Ghent and Charleroi. The registration procedures, strictly standardized between the two cities, allowed comparison of the incidence data. In males, the total incidence of acute myocardial infarction is 10% higher in Charleroi than in Ghent. In the female population, the incidence is 37% higher in the Walloon city compared to the Flemish city.

Adult↗

Belgian heart disease prevention project: incidence and mortality results.

Results are presented from the Belgian Heart Disease Prevention Project, part of the WHO European Collaborative Trial in the Multifactorial Prevention of Coronary Heart Disease (CHD). 19 409 men aged 40-59 yr took part; they were employed in thirty factories which formed the allocation units for a randomised controlled trial lasting 5-6 yr. The intervention package consisted largely of health education promoting a cholesterol-lowering diet, smoking cessation, weight control, physical activity, and treatment of arterial hypertension. A programme of information was supplemented by face-to-face counselling at the workplace by two physicians attached to the project. The coronary risk profile was reduced in the intervention group, compared with that in the control group, especially during the first 4 yr, by effects on serum cholesterol, number of cigarettes smoked daily, and arterial blood-pressure. Total mortality was 17.5% lower in the intervention group than in the control group (p = 0.038). Coronary mortality was reduced by a non-significant 20.8% whereas CHD incidence (non-fatal myocardial infarction plus fatal myocardial infarction plus sudden deaths) was reduced by 24.5% (p = 0.031). Non-fatal myocardial infarction (not a major end-point) was similarly reduced by 26.1% (p = 0.030).

Adult↗

Behavior, stress, and psychosocial traits as risk factors.

Although psychosocial factors have long been associated with the pathogenesis of heart disease, the independent relation between these variables and coronary heart disease (CHD) is still controversial. However, when experimental, clinical pathological, and epidemiologic studies are taken together, strong evidence is provided that psychosocial and behavioral factors are important in the development and the provocation of clinical CHD manifestations. Heterogeneity in study results is partially due to methodological problems in defining and measuring behavior, stress, and psychosocial traits in population groups as well as in individuals. The difficulties in separating the role of psychosocial factors from the classic risk factors strengthen the importance and need for these factors to be considered in the design of further clinical and epidemiologic studies, not only to explore their independent predictive value but also to study their role in adherence to preventive advice and in the reversibility of risk. In these respects results are presented from a prospective epidemiologic and from a controlled multifactorial intervention study.

Adult↗

Type A in relation to job-stress, social and bioclinical variables: the Belgian Physical Fitness Study.

The present study focuses on the relationship of Type A behavior, a suspected coronary-prone behavior pattern in its overall or specific aspects, to "stress" experienced at work, and to social and coronary bioclinical risk factors. In order to measure Type A behavior and Job-Stress, respectively, the Jenkins Activity Survey Questionnaire (J.A.S. for employed persons, 1969 version) and a self-constructed Job-Stress Questionnaire were administered at a base-line examination to 2,302 men aged 40-50 years. The multivariate analysis shows: A strong Type A behavior-Job-Stress relationship; An important relationship between employment grade, educational attainment and--to a lesser extent--, marital status and, overall Type A behavior, Speed and Impatience and Job-Involvement, A weak relationship between cholesterol and triglycerides (not found in univariate analysis), and, overall Type A behavior; a small weak relationship between smoking habits, and, Speed and Impatience and Hard-Driving. A direct relationship between heavy physical activity during leisure-time and Job-Involvement.

Adult↗

Metrological study of psychological questionnaires with reference to social variables: the Belgian Heart Disease Prevention Project (BHDPP).

In the framework of a controlled trial on the multifactorial prevention of coronary heart disease, two measures of type A behavior--determined by the Bortner scale and the Jenkins Activity Survey (JAS)--and one personality questionnaire--the Sandler Hazary Questionnaire and Eysenck Personality Inventory (SHEPI)--were used. Their interrelations and relations with social variables are analyzed. It appears that the Bortner scale and the JAS do not measure the overall syndrome of the coronary-prone behavior pattern (CPBP), but similar and different specific aspects of it. There exists a direct relation of the Bortner score, JAS-AB, JAS'-S, and JAS-J with the study level and the socioprofessional class. Neuroticism or emotional hyperreactivity determined by the SHEPI is highly correlated with these scores. No or small relations of social variables with personality traits are found.

Adult↗

Discriminative value of lipids and apoproteins in coronary heart disease.

Serum cholesterol, HDL cholesterol (HDL-C), and apoproteins, A1, A2 and B were determined in 70 male survivors of myocardial infarction and in an equal number of healthy controls, matched for age, sex and body mass index. In univariate analyses, the Apo B/Apo A1 ratio discriminated the best between cases and controls, giving a 72% exact classification. In a multivariate analysis, the Apo B/Apo A1 ratio, HDL-C and the Apo A2/Apo A1 ratio contributed independently to the discrimination of cases from controls while the overall exact classification was 82%. These promising results were comparable in younger and older subgroups. Thus, the determination of apoproteins yielded complementary information in this cross-sectional survey and warrants further study in a prospective setting.

Adult↗

Double-blind comparison of Diltiazem and placebo in the treatment of exercise-inducible chronic stable angina pectoris.

The effect of Diltiazem, a calcium antagonist drug, were compared with those of placebo on exercise performance. Twenty four patients with exercise-inducible chronic stable angina pectoris were studied over a double-blind period of 8 weeks. The active product was generally well tolerated. Diltiazem was effective in increasing the anginal threshold, in decreasing the ST-segment depression at an identical submaximal workload and in increasing the time to termination of exercise. These results are in accordance with those of others but the mechanisms whereby these effects occur are unclear; the observed results suggest that peripheral effects are not primarily responsible for the drugs' efficacy.

Aged↗

The Belgian Heart Disease Prevention Project: type "A" behavior pattern and the prevalence of coronary heart disease.

A relation between the Type A behavior pattern and the prevalence of coronary heart disease (CHD), independent of other coronary risk factors, was demonstrated in the Belgian Heart Disease Prevention Project. The association was strongest with angina pectoris or with electrocardiogram (ECG) abnormalities in subjects with known CHD; however, particular aspects of the Type A behavior pattern dealing with time urgency were also related to ECG abnormalities in patients with no angina pectoris and no history of CHD.

Adult↗

Physical activity and physical fitness levels of Belgian males aged 40-55 years.

Physical activity during leisure time and on the job have been measured with standardized interview techniques in 1,513 normal men, aged 40-55 years, who were regularly employed in different industries. Physical fitness was simultaneously estimated by measuring the work load at which a heart rate of 150 bpm was reached on a standardized exercise test. The median energy expenditure from leisure time activities above the basal metabolic rate was 195 kcal/day; 19% of these activities were classified as heavy, 37% as moderate and 43% as light intensity. The median energy expenditure from job physical activity was 1,676 kcal/day including basal metabolic rate. The median physical fitness level was 125 W. The leisure time activity score was significantly related to physical fitness through the light and the heavy intensity subscores. Independently, job physical activity was also significantly related to physical fitness. However, both activity scores accounted for only 2% of the variance in physical fitness. The data illustrate an overall low energy expenditure profile of middle-aged normal men and a low order relationship between physical activity pattern and physical fitness.

Adult↗

Lipid and apoprotein levels in myocardial infarction survivors. A case-control study.

Serum cholesterol (TC), Triglycerides (TG), high density lipoprotein (HDL) cholesterol and the apoproteins A1 and B were determined in 20 males survivors of myocardial infarction and in 20 healthy age and sex matched controls. HDL-C, HDL-C/TC and apo B/apo A1 were significantly different between the two groups. In a multivariate statistical analysis 85% of all subjects were correctly classified by using the HDL-C/TC and the apo B/apo A1 ratio. This study indicates that the apoproteins quantification yield complementary information in discriminating young male myocardial infarct survivors from normal controls.

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[The Belgian Heart Disease Prevention Project (author's transl)].

The Belgian Heart Disease Prevention Project is a controlled multifactorial preventive trial. It is basal on the well-documented epidemiologic notion of major coronary risk-factors: hypercholesterolemia, hypertension, smoking and obesity. This Project has been executed in industries, in males aged 40-59 yrs at the base-line screening. It is part of the WHO European Collaborative Trial including the United-Kingdom, Italy, Poland and Spain. This trial should verify a double work-hypothesis: 1 degree it is possible to modify significantly the coronary risk profile in middle-aged males through a comprehensive intervention program, 2 degrees this modification should, in turn, significantly reduce total mortality as compared to a control group. The authors discuss the pros and cons of a preventive trial in industry and review the numerous problems raised by the difficulties in modifying well-established life-styles as well as those related to the follow-up morbidity and mortality. Final screening took place in 1979-80 and results regarding incidence should be available by 1981.

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