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Biomedical subjects

G Lamm

Publications and source records attributed to G Lamm.

31 records · Page 2Linked to original sources
PubMed1985

Risk factors for coronary heart disease in rural Hungary.

This is a ten-year study of a cohort of 1088 Hungarian men aged 40-59 at entry, with a 99% baseline response rate and complete ascertainment of cases and follow-up. The methods were state of the art for the period the survey was performed, with quality control for standard procedure and training. Zero, five- and ten-year examinations were carried out and standard risk factors measured and analysed in relation to the ten-year experience, ie, age, blood cholesterol, blood pressure, smoking, body mass, vital capacity, and skinfolds. Risk factor levels were high relative to the Mediterranean and Oriental populations in the Seven Countries Study. The five-year coronary heart disease rates were intermediate between the low rates in Yugoslavia and Greece and high rates in Finland. Ten-year events were significantly and linearly related to quintile values of serum cholesterol and of 3, 4, 6, and 9 risk factors in the Walker-Duncan logistic model. Discrimination was not substantially improved beyond three factors apart from age. The maximal prediction concentrated 62% of events in the upper 20% of multifactor risk, and up to 80% in the upper 40% of risk. The authors conclude, from this separate but comparable study to the Seven Countries Study, that the results are not greatly different from that study or from the US Pooling Project. Unique features of the study, and its results, are the eastern European population, the absence of a strong CHD relationship with smoking, and the strong independent relationship with body mass.

Adult↗
PubMed1983

Clinical implications of population-based studies in Europe.

The cross-fertilization of epidemiology and clinical medicine is a continuous process. The impressive progress in cardiovascular disease (CVD) epidemiology of the last 30 years was substantially reinforced by large population-based intervention studies in the last decade. As a result, guidelines for prevention are emerging with relatively clear implications for clinical medicine in general. Two such guidelines were recently published by the Royal College of General Practitioners (2, 5). However, the application of these general principles in day-to-day doctor-patient interaction is not easy. General health promotion counseling in the family, conscientious case findings, and regular follow-up are the main points of agreement between epidemiologists and progressive clinicians. Preventive treatment with drugs, however, needs to be decided in each case individually. The ever-increasing new epidemiological knowledge, the intimate knowledge of the individual and his family, and the careful balancing of potential benefits and possible side effects of treatment coupled with the art of the clinician are helping physicians to make these difficult decisions correctly. In order to maximally diminish the current need for such difficult decision making, when the patient's risk is already high, generally adopted, sound, and safe health promotion efforts should be pursued by clinicians in their everyday activities. WHO will continue to encourage the accumulation of sound knowledge in prevention of CVD and other chronic diseases. The future calls for comprehensive health promotion policies focused on the individual and on the community, not only in regard to single diseases.

Coronary Disease↗
PubMed1976

Community control of cardiovascular diseases. The pro and cons.

The need for an effective control of cardiovascular diseases is evident. Possibilities to achieve this both in the curative and the preventive field are restricted mainly due to the insufficient knowledge of their etiopathogenesis. Although the cause is not known, the discovery to risk factors provides a sound evidence for prevention. Attempts to reverse elevated risk factor levels are all directed towards a more healthy way of life. Group oriented prevention is one of the most frequently applied approaches to test the hypothesis of preventability. While it offers many advantages, the delayed timing of the intervention and the restricted coverage limits the possibility of inference from its results. The community approach implies acting on the whole population by changing their behaviour towards a more healthy way of life. Apart from the beneficial "side effects" on other chronic diseases, their outcome in the pilot areas may be inferred to the total population. The final proof of any scientific evidence from the public health point of view is, after all, its applicability and effectiveness in real life situation.

Cardiovascular Diseases↗