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Biomedical subjects

G Wannamethee

Publications and source records attributed to G Wannamethee.

46 records · Page 3Linked to original sources
PubMed1990

Weight change in middle-aged British men: implications for health.

The relationship between weight change over a 5-year period and subsequent mortality during a further 4-year follow-up was examined in a prospective study of 7735 British middle-aged men. Over half of the men remained stable (less than 4 per cent change in body weight), 31 per cent gained weight and 14 per cent lost weight over 5 years. There were 357 deaths from all causes and men with stable weight had the lowest mortality rates. Considerable weight gain (greater than 15 per cent gain in body weight) was associated with an increased risk of cardiovascular (CVD) mortality even after adjustment for initial age, body mass index, blood cholesterol, systolic blood pressure and smoking status. Loss of weight was significantly associated with increased mortality largely due to cancer and other non-cardiovascular causes. The association between weight loss and cancer was more marked in non-obese men and emphasizes that weight loss is a potentially serious symptom. Weight loss to non-obese status was associated with a halving of cardiovascular mortality. The benefit was restricted to hypertensive obese men in whom the mortality reduction was considerable and significant. Considerable weight gain in later adult life, even over a short period of follow-up, is not a benign process, it is harmful to health.

Body Weight↗
PubMed1989

Body weight and mortality in middle aged British men: impact of smoking.

OBJECTIVE: To assess the relation between body mass index and mortality in middle aged British men. DESIGN: Men who were recruited for the British Regional Heart Study were followed up for a mean of nine years. SETTING: General practices in 24 British towns. SUBJECTS: 7735 Men aged 40-59 years selected from the age-sex registers of one group practice in each of the 24 towns. MAIN OUTCOME MEASURE: Mortality from cardiovascular and non-cardiovascular causes. RESULTS: 660 Of the men died. There was a U-shaped relation between body mass index and total mortality. Very lean men (less than 20 kg/m2) had by far the highest mortality followed by lean men (20-22 kg/m2) and obese men (greater than or equal to 28 kg/m2). The high mortality in lean and very lean men was due largely to non-cardiovascular causes, particularly lung cancer and respiratory disease, which are associated with cigarette smoking. In obese men deaths were more likely to be due to cardiovascular causes. There was a strong inverse association between body weight and cigarette smoking. When the pattern of mortality was examined by age, smoking habits, and pre-existing smoking related disease both very lean men and obese men consistently had an increased mortality. The U-shaped relation was most prominent in men in the oldest age group (55-59). Current smokers had a higher mortality than former smokers at virtually all values of body mass index. An increased mortality in lean men was seen only in current smokers and in men with smoking related disease. Among men who had never smoked, lean men had the lowest total mortality, thereafter mortality increased with increasing body mass index (p less than 0.01). CONCLUSIONS: This study provides strong evidence of the impact of cigarette smoking on body weight and mortality and strongly suggests that the benefits of giving up smoking are far greater than the problems associated with the increase in weight that may occur.

Adult↗
PubMed1988

Alcohol and mortality in British men: explaining the U-shaped curve.

In a prospective study of 7735 middle-aged 7 British men, 504 of whom died in a follow-up period of 7.5 years, there was a U-shaped relationship between alcohol intake and total mortality and an inverse relationship with cardiovascular mortality, even after adjustment for age, cigarette smoking, and social class. These mortality patterns were seen in all smoking categories (with ex-smoking non-drinkers having the highest mortality) and were observed in manual but not in non-manual workers. The alcohol-mortality relationships (total and cardiovascular) were present only in men with cardiovascular or cardiovascular-related doctor-diagnosed illnesses at initial examination. The data suggest that the observed alcohol-mortality relationships are produced by pre-existing disease and by the movement of men with such disease into non-drinking or occasional-drinking categories. The concept of a "protective" effect of drinking on mortality, ignoring the dynamic relationship between ill-health and drinking behaviour, is likely to be ill founded.

Alcohol Drinking↗
PubMed1988

Seroepidemiologic studies on the acquisition of antibodies to cytomegalovirus, herpes simplex virus, and human immunodeficiency virus among general hospital patients and those attending a clinic for sexually transmitted diseases.

A total of 731 sera were collected from general hospital patients, divided into five distinct subgroups, and tested for the presence of immunoglobulin (IgG) to cytomegalovirus (CMV) and herpes simplex virus (HSV). The results indicate a high level of association between the two viruses, although HSV was found to be more prevalent in the earlier years of life, whereas CMV was acquired constantly throughout life. An increase in age was also accompanied by significantly higher antibody levels to both viruses. Individuals with antibody to HSV were significantly more likely to have antibodies to CMV, suggesting that these viruses are transmitted by similar routes (?saliva). In addition, 430 sera from 94 homosexual and 336 heterosexual males attending a clinic for sexually transmitted diseases were tested for antibody to CMV, HSV, and human immunodeficiency virus (HIV). Homosexual males were more likely to have antibody to CMV and HIV than were heterosexuals, but no difference was seen for HSV antibodies. The levels of CMV-specific IgG were significantly raised in homosexuals, compared with heterosexuals, but again no difference was seen for HSV antibodies as in the general hospital patients, however, individuals with HSV antibodies were significantly more likely to possess antibodies to CMV. However, the additional association of CMV antibodies with a homosexual lifestyle suggests that an alternative route for acquisition of this virus exists (?semen). As raised levels of CMV antibodies, but not HSV antibodies, were found among homosexuals, this suggests that frequent CMV reinfections, rather than merely reactivation of latent herpes viruses, may be occurring.

Antibodies, Viral↗
PubMed1988

Men who do not drink: a report from the British Regional Heart Study.

Men who do not drink are frequently used as a baseline against which the effects of alcohol consumption are measured. The characteristics of such men have been examined in a large-scale prospective study of cardiovascular disease involving 7735 middle-aged men drawn from general practices in 24 British towns. Non-drinkers include lifelong teetotallers and ex-drinkers, both long-term and recent. Long-term ex-drinkers have many characteristics likely to increase their morbidity and mortality; recent ex-drinkers have similar characteristics but to a less marked degree. Ex-drinkers are older than the other groups and include an increased proportion of unmarried men and men in manual occupations. They have the same high percentage of current cigarette smokers as moderate/heavy drinkers and a prevalence of hypertension and obesity similar to moderate/heavy drinkers and higher than lifelong teetotallers or occasional/light drinkers. Ex-drinkers have the highest percentage of men with multiple doctor-diagnosed disorders. In particular, they have the highest prevalence rates of angina and possible myocardial infarction on standardized questionnaire, of myocardial infarction on electrocardiogram and of recall of a doctor-diagnosis of ischaemic heart disease. They also have high prevalence rates of recall of high blood pressure, peptic ulcer, diabetes, gall bladder disease and bronchitis. They have the highest rates for regular medical treatment and the highest proportion of men who consider their health to be poor. It is abundantly clear that the general category of non-drinkers, which includes a large proportion of ex-drinkers, should not be used as a baseline against which to measure the effects of alcohol consumption. Overall, it would appear that the occasional/light drinking category (less than 15 drinks/week) provides a large and satisfactory baseline group for comparative purposes in the study of cardiovascular and other organic disorders.

Adult↗
PubMed1988

Height and social class in middle-aged British men.

A study of 7735 middle-aged British men drawn from general practices in twenty-four towns shows that there has been a progressive increase in mean height in the men who were born between 1919 and 1939. This is true for both manual and non-manual classes, but the mean heights of the two groups are significantly different and remain widely separated over this period of time. Manual workers lag twenty years behind non-manual workers in their attained height. Data from other studies indicate that this social class difference in adult height is still present in those born up to 1960. The variation in mean height between the twenty-four towns is less marked than the variation in mean height between the social classes. After social class and age have been taken into account, a "town effect" on height is still present. If height is accepted as an indicator of socio-economic circumstances in childhood, then there is a difference in adult height between social class groups in Great Britain which does not appear to be diminishing.

Body Height↗
PubMed1988

Alcohol and blood pressure in middle-aged British men.

The relationships between alcohol intake and blood pressure have been examined in 7,735 middle-aged men drawn at random from general practices in 24 British towns. Both mean systolic and diastolic BP are increased in moderate (16-42 drinks/week) and heavy (greater than 42 drinks/week) drinkers. The alcohol-blood pressure relationship is independent of age, body mass index and social class despite their associations with both alcohol intake and BP. The prevalence of hypertension (systolic greater than or equal to 160 mmHg or diastolic greater than or equal to 90 mmHg) is increased in both moderate and heavy drinkers. Non-drinkers have higher rates of diastolic hypertension than occasional or light drinkers, probably due to changes in drinking habits made by those diagnosed as hypertensives. Furthermore, recall of doctor diagnosis of hypertension and of anti-hypertensive treatment is highest among non-drinkers. It is estimated that about 10% of hypertension (systolic or diastolic) can be attributed to moderate or heavy drinking. There is a clear need for increased awareness of the alcohol-blood pressure relationship. Current drinking status should be determined in all hypertensive subjects, and assessment of alcohol effect by temporary withdrawal should be the first step in the management of anyone with sustained hypertension who drinks.

Adult↗
PubMed1988

Changes in drinking habits in middle-aged British men.

The drinking behaviour of 7735 middle-aged men drawn from general practices in 24 British towns was determined in 1978-80 and five years later in 1983-85. Those with heavier initial drinking were more likely to have reduced consumption after five years. At every level of consumption manual workers showed a greater tendency to decrease drinking than non-manual workers. Of those who became non-drinkers over the five years, 12% had been moderate or heavy drinkers. Men who were told by a doctor that they had developed ischaemic heart disease during the five years were more likely to reduce their alcohol consumption than men who remained free of ischaemic heart disease. Similarly, men who were put on regular medical treatment of any kind or who acquired two or more diagnoses of illness (including ischaemic heart disease) were more likely to become occasional or non-drinkers. Nondrinkers at both reviews had higher rates of diagnosed illness than drinkers. In particular, the ex-drinkers, who comprised 70% of non-drinkers at follow up, had higher rates of ischaemic heart disease and cardiovascular-related problems, such as high blood pressure and diabetes, than drinkers.It is essential to be aware of the tendency for moderate or heavy drinkers to reduce or stop drinking over time, particularly if illness has been diagnosed. Non-drinkers and exdrinkers should not be used as a baseline in studies relating alcohol to disease.

Alcohol Drinking↗
PubMed1988

Observer bias in blood pressure studies.

Observer variation in blood pressure measurement following training with standard techniques has been investigated in a study of 7735 middle-aged men. The initial training produced consistent results between observers, but there were progressive deteriorations in the ensuing months. Subsequent re-training led to marked though inconsistent reductions in variation, but within 1 or 2 months, observers reverted back to an individual level of bias. The magnitude of observer variation is in line with the few other published accounts, and is sufficient to have important implications for group comparisons, clinical trials, and the clinical care of individual patients. Four methods of reducing observer variation are considered: regular re-training, self-measurement and ambulatory monitoring, automatic sphygmomanometers, and adjustment in the analysis. The adjustment procedure used in the British Regional Heart Study is described. Regular and frequent re-training with monitoring of performance, or the use of automatic machines are presently considered the two most practical methods of reducing observer variation.

Adult↗