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H Blackburn

Publications and source records attributed to H Blackburn.

At least 91 records · Page 5Linked to original sources
PubMed1989

Seven Countries Study. First 20-year mortality data in 12 cohorts of six countries.

Out of the original 16 cohorts in the Seven Countries Study on Cardiovascular Diseases, 12 population samples in six countries have reached the 20 year follow-up deadline. Data on mortality became fully available for a total of 8287 men aged 40-59 at entry examination (two cohorts in Finland, one in the Netherlands, three in Italy, two in Yugoslavia, two in Greece, and two in Japan). Death rates from CHD as well as from all causes follow the traditional falling north to south trend (18 fold between the extremes for CHD; 2.7 fold for total mortality). The differences in all causes mortality are, however, largely accounted for by the variation in CHD mortality. The mean entry levels of serum cholesterol and representative levels of the consumption of saturated fats, mono-unsaturated fats, poly-unsaturated fats and carbohydrates explain a large proportion of inter-cohort difference in CHD mortality (81% for saturated fats). By applying the proportional hazards model to the pools of national cohorts, with CHD deaths as end-point and five risk factors as covariates, only age and mean blood pressure are universally significant predictors of fatal events. Cholesterol, smoking habits, body mass index and physical activity play some part but not in all the pools. Age and mean blood pressure are also the only universal risk factors for all causes of death.

Adult↗
PubMed1989

Trends and determinants of CHD mortality: changes in risk factors and their effects.

Cardiovascular disease risk factor and mortality data collected since the 1978 Conference on the Decline in Coronary Heart Disease Mortality were reviewed. Risk factor and disease trends were generally parallel and compatible with current hypotheses of cause and prevention. A few discrepancies between risk factors and disease change were noted and discussed. Models were presented for estimating effects of risk factor and medical care changes on disease trends. Their usefulness and limitations were considered. An ongoing need was elaborated for systematic and innovative surveillance research to expand and improve the capability to measure, explain, and predict disease trends. Rational public health policy depends on competent and sustained surveillance.

Coronary Disease↗
PubMed1989

The relationship between social status and body mass index in the Minnesota Heart Health Program.

This study investigated relationships between social variables and body mass index (BMI) in 2465 men and 2792 women aged 25 to 74 in six upper midwestern communities. After controlling for age and cigarette smoking status, BMI was significantly related to education, income, occupation, and marital status in both men and women. SES variables tended to be inversely related to BMI, with a steeper gradient for women than for men. A curvilinear trend was noted, however, in that social status tended to be lower at both ends of weight distribution than in the middle. The relationship between marital status and BMI was also found to be curvilinear. Highest rates of marriage were in the middle portion of the weight distribution for both sexes.

Adult↗
PubMed1989

Trends in CHD mortality, morbidity and risk factor levels from 1960 to 1986: the Minnesota Heart Survey.

The Minnesota Heart Survey (MHS) assessed population trends in coronary heart disease (CHD) mortality, morbidity and risk factor levels in the Twin Cities metropolitan area to explain the decline in CHD deaths. Age-adjusted CHD mortality rates declined in Twin Cities residents aged 30 to 74 from 1968 to 1986 by 52% in men and 58% in women. Much of the decline in CHD mortality was attributable to decreased out-of-hospital deaths. Attack rates based on hospitalized definite myocardial infarction (MI) did not change from 1970 to 1985, and hospital case-fatality rates declined consistently from 1970 to 1985 (from 21% to 11% in men, from 27% to 17% in women). Dramatic increases were noted in the percentage of patients undergoing cardiac procedures (coronary artery bypass, angioplasty, and thrombolytic agents). Trends in CHD rates were associated with improved population levels of risk factors. Average serum total cholesterol levels decreased by 8 mg/dl and 11 mg/dl between 1973 and 1987 in men and women, respectively. Cigarette smoking prevalence declined from approximately 40% to 30%. Average systolic blood pressure apparently declined about 1 mm Hg and diastolic blood pressure by 2 mm Hg from 1973 to 1987. Body mass index (wt/ht2) increased by 1 unit in men and 1.7 units in women from 1973 to 1987. These data suggest that a combination of primary prevention and improved medical care of acute CHD contributed to the decline in CHD mortality.

Adult↗
PubMed1988

Cardiovascular risk factor change--1973-74 to 1980-82: the Minnesota Heart Survey.

Reductions in population risk factor levels, including blood pressure, blood cholesterol, and cigarette smoking may be associated with the observed decline in cardiovascular disease (CVD) mortality rates. However, few recent population-based comparisons of risk trends are available. To evaluate changes in these risk characteristics in the recent period, data were compared from two surveys performed in the same metropolitan area using similar methods. The Lipid Research Clinic (LRC) Prevalence Study surveyed a population sample of 4185 adults aged 25-59 in 1973-74. The Minnesota Heart Survey (MHS) surveyed a population sample of 2914 adults of the same age in the same metropolitan area in 1980-82. The average systolic and diastolic blood pressures were significantly lower in the 1980-82 survey averaging 1.5/3.8 mmHg for men and 1.6/2.8 mmHg for women. The use of anti-hypertensive medications increased significantly over the period while the prevalence of hypertension was similar. Significant declines in mean serum cholesterol were also observed in 1980-82, averaging 3.3 mg/dl for men and 5.5 mg/dl women. The prevalence of regular cigarette smoking in men was also lower in 1980-82, 36.3 vs 42.1% in 1973-74. Women had a lower prevalence of smoking (38.8-35.6%) but the average woman smoker increased consumption of cigarettes while the average man did not. These observations suggest that population risk defined by these characteristics is declining which may explain part of recent Minnesota trends in CVD mortality and could have a favorable effect on future disease patterns.

Adult↗
PubMed1988

Educational attainment and nutrient consumption patterns: the Minnesota Heart Survey.

To explore whether dietary patterns differ according to educational attainment, we examined the associations of nutrient intake with educational level in a sample of 825 male and 893 female Twin Cities (Minneapolis and St. Paul) residents aged 25 to 74 years who were surveyed between 1980 and 1982. Of particular interest was the pattern of macronutrient consumption, since the proportion of fat and type of fat in the diet is thought to be related to the development of chronic disease. Estimates of nutrient intake were based on 24-hour dietary recalls, while information on education was obtained through interview. Educational attainment was positively associated with nutrient consumption patterns that may decrease risk of chronic disease for both men and women. For women, the proportion of dietary fat was less (p = .03) and carbohydrate greater (p = .004) with increasing education. For men, the Keys dietary score decreased as education increased (p = .05) (high scores indicate greater blood cholesterol-raising effect of the diet). Inverse associations of average total serum cholesterol level with education in both men (p = .02) and women (p = .06) support these dietary associations. These results suggest that educational attainment is related positively to eating patterns that may carry a decreased risk of cardiovascular and other chronic disease. Whether or not this association is causal, it would appear to point to a need for more effective nutrition education strategies for those with less education.

Adult↗
PubMed1987

Improvement in long-term survival among patients hospitalized with acute myocardial infarction, 1970 to 1980. The Minnesota Heart Survey.

The mortality rate associated with coronary heart disease in the United States has declined steadily since 1968, but the reasons for this favorable trend have not been completely elucidated. In particular, it is not clear to what extent the decline reflects decreasing incidence as opposed to improved survival. To assess whether improved survival after myocardial infarction has contributed to the decline, the Minnesota Heart Survey compared the four-year survival rate in patients discharged with a diagnosis of acute myocardial infarction from hospitals in the Twin Cities area in 1970 and 1980. After adjustment for clinical characteristics related to outcome, the survival rate among patients with a definite myocardial infarction was significantly higher in the 1980 than in the 1970 group. The four-year survival for men was 35 percent better in the 1980 than in the 1970 group (95 percent confidence interval, 21 to 50 percent), and for women it was 27 percent better (95 percent confidence interval, 1 to 46 percent). Improvement in survival during the period of hospitalization accounted for 70 percent of the overall gain in survival between 1970 and 1980 in men and for virtually all of the gain in women. We conclude that improved long-term survival among patients with acute myocardial infarction has made an important contribution to the decline in mortality from coronary disease.

Female↗
PubMed1987

Nutrient intake in a metropolitan area, 1973-74 vs 1980-82: the Minnesota Heart Survey.

Trends in dietary intake in the Twin Cities metropolitan area were measured by comparing data from two independent surveys conducted in 1973-74 and 1980-82. Dietary information was collected by 24-h recall and coded by a single coding center. For men reported caloric intake declined significantly and fat, protein, and carbohydrate each declined approximately 6%; changes in reported dietary intake for women were smaller and mostly nonsignificant. Few trends were observed for either sex in nutrient intake relative to energy intake. Changes in mean serum total-cholesterol levels and body mass indices between 1973-74 and 1980-82 were not consistent with the direction of dietary trends. The proportion of subjects whose 24-h intake met five selected US dietary goals was calculated. In 1980-82, less than 15% of persons reached the goals for carbohydrate and fat intake on the day surveyed; the cholesterol-intake goal (less than or equal to 300 mg/d) was met by 39% of men and 64% of women during the 24-h period surveyed.

Adult↗
PubMed1986

Systematic risk factor screening and education: a community-wide approach to prevention of coronary heart disease.

Within a community-wide heart disease prevention effort, it was hypothesized that personalized risk factor screening and education would result in modified health behaviors and reduced risk factor levels for coronary heart disease. Adults from a population sample were randomized to a community-wide screening and education program or were excluded from that program for 1 year. At the end of that year, both groups were measured for risk factor levels and related health behaviors. Those who received the screening and education program had significantly lower risk factor levels and other evidence of health behavior change, including lower blood cholesterol (206.9 vs 211.5 mg/dl), lower diastolic blood pressure (68.7 vs 70.0 mm Hg), lower resting heart rate (71.4 vs 72.7 bpm), and increased selection of low-fat and low-sodium meals in local restaurants. These data suggest that systematic risk factor screening and education may result in lower population risk for coronary heart disease.

Adult↗
PubMed1986

The diet and 15-year death rate in the seven countries study.

In 15 cohorts of the Seven Countries Study, comprising 11,579 men aged 40-59 years and "healthy" at entry, 2,288 died in 15 years. Death rates differed among cohorts. Differences in mean age, blood pressure, serum cholesterol, and smoking habits "explained" 46% of variance in death rate from all causes, 80% from coronary heart disease, 35% from cancer, and 45% from stroke. Death rate differences were unrelated to cohort differences in mean relative body weight, fatness, and physical activity. The cohorts differed in average diets. Death rates were related positively to average percentage of dietary energy from saturated fatty acids, negatively to dietary energy percentage from monounsaturated fatty acids, and were unrelated to dietary energy percentage from polyunsaturated fatty acids, proteins, carbohydrates, and alcohol. All death rates were negatively related to the ratio of monounsaturated to saturated fatty acids. Inclusion of that ratio with age, blood pressure, serum cholesterol, and smoking habits as independent variables accounted for 85% of variance in rates of deaths from all causes, 96% coronary heart disease, 55% cancer, and 66% stroke. Oleic acid accounted for almost all differences in monounsaturates among cohorts. All-cause and coronary heart disease death rates were low in cohorts with olive oil as the main fat. Causal relationships are not claimed but consideration of characteristics of populations as well as of individuals within populations is urged in evaluating risks.

Adult↗
PubMed1986

Population strategies to enhance physical activity: the Minnesota Heart Health Program.

A population-wide, community-based program in cardiovascular disease prevention, the Minnesota Heart Health Program (MHHP), has been designed to promote more frequent and vigorous physical activity in North American communities, along with improved eating and smoking patterns. The physical activity component of this broad-based education strategy is based on the facilitation which physical activity provides to lowering of other risk characteristics for heart disease and its enhancement of other healthy behaviors and on the potential for prevention of elevated risk in the first place. The rationale for a population strategy to complement medical approaches to prevention is that exercise patterns are largely socially learned and culturally determined. The MHHP Physical Activity Program is implemented through three major education strategies: direct education, community organization, and mass communications. Early results from this 10-year project indicate that it is feasible to enter U.S. communities and to involve their leadership actively in MHHP activities of health promotion. Moreover, attitudes, knowledge, awareness, participation, and behaviors related to exercise and eating patterns appear to be changed by the program. Nevertheless, there are problems in the design, implementation, analysis and interpretation of population changes in physical activity and other health behaviors in community demonstration programs. These issues, along with their solutions, should provide useful information for medical science and for the public health about population strategies of disease prevention and health promotion.

Adolescent↗