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H Blackburn

Publications and source records attributed to H Blackburn.

At least 109 records · Page 6Linked to original sources
PubMed1986

Physical activity and hypertension.

Cross-sectional comparisons of athletes and nonathletes and of active and inactive occupations do not support the hypothesis that habitual physical activity protects against hypertension. However, more powerful cohort studies tend to support the hypothesis but indicate that the effect, if any, is not great. Conditioning level experimental exercise studies suggest, but do not establish, a lowering effect of activity on normal and elevated blood pressure. However, the potential effect of regular physical activity in the population is considered to be great in the prevention of high blood pressure because of the influence of a small beneficial effect acting on large numbers of people over time.

Animals↗
PubMed1986

[Prevention and treatment of hypertension at the population level: the Minnesota Heart Health Program].

The Minnesota Heart Health Program is a ten year research and demonstration trial for the primary prevention of coronary heart disease. Community wide prevention and control of hypertension is among the major goals of this study. Systematic population screening for hypertension, mass media campaigns, adult and youth education programs, physician and health professional programs, and community organization efforts are part of the multiple strategy approach to prevention. Replication in three sites, annual risk factor surveys and morbidity/mortality surveillance will provide evidence for the value of this community wide approach at the end of ten years.

Adolescent↗
PubMed1985

Smoke exposure in pipe and cigar smokers. Serum thiocyanate measures.

Pipe or cigar smoking traditionally has been considered a less risky alternative to cigarette smoking. Some surveys and experimental studies have suggested, however, that former cigarette smokers who switch to cigars and/or pipe (CP) are more likely to inhale then CP users who never smoked cigarettes; but this relationship has not been consistently noted. To clarify smoke-exposure levels from CP smoking, smoking histories and serum thiocyanate (SCN) levels were studied in 9,106 adults aged 25 to 74 years in population-based surveys of seven upper Midwestern communities. Analyses of the 306 male CP smokers indicated a significantly higher SCN level in the ex-cigarette-smoking CP users vs the CP users who never smoked cigarettes. Serum thiocyanate levels of both CP groups were significantly higher than those of nonsmokers and lower than cigarette-only smokers. However, the number of pipe bowls or cigars smoked per day was also significantly related to SCN levels, and this could account for much of the association between SCN and previous cigarette smoking status. Individuals currently smoking four or more pipe bowls or four or more cigars per day had an elevated smoke exposure equivalent to about ten cigarettes per day, whether or not they previously smoked cigarettes. Because of these findings and because former cigarette smokers were more likely to report heavy CP usage, cigarette smokers should be advised to quit rather than to switch to a pipe or cigar.

Adult↗
PubMed1985

Population risk of cardiovascular disease: the Minnesota Heart Survey.

A decline in age-adjusted ischemic cardiovascular disease mortality has been observed in the United States during the past two decades. Among the leading explanatory hypotheses is improvement in the major known risk factors for heart attack and stroke in the general population, specifically hypertension, smoking, and lipid levels. To better understand risk factor trends, the Minnesota Heart Survey (MHS) began systematic risk factor surveys of the Minneapolis-St Paul population in 1980, (population 1.99 million). The metropolitan area was divided into 704 subareas (clusters) of approx. 1000 households each, utilizing geographic boundaries. In a two-stage cluster sampling technique, 40 subareas were randomly chosen and mapped. Approximately 8.75% of households were chosen from each subarea and selected residents age 25-74 years invited to participate. A total 4451 individuals participated in 1980-82. The response rate for a home interview was 81.9 and 84.4% for a subsequent survey center visit, producing an overall response of 69.1%. The age and sociodemographic characteristics of the survey participants were similar to those found in the 1980 census. The prevalence of hypertension was 18.3% in this population with 76.0% taking medications and 65.0% controlled. Total cholesterol and HDL-cholesterol levels demonstrated age and sex differences similar to those reported elsewhere. Current smoking of cigarettes was equally prevalent in men (34.5%) and women (33.5%) although more men were former smokers (35.2 vs 20.6%). Comparison of the MHS with the National HANES II data (1976-80) indicates lower regular cigarette smoking among Minnesota males, with similar rates in females. Minnesota residents had better control of high blood pressure.

Adult↗
PubMed1985

Acute stroke in a metropolitan area, 1970 and 1980. The Minnesota Heart Survey.

Mortality rates for stroke, and hospitalization and case fatality rates for acute stroke in 1970 and 1980 were obtained for residents aged 30-74 of the Twin Cities (Minneapolis--St Paul) metropolitan area to determine whether improved hospital care contributed to the decline in stroke mortality. Age-adjusted mortality rates per 100,000 declined significantly in that decade for men (1970, 89.4; 1980, 47.5; p less than 0.01) and women (1970, 72.6; 1980, 40.9; p less than 0.01). Age-adjusted hospitalization rates per 100,000 population also declined significantly for men (1970, 438; 1980, 323; p less than 0.01) and women (1970, 331; 1980, 203; p less than 0.01). Age-adjusted mean length of hospital stay did not change significantly. Hospital case fatality declined for men aged 30-64 years (1970, 22.5%; 1980, 15.1%; p less than 0.01) but did not change significantly for 65 to 74 year-old men (1970, 16.5%; 1980, 20.0%; p = 0.09) or for all women (age-adjusted rates: 1970, 13.6%; 1980, 16.0%; p = 0.17). There was no change in the distribution of severity of hospitalized cases between years. Therefore, the decline in stroke mortality is consistent with a decreased incidence of stroke resulting from improved hypertension control. Improvements in hospital medical care appear not to have contributed substantially to the decline in stroke mortality.

Adult↗
PubMed1985

The primary prevention of high blood pressure: a population approach.

This article presents our view of the evidence and strategies for the primary prevention of high blood pressure. We (a) attempt to indicate where the potential for prevention, along with relative safety, is sufficient for action, and (b) provide an outline of our ideas and experience in communicating these strategies. We believe that a unified preventive message and plan to control and prevent high blood pressure in whole communities is possible. Such a plan must emphasize the benefits that may accrue from a more healthful lifestyle. We believe that an eating and activity pattern that is attractive, palatable, and feasible can be proposed and modeled to fit different cultures and traditions. Finally, we present the idea that medical, preventive strategies and safe, feasible, and credible community-based programs are complementary modes of dissemination. In such programs, health professionals and medical services share roles with community leaders and organizations. This population strategy is indicated along with vigorous systematic hypertension detection and treatment as well as further research. A population strategy is, we believe, essential to the primary prevention of hypertension, i.e., to the prevention of elevated blood pressure in the first place.

Cholesterol↗
PubMed1985

Leisure time physical activity and its relationship to coronary risk factors in a population-based sample. The Minnesota Heart Survey.

Energy expenditure in leisure time physical activity was measured using the Minnesota Leisure Time Physical Activity Questionnaire in a probability sample of 25- to 74-year-old residents of the seven-county metropolitan area of Minneapolis-St. Paul, Minnesota. Geometric mean estimates of leisure time physical energy expenditure were 193 kcal per day for men and 111 kcal per day for women. Only 34% of men and 17% of women expended 2,000 kcal or more per week in leisure time physical activity. Energy expenditure, especially in heavy intensity activities, declined with age, more so for women than men. Significant associations were observed between leisure time physical activity, particularly heavy intensity activity, and other coronary heart disease risk factors. Greater heavy intensity activity was associated with higher education (r = 0.14 to 0.26), greater Type A behavior (r = 0.14 to 0.15), higher serum high density lipoprotein (HDL) cholesterol levels (r = 0.09 to 0.10), lower serum thiocyanate (r = 0.10 to -0.14), lower body mass index (r = -0.10 to -0.11), lower heart rate (r = -0.07 to -0.10), and lower systolic blood pressure (r = -0.06 to -0.09). Thus, although energy expenditure was generally low in this population, greater leisure time physical activity for the most part was associated with lower coronary risk factors.

Adult↗
PubMed1985

Serum cholesterol and cancer mortality in the Seven Countries Study.

In the Seven Countries Study, carried out in Finland, Greece, Italy, Japan, The Netherlands, the United States, and Yugoslavia, among 11,325 "healthy" men aged 40-59 years in 15 years, there were 594 cancer deaths. Among 477 cancer deaths five years after cholesterol measurement, there was a significant excess of lung cancer deaths in the bottom 20% of the cholesterol distributions in the populations. Age, blood pressure, smoking habits, occupation, and relative body weight did not help explain this. A U-shaped relationship between cancer and cholesterol was not seen in any population. Trend analysis with various cutting points indicated increasing risk of lung cancer death at cholesterol levels under 170 mg/dl. The 45 men dead from cancer in the first two years had lower cholesterol levels than their compatriots who died from cancer later but they did not differ in relative weight or fatness. In contrast to relationships for individuals within populations, the highest cancer death rates were in northern Europe, where the general level of cholesterol was also highest. Other characteristics of the populations--age, relative weight, smoking habits, blood pressure, physical activity, and vitamin A and ascorbic acid in the diet--did not help in the attempt to understand the regional differences in cancer mortality. There is no evidence that any of the observed cancer-serum cholesterol relationships among or within the populations involve an effect of serum cholesterol concentration on oncogenesis or cancer mortality but the possibility of such an effect cannot be denied.

Adult↗
PubMed1984

Decline in coronary heart disease mortality. Old questions and new facts.

By 1979, mortality rates for coronary heart disease had declined for 14 consecutive years in the United States. Preliminary data indicate a continued decline. This review of reports published in the last five years documents the consistency of most data with the following hypotheses: (1) Reductions in population levels of hypertension and cigarette smoking have contributed to the decline in mortality from coronary heart disease. (2) Improved medical care for acute myocardial infarction has also contributed to the decline. Data are lacking to specify the contributions of changes in other risk factors, emergency medical services, medical care of chronic coronary heart disease, or other changes in the physical and social environment. Long-term, simultaneous surveillance of mortality, morbidity, medical care, and risk factors should be supported in five to 10 centers around the United States.

Adult↗
PubMed1984

Cardiovascular mortality trends in Minnesota, 1960-1978. The Minnesota Heart Survey.

Age-adjusted mortality rates from coronary heart disease (CHD) and other causes were examined in Minnesota for the years 1960-1978. Regions differed in CHD mortality levels and time trends. The greatest decline in CHD mortality occurred in the Twin Cities. The Northeast region had the highest CHD mortality. Influenza and pneumonia death rates were unrelated to CHD trends. Stroke mortality, which also declined sharply, showed no regional differences. Cancer mortality was highest in the Twin Cities and Northeast regions and increased significantly over the period; most of this increase was due to a striking increase in lung cancer mortality. The authors conclude that: (1) the CHD mortality decline in Minnesota was similar to that in the United States; (2) regional differences within the state in CHD mortality levels and trends were statistically significant; (3) CHD trends were not explained by influenza epidemics; (4) regions differed in mortality rates for hypertension in the same way as they did in CHD mortality, but differed little in stroke mortality. This leaves unclear the role of hypertension in regional CHD differences. (5) Trends in cancer mortality indicate that a general decline in mortality, due to factors affecting a wide variety of diseases does not explain the downward trends in CHD mortality.

Adult↗
PubMed1984

The seven countries study: 2,289 deaths in 15 years.

Among 11,579 men ages 40-59 without evidence of cardiovascular disease, 2,289 died in 15 years, 618 from coronary heart disease. The 15 cohorts in seven countries (four regions) differed in all-causes death rate, mainly reflecting great differences in coronary mortality. Among characteristics of entry, only mean blood pressure helped to explain cohort differences in all-causes death rate. Three-quarters of the variance in coronary death rate was accounted for by differences in mean serum cholesterol and blood pressure of the cohorts. The mortality risk for individuals was examined in each of the regions. For coronary death, age, serum cholesterol, blood pressure, and smoking were highly significant in all regions except Japan, where coronary deaths were too few for evaluation. Relative weight was not significant anywhere. Physical activity was significant only in southern Europe, where differences are associated with socioeconomic status. For all-causes death, age and blood pressure were highly significant risk factors in all regions as was smoking habit, except in Japan. Relative body weight tended to be a negative risk factor everywhere, significantly so in southern Europe. Expectations for coronary death from the experience in the United States and northern Europe greatly exceeded observed deaths in southern Europe for men of their age, serum cholesterol, blood pressure, smoking habits, physical activity, and relative weight. The reverse, prediction of coronary deaths in America and in northern Europe from the southern European experience, greatly underestimated the deaths observed. Similar cross-predictions between the United States and northern Europe were good for all-causes deaths, excellent for coronary deaths. Analysis of time trends in relationships of mortality to entry characteristics showed continued importance of age, blood pressure, and smoking and a tendency for the importance of cholesterol to fall in the last 5 years of follow-up.

Adult↗
PubMed1984

Prevalence of overweight and weight loss behavior in a metropolitan adult population: the Minnesota Heart Survey experience.

Data from two major surveys, conducted in the Minneapolis-St. Paul metropolitan area in 1973-74 and 1980-81, were used to estimate the prevalence of overweight. In 1980-81, weight history and the prevalence of dieting behaviors were also obtained. The prevalence of overweight was greater in the 1980-81 survey than in 1973-74. Increases were observed in all ages in women, but only in the 40-59 year age ranges in men. In 1980-81, dieting to control weight was widely reported by both sexes, even among those who had never been overweight. Of those who reported having been overweight, approximately one-third reported they had successfully reduced. More men than women reported having been overweight, but more women reported having dieted to lose weight. Formal weight reduction programs were used much more by women than men. Although most dieting attempts consisted of balanced, reduced calorie regimens, a significant percentage were "fad" types, whose nutritional safety may be questioned. Overall, contrary to findings based on clinical populations, weight reducing efforts often appear to be successful. Nevertheless, overweight remains a significant public health problem in this community.

Adult↗
PubMed1984

Coronary heart disease mortality trends in Minnesota, 1960-80: the Minnesota Heart Survey.

Age-adjusted mortality rates and trends from coronary heart disease (CHD) in Minnesota for the years 1960 to 1980 differed among eight health service areas. Regression of ten socioeconomic and demographic factors and intensive care and coronary care unit beds on area CHD mortality levels and slopes revealed a significant positive association only for levels of welfare income-maintenance assistance with CHD mortality levels; there were no associations with trends. Further studies are needed to explain variation within states of CHD mortality rate levels and trends.

Adult↗
PubMed1984

Citizen cardiopulmonary resuscitation training and use in a metropolitan area: the Minnesota Heart Survey.

To assess the prevalence and utility of citizen cardiopulmonary resuscitation (CPR) training, a systematic population-based sample of Minneapolis-St. Paul area adults, age 25-74 years, was interviewed in 1980-81. Twenty-three per cent were CPR trained. Of these, 13 percent have encountered out-of-hospital cardiac arrests and 38 per cent reported using their skills in such an emergency. Most of those performing out-of-hospital CPR (59 per cent) were health professionals. Only 19 per cent of trainees have maintained their certification by retraining within one year.

Adult↗
PubMed1984

The primary prevention of high blood pressure--a population approach.

The primary prevention of high blood pressure is one of the more significant challenges to scientists and public health leaders alike. The areas of relative certainty and uncertainty reviewed here about the potential for prevention may be taken up by official bodies and translated into more specific recommendations. Prevention principles can be applied to each of the major precursors of hypertension in the population. The potential for prevention along with relative safety is sufficient for action. Prevention of high blood pressure in whole communities is possible and an eating and activity pattern which is attractive and feasible can be proposed and modeled to different traditional cultures. Medical preventive strategies are proposed along with reasonable, practical, safe, feasible, credible community-based programs as the principal mode of dissemination. In such programs, health professionals and medical services share roles with community leaders and organizations. A population strategy is essential to the primary prevention of hypertension. Further research is needed in prevention and health promotion methods.

Adult↗
PubMed1983

Sudden death and acute myocardial infarction in a metropolitan area, 1970-1980. The Minnesota Heart Survey.

To determine the causes of the nationwide decline in deaths due to coronary heart disease, the Minnesota Heart Survey enumerated coronary deaths among persons 30 to 74 years old in Minneapolis-St. Paul. The survey also ascertained rates of hospitalization and case fatality during hospitalization for acute myocardial infarction. For deaths occurring between 1970 and 1978 that were due to coronary heart disease, the rates outside the hospital declined by 43 per cent in men and 40 per cent in women, and the rates in hospital emergency rooms increased by 311 per cent in men and 200 per cent in women. In both these years about two thirds of all such deaths occurred outside hospital wards. Between 1970 and 1980, hospitalization rates for acute infarction in persons 30 to 74 years old declined 8 per cent among men and 26 per cent among women, and case fatality in the hospital in persons 45 to 74 years old declined 29 per cent in men and 27 per cent in women. These changes are probably due to the combined influence of changes in risk factors in the population and improved care of patients with acute myocardial infarction before and during hospitalization.

Adult↗