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Biomedical subjects

J Stamler

Publications and source records attributed to J Stamler.

At least 235 records · Page 13Linked to original sources
PubMed1984

Primary prevention of hypertension--a randomized controlled trial.

Nutritional-hygienic intervention is a key strategy in the control of hypertension through primary prevention. To test the efficacy of this approach, 201 men and women were selected to participate in a randomized controlled trial on the primary prevention of hypertension. Individuals were taken into the trial if their diastolic blood pressure at entry was 80-89 mm Hg with either relative weight 1.10-1.49 or heart rate of 80 or greater. Half of the eligible persons were randomized into the monitored group and half were randomized into the intervention group receiving individual intervention to achieve a weight loss of 10 or more lbs (greater than or equal to 4.5 kg), to reduce Na intake to 75 mmol (1800 mg), to limit alcohol intake to no more than 2 drinks per day (26 g) and to engage in regular moderate physical activity. At two years, the 75 participants of the intervention group showed a mean weight loss of 5.2 lbs. among those initially overweight, a mean reduction in Na intake of 44% of goal and a moderate reduction of alcohol intake. Self-reported exercise had also increased and was reflected in the larger decrease in mean heart rate compared with the monitored group. Diastolic blood pressure was only slightly lower among the intervention group compared to the monitored group, but was an additional 4.0 mm Hg lower among those intervention participants achieving weight loss and reduction in Na intake greater than the median for the group. In addition, at two years, a rise in diastolic blood pressure sufficient to require antihypertensive medication occurred in 5 participants of the control group compared to 0 of the intervention group. At three years, 11 monitored and 3 intervention group participants required antihypertensive medication.

Adult↗
PubMed1984

Trial on control of hypertension by nutritional means: three-year results.

Ability to safely withdraw medication from well-controlled mild hypertensives was tested in a 3-group randomized trial. Group I (Intervention): drugs were stopped 2 months after nutrition counseling began. Counselling continued throughout the remaining years of the trial to achieve: a minimum of 10 lb weight loss if overweight; reduction of sodium intake to 1800 mg/day or less; reduction of alcohol intake to not more than 2 drinks per day. Group II (control group 1): drugs were stopped to see if previous long-term blood pressure control had a carryover effect without diet change. Pressure was monitored frequently in both groups with return to treatment if diastolic blood pressure rose to 90 mmHg or above. Group III (control group 2) remained on drugs for comparison of blood pressure and biochemical variables. In Group I mean weight loss at 3 years was 7 lb (3.18 kg) with 39% losing 10 lb (4.55 kg) or more; sodium intake was reduced by 37%. Blood pressure control without drugs was achieved in 44% of Group I patients. This compares with only 15% in Group II. These findings suggest it may be possible after establishing good blood pressure control, to maintain control in a sizeable proportion with less or no medication, when reduction of weight, sodium, and alcohol is achieved.

Antihypertensive Agents↗
PubMed1984

Seventh-Day Adventist adolescents--life-style patterns and cardiovascular risk factors.

The life-style of adolescents attending a Seventh-Day Adventist boarding school was evaluated as it related to cardiovascular risk factors. The diet contained 34% calories as fat, with 11% derived from saturated fat. Total serum cholesterol levels were low (mean, standard deviation=138+/-15 mg per dl), and apolipoprotein B level was low as well (46+/-9 mg per dl). The high-density lipoprotein cholesterol level was within the usual range (52.4+/-13.3 mg per dl). Mean blood pressures were also low (systolic, 104.1+/-9.6 mm of mercury; diastolic, 65.7+/-9.7 mm of mercury). There was no self-reported use of cigarettes. If this life-style were to continue through adulthood, the incidence of premature atherosclerotic disease, particularly coronary artery disease, for this group might well be reduced, compared with other North Americans, as suggested by findings from previous studies of adult Seventh-Day Adventists.

Adolescent↗
PubMed1983

Increased sodium-lithium countertransport in college students with elevated blood pressure.

Blood pressure screening was carried out on a university campus to identify early hypertension or high-normal BP in young adults. Compared with normotensive control subjects of a similar age, drawn from the same population, persons identified as being at the upper end of the BP distribution had significantly increased levels of sodium-lithium countertransport. This difference persisted when other potential confounding variables, eg, overweight, sex, ethnicity, sodium excretion, and age, were taken into account. A positive family history was associated with slightly higher levels of sodium-lithium countertransport, although the effect could be explained by higher present levels of BP. These data suggest that abnormalities of cation transport are present early in the course of the development of hypertension. Measurement of transport levels may provide an estimate of risk of hypertension and allow identification of susceptible persons.

Adult↗
PubMed1983

Dietary salt and blood pressure.

Research evidence on the role of dietary sodium in the etiology and pathogenesis of hypertension is briefly reviewed. This matter is assuming new importance at present, given new data on the efficacy of normalization of blood pressure for adults with so-called "mild" hypertension (average diastolic 90-104 mm Hg), hence the need for safe nutritional-hygienic alternatives to years-long drug treatment for millions of people with such hypertension. Two trials by the authors deal with some unresolved questions in this area. The first, a preliminary study, involved 21 lacto-ovo-vegetarian high school students living in a boarding school. With decrease in daily Na intake from 216 to 72 meq for the experimental compared with the control group, red blood cell Na concentration was significantly lower in the former; systolic pressure was slightly but not significantly lower. The second trial, the Primary Prevention of Hypertension, involves over 200 hypertension-prone persons aged 30-44, and explores the ability in the experimental group to reduce blood pressure and prevent development of hypertension by safe nutritional-hygienic means (weight reduction, dietary Na decrease, avoidance of excess alcohol, rhythmic exercise). Initial results at 6 months are presented. Trials on the prevention and control of hypertension by nonpharmacologic means, including reduced Na intake, and involving analyses of the inter-relationships among dietary Na, other dietary factors, Na metabolism, and blood pressure in samples from different population strata, are an important present-day research need.

Adolescent↗
PubMed1983

Nervous tension and serum cholesterol: findings from the Chicago Coronary Prevention Evaluation Program.

Of 519 coronary-prone middle-aged men participating in the Chicago Coronary Prevention Evaluation Program, 416 reported their self-perceived state as one of no tension or tension at various periodic visits over years in the Program. Group mean serum cholesterol was significantly higher by about 4 mg/dl with tension vs. no tension (slight, moderate, or marked). This relationship was independent of weight change, intercurrent infection, use of medication, and month of year.

Adult↗
PubMed1983

Coffee and pancreatic cancer: an analysis of international mortality data.

This study assessed the relationship of per capita coffee imports and consumption, total dietary fat, saturated fat, cholesterol, tobacco, cigarettes, and national income for 1957-1965 to age-adjusted pancreatic cancer death rates of men and women from 22 countries in 1971-1974. With simple correlation analysis, coffee, total dietary fat, saturated fat, and national income were each significantly correlated with both male and female pancreatic cancer mortality. Bivariate partial correlation coefficients of coffee with pancreatic cancer mortality were significant (one-tailed) in 11 of 12 analyses and borderline significant in two-way analyses of variance (ANOVA) (two-tailed) controlling for each of the other variables. Saturated fat and pancreatic cancer were also significantly related in univariate analyses, and in 11 of 12 bivariate partial correlation analyses; in ANOVA, significance was borderline in 10 of 12 analyses. Total fat and pancreatic mortality were also significantly associated in most of the univariate and bivariate correlation analyses, but not in the two-way analyses of variance. The findings of this study are consistent with the hypothesis that coffee and dietary lipid are involved in the etiology of pancreatic cancer.

Adolescent↗
PubMed1983

Family history of hypertension and red cell cation transport in high school students.

High school students who had at least one parent with hypertension (n = 22) were compared to schoolmates of the same age with a negative family history of hypertension in the parents (n = 21). We investigated in both groups the maximal rate of the ouabain-sensitive Na pump and the Na-K cotransport in nystatin-loaded cells and the Lii-Nao countertransport in lithium-loaded cells. The two groups were significantly different only in the sum of net Na transport mediated by the Na-K pump and Na-K cotransport. The mean diastolic blood pressure in the positive family history group was significantly higher. With control for blood pressure the difference in the maximal rate of Na transport was no longer significant; it remains uncertain if control for blood pressure represents "over-adjustment'. The finding of a higher maximal rate of Na transport in these adolescents who are at increased risk of future hypertension, yet currently well within the normal range, suggests that abnormal sodium metabolism may be a useful marker and appears early in the pathogenesis of this disease.

Adolescent↗
PubMed1983

Red cell cation transport: differences between black and white school children.

Differences in red cell sodium content and sodium-lithium countertransport were studied in black and white children with a mean age of 12 years. For both boys and girls red cell sodium content was higher in blacks and countertransport lower (P less than 0.05). For both ethnic groups red cell sodium was lower in girls than boys and a consistent positive relationship was noted between body mass index and countertransport. Despite the lower red cell Na-Li countertransport values in black compared to white children, a significant positive correlation with systolic blood pressure was found independent of adiposity. In contrast, no correlation was evident between Na-Li countertransport and blood pressure in the white children. If red cell cation transport is confirmed as a marker for hypertension, study of racial differences may help explain the twofold higher prevalence of this disease among blacks.

Adolescent↗
PubMed1982

The selective lipid-lowering effect of vegetarianism on low density lipoproteins in a cross-over experiment.

In a cross-over experiment the effect of short-term vegetarianism on serum lipids, lipoproteins and apoproteins was studied. The experimental diet was free of animal products, with the exception of skim milk, and consequently low in saturated fat and cholesterol. Fifteen free-living individuals were randomly assigned to 3-week periods on either the experimental diet or a control diet which closely approximated the usual intake in the U.S.A. Significant reductions in total cholesterol (12.5%), low density lipoprotein cholesterol (14.7%), and apo B (13.2%) were observed, accompanied by a non-significant decrease in high density lipoprotein cholesterol (10%), apo A-I (3%) and a non-significant increase in apo-II (4%). These data suggest that a fat-modified diet low in total fat, saturated fat and cholesterol, and moderate (not high) in polyunsaturated fat may not lower HDL-C or its apoproteins as much as a diet high in polyunsaturated fat, while having similar effects on LDL-C, and would therefore be preferable as the basis for primary prevention of atherosclerosis.

Adult↗
PubMed1982

Methodological problems in characterizing an individual's plasma glucose level.

Two methodological problems in characterizing an individual's plasma glucose level are examined in this study. First, how large is the intra-individual variation of an individual's 1-hr post-load glucose level and for this estimated intra-individual variation what are the probabilities of misclassifying individuals based on a one-time measurement only of glucose level? Second, do different tests-i.e. fasting, 1-hr, 2 hr post-load, GTT-yield consistent ranking for the same individual? The first of these was explored with data on subsamples from the Chicago Peoples Gas Company (PG) study and the Chicago Heart Association Detection Project in Industry (CHA) study; the second, with data from the Chicago Coronary Prevention Evaluation Program (CPEP). For both the PG and CHA studies, the estimated ratios of the intra- to inter-individual variances were generally higher for post-load plasma glucose than blood pressure, heart rate, weight and serum uric acid. The conditional probabilities of misclassifying individuals into quintiles or deciles based on one measurement of 1-hr post-load glucose were also estimated from these data. These estimated probabilities indicated that the possible attenuation due to intra-individual variation cannot abolish a strong association; however, it may create some problem if the relationship is not very strong. Furthermore, both rank correlation and quintile classification analyses show that fasting, 1-hr and 2-hr plasma glucose level characterize individuals differently. Thus it is possible that the inconsistent results of previous studies, all using a one-time measure of plasma glucose, are partially due to the large intra-individual variation of this variable, and the use of methods that are not highly consistent in their classification of individuals.

Adult↗
PubMed1982

Pulse pressure-I. Level and associated factors in four Chicago epidemiologic studies.

Because systolic blood pressure rises more sharply than diastolic blood pressure for those middle aged and beyond, leading to an increasing prevalence with advancing age of elevated systolic blood pressure without elevated diastolic pressure, i.e. so-called pure systolic hypertension, the question arises as to whether or not factors that have been shown to be related to blood pressure and hypertension are related to pure systolic hypertension or to 'classical' hypertension, i.e. hypertension defined solely by the level of the diastolic pressure. This question was examined in four Chicago epidemiologic studies by examining the associations between several variables and pulse pressure, with pulse pressure redefined so that the association between a variable and pulse pressure indicated whether the variable was more strongly related to systolic or diastolic blood pressure. In these four studies, glucose, heart rate and cigarette use tended to show a stronger association with systolic pressure, suggesting a possible association with pure systolic hypertension, while hematocrit, serum cholesterol, and uric acid tended to be more strongly associated with diastolic pressure, or equally associated with systolic and diastolic pressure, suggesting an association with 'classical' hypertension. Relative weight tended to be more strongly associated with systolic pressure under the age of 35 and more strongly associated with diastolic pressure after age 45.

Adolescent↗