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J Stamler

Publications and source records attributed to J Stamler.

At least 253 records · Page 14Linked to original sources
PubMed1982

Pulse pressure-II. Factors associated with follow-up values in three Chicago epidemiologic studies.

This report, the second in a series on pulse pressure and pure systolic hypertension, examined in prospective analyses the associations between both the initial values of five variables and the changes in these variables and pulse pressure, utilizing data from three Chicago epidemiologic studies, in order to determine whether variables known to be related to blood pressure and hypertension are related to pure systolic hypertension or 'classical' hypertension. In these analyses follow-up pulse pressure, which was measured from 2-5 years after the initial measurement of the other variables, was redefined so that the association between the initial value or change and pulse pressure indicated whether the initial value or change was more strongly related to follow-up systolic or diastolic blood pressure. In these three studies, only the initial value for cigarette use had a consistent positive association with follow-up pulse pressure. Change in heart rate was generally positively related to follow-up pulse pressure, while the initial value was not. For relative weight and serum cholesterol, both the change and the initial tended to be negatively related. For glucose, the association was not consistent for either the initial value or the change. The results from these prospective analyses thus suggest that cigarette use is related to pure systolic hypertension, rather than 'classical' hypertension.

Adult↗
PubMed1982

Pulse pressure-III. Prognostic significance in four Chicago epidemiologic studies.

This report, the third in a series on pulse pressure and pure systolic hypertension, examines the associations between blood pressure and the cardiovascular diseases and coronary heart disease, both cross-sectionally and prospectively, utilizing data from four Chicago epidemiologic studies, in an effort to determine whether or not a widened pulse pressure, or pure systolic hypertension, is an independent risk factor. In these analyses, blood pressure is divided into two components, one related to level and the other to pulse pressure, with pulse pressure redefined so that the association between pulse pressure and the prevalence of ECG abnormalities or mortality, indicates whether the endpoint is more strongly related to systolic or diastolic blood pressure. In these studies, blood pressure level is significantly related to both ECG abnormalities and mortality. In the cross-sectional analyses, pulse pressure is generally positively related to the prevalence of ECG abnormalities, indicating a stronger association for systolic blood pressure, and thus a possible association with pure systolic hypertension. However, in the prospective analyses, pulse pressure is generally not related to mortality, indicating an equal association with mortality for systolic and diastolic blood pressure in these studies. Thus, although the cross-sectional analyses generally support the hypothesis that a widened pulse pressure, or pure systolic hypertension, is an independent risk factor for the cardiovascular diseases and coronary heart disease, the prospective analyses do not.

Adolescent↗
PubMed1982

Relative weight and blood pressure in four Chicago epidemiologic studies.

Because systolic blood pressure rises more sharply with age than diastolic blood pressure, 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 pure systolic hypertension has its own etiology and pathogenesis. Since pure systolic hypertension is characterized by a widened pulse pressure, the present report examined the association between relative weight and pulse pressure, both cross-sectionally and prospectively, in addition, to the association between relative weight and the level of blood pressure, in four Chicago epidemiologic studies. The positive association between relative weight and the level of blood pressure in these studies, in both cross-sectional and prospective analyses, reaffirms the finding in previous studies of a positive association between weight and blood pressure and the prevalence and incidence of hypertension. However, the results of these studies did not generally support the hypothesis that relative weight is related to pulse pressure, and thus possibly to pure systolic hypertension.

Adolescent↗
PubMed1982

Dietary lipids and serum cholesterol level: change in diet confounds the cross-sectional association.

In the Chicago Western Electric Company study, diet was assessed at the initial examination, in 1957-1958, of 1900 middle-aged men and again at their second examination about one year later. At the first examination, lipid composition of the diet, as summarized by a score based on the formula of Keys, Anderson and Grande (Grande, F. Predicting change in serum cholesterol from change in lipid composition of the diet. In: Lauer RM, Shekelle RB, eds. Childhood Prevention of Atherosclerosis and Hypertension. New York: Raven Press, 1980:145-53), was positively associated with level of serum cholesterol. Between the first and second examinations, however, hypercholesterolemic men were more likely than others to have reduced intake of dietary saturated fatty acids and cholesterol. As a result, at the second examination the cross-sectional linear association between the diet score and serum cholesterol concentration was significantly positive for men with initial levels of serum cholesterol less than 250 mg/dl, significantly negative for men with initial levels of 250 mg/dl or higher and not significantly different from zero for all men together. The bias introduced by change in diet among hypercholesterolemic men differs importantly from bias due to unreliability of measurement and to interindividual differences in intrinsic level of serum cholesterol, because it can produce statistically significant but spurious correlations.

Cholesterol↗
PubMed1982

Diet and coronary heart disease.

This paper reviews key aspects of the relationship of diet to coronary heart disease, as demonstrated in epidemiologic and other research over the last 25 or more years. It summarizes the extensive findings that have demonstrated an etiologically significant association among dietary lipid, serum cholesterol, and coronary heart disease; between caloric imbalance and two of the major CHD risk factors, hypertension and hypercholesterolemia; on the relationship between habitual diet high in sodium and hypertension. It also reviews the data on the relationship of habitual dietary lipid intake of individuals within a population to the serum cholesterol and CHD risk of individuals, indicating that valid positive findings in this area are consistent with evidence from cross-population epidemiologic studies, controlled experiments on diet change in man, and findings from animal research. It delineates the controlled experiments on diet change in man, and findings from animal research. It delineates the methodological problems that have stood in the way of the sound elucidation of this matter, and of the similar ones making it difficult to fully resolve the issue of the relationship of habitual dietary sodium intake of individuals within a population to their blood pressure. It reviews recent findings on the relationship of diet, particularly dietary lipid and calorie balance, to fractions of plasma total cholesterol, i.e., LDL-cholesterol, VLDL-cholesterol, and HDL-cholesterol, and summarizes the evidence indicating that recommendations for improved nutrition in the United States--emphasizing sizable reduction in saturated fat and cholesterol intake, moderate decrease in intake of total fat and of refined and processed sugars, and of calories for overweight persons--produce changes in plasma lipidlipoprotein levels that are favorable in all respects. Finally, it summarizes the findings with respect to the marked decline in mortality from coronary heart disease, stroke, all cardiovascular diseases, and all causes in the United States from 1968 to 1978, and presents evidence indicating that improvements in life style (eating, smoking, and exercise habits) and control of high blood pressure have contributed significantly to these trends.

Cholesterol↗
PubMed1982

Smoking cessation in the Chicago Coronary Prevention Evaluation Program.

Quit-rates for cigarette smokers in a lifestyle intervention program aimed at reducing coronary risk were 24 percent for all participants and 34 percent for non-dropouts. Recidivism remained very low during participation in the program. Half of the smokers who quit did so after being in the program more than two years. These data suggest that while engaging in an effort to make other changes in lifestyle, many smokers can be helped to quit. Sustained antismoking efforts in the clinical practice of medicine can be expected to share these same positive aspects. While mass public health programs to eliminate smoking and prevent young people from taking up the habit are being developed, health practitioners can make a significant contribution by including vigorous efforts at smoking cessation as part of routine practice.

Adult↗
PubMed1981

Dietary vitamin A and risk of cancer in the Western Electric study.

Intake of dietary provitamin A (carotene) was inversely related to the 19-year incidence of lung cancer in a prospective epidemiological study of 1954 middle-aged men. The relative risks of lung cancer in the first (lowest) to fourth quartiles of the distribution of carotene intake were respectively, 7.0, 5.5, 3.0, and 1.0 for all men in the study, and 8.1, 5.6, 3.9, and 1.0 for men who had smoked cigarettes for 30 or more years. Intake of preformed vitamin A (retinol) and intake of other nutrients were not significantly related to the risk of lung cancer. Neither carotene nor retinol intake was significantly related to the risk of other carcinomas grouped together, although for men in whom epidermoid carcinomas of the head and neck subsequently developed, carotene intake tended to be below average. These results support the hypothesis that dietary beta-carotene decreased the risk of lung cancer. However, cigarette smoking also increases the risk of serious diseases other than lung cancer, and there is no evidence that dietary carotenoids affect these other risks in any way.

Adult↗
PubMed1981

Methodological assessment of assays for red cell sodium concentration and sodium-dependent lithium efflux.

Assays for red cell sodium concentration and sodium-dependent lithium efflux were studied from a methodological point of view. The technical errors for sodium concentration--based on concurrent analysis of randomized blind duplicate samples--was 2.5% and for lithium efflux 6.4%. Based on repeated measures in the same individual, the assays were stable over time and reproducible; individual differences at a mean interval of 16 days were not significantly different. A wait of two hours from time of phlebotomy to analysis yielded a slight (3.8%) but significant fall in the sodium concentration; no further change was found at four hours. No change occurred in the lithium efflux over time. A standardized breakfast containing 664 mg sodium did not affect the measurements when fasting and three-hour postprandial levels were compared. The ratios of intra- to inter-individual variance were small--0.04 for red cell sodium concentration and 0.09 for sodium-stimulated lithium efflux. These assays appear to be reproducible and stable and can be applied in large scale field trials.

Adult↗
PubMed1981

Diet, serum cholesterol, and death from coronary heart disease. The Western Electric study.

Over twenty years ago, we evaluated diet, serum cholesterol, and other variables in 1900 middle-aged men and repeated the evaluation one year later. No therapeutic suggestions were made. Vital status was determined at the 20th anniversary of the initial examination. Scores summarizing each participant's dietary intake of cholesterol, saturated fatty acids, and polyunsaturated fatty acids were calculated according to the formulas of Keys and Hegsted and their co-workers. The two scores were highly correlated, and results were similar for both: there was a positive association between diet score and serum cholesterol concentration at the initial examination, a positive association between change in diet score and change in serum cholesterol concentration from the initial to the second examination, and a positive association prospectively between mean base-line diet score and the 19-year risk of death from coronary heart disease. These associations persisted after adjustment for potentially confounding factors. The results support the conclusion that lipid composition of the diet affects serum cholesterol concentration and risk of coronary death in middle-aged American men.

Adult↗
PubMed1981

Dietary sodium, erythrocyte sodium concentration, sodium-stimulated lithium efflux and blood pressure.

1. There was a significant positive relationship between sodium-stimulated lithium efflux and systolic blood pressure (r = 0.512) in erythrocytes of black school children. Weight was also positively and significantly correlated with blood pressure. Although erythrocyte sodium concentration did not bear any significant relationship with blood pressure, it did bear significant inverse relationship with urinary sodium excretion. 2. High-school students were randomly assigned to either the experimental or the control group. In the former a reduction of about 70% in salt intake was achieved. After 24 days, the erythrocyte sodium concentration was significantly reduced in the experimental group. A non-significant decline in systolic blood pressure was observed in the experimental group; no change was detectable in the control group for either erythrocyte sodium concentration or systolic blood pressure.

Adolescent↗
PubMed1981

Heart rate: a risk factor for cancer?

The relationship between heart rate and cancer mortality was examined in 3 Chicago epidemiologic studies: 1233 white men originally age 40-59 followed 18 years from the Chicago Peoples Gas Company study; 1899 white men originally age 40-55 followed 17 years from the Chicago Western Electric Company study; 5784 white men originally age 45-64 followed 5 years from the Chicago Heart Association Detection Project in Industry. There was a significant association between heart rate and cancer mortality in both univariate and multivariate analyses in men from the Gas Company study and in men from the Chicago Heart Association study, but there was no association between heart rate and cancer mortality in men from the Western Electric study. The relationship persisted in the Gas Company study but not in the Chicago Heart Association study after eliminating deaths within the first 2 years of follow-up. With cancer deaths broken down by the site, mortality from lung and colon cancer in the Gas Company study and mortality from lung cancer in the Chicago Heart Association study were significantly associated with baseline heart rate on univariate analysis and on bivariate analysis controlling for age. Only colon cancer in the Gas Company, however, remained associated with heart rate when other variables were controlled. Thus, in 2 of the 3 studies examined, heart rate appeared to be an independent risk factor for cancer mortality in men.

Adult↗