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Biomedical subjects

J Stamler

Publications and source records attributed to J Stamler.

At least 361 records · Page 20Linked to original sources
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Serum cholesterol and mortality from coronary heart disease in young, middle-aged, and older men and women from three Chicago epidemiologic studies.

The association of total serum cholesterol with mortality from coronary heart disease was examined in 1210 white men aged 42 to 60 in 1959 to 1963 and 1008 white men aged 45 to 64 in 1959 to 1969, followed up to 25 years from the Chicago Peoples Gas Company Study; in 1903 white men aged 41 to 57 in 1959, followed up to 24 years from the Chicago Western Electric Company Study; and in 17,880 white men aged 25 to 74 and 8327 white women aged 40 to 74 in 1967 to 1973, followed up to 18 years from the Chicago Heart Association Detection Project in Industry. In these studies total cholesterol level was related positively to coronary mortality in young men and in middle-aged and older men and women. Relative risks of mortality were generally higher in young and middle-aged persons compared to older persons, whereas absolute excess risks were generally greater in older than in younger persons.

Adult↗
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Neuroticism and cynicism and risk of death in middle-aged men: the Western Electric Study.

MMPI measures of neuroticism (N) and of cynicism (C) were obtained at the initial examination of 1871 employed, middle-aged men in Chicago. Neither N nor C was significantly associated cross-sectionally with systolic blood pressure or serum cholesterol, but both were positively associated with cigarette smoking and alcohol consumption. N was not significantly associated with risk of death from coronary disease, other cardiovascular diseases, cancer, all other causes combined, or all causes combined after adjustment for C, age, cigarette smoking, alcohol consumption, systolic blood pressure, and serum cholesterol. C was significantly associated with coronary death and total mortality after adjustment for N and the other variables listed above, and relative risks of 1.4 to 1.6 were observed for all endpoints. These results support the idea that neuroticism is not associated with major causes of mortality, but that cynicism is associated with several causes. The associations between cynicism and mortality may be mediated by cigarette smoking and excessive alcohol consumption since adjustment for these factors may have been incomplete due to correlation between cynicism and errors in self-reported data.

Adult↗
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Dietary lipids, sugar, fiber and mortality from coronary heart disease. Bivariate analysis of international data.

Univariate analyses with data for the years 1954-1969 from 20 economically advanced countries showed that a combined dietary lipid score based on per capita consumption of saturated fat, cholesterol, and polyunsaturated fat (equation of Keys, et al.) and the consumption of refined and processed sugars were both highly correlated with age-standardized coronary heart disease (CHD) mortality rates for the years 1969-1973 for both men and women aged 35-74 years (r values of 0.54 to 0.72). Fiber intake, estimated as the sum of calories available from vegetables, fruits, grains, and legumes, yielded a significant inverse correlation with CHD mortality rates (r = -0.49 to -0.68). These three dietary variables are highly intercorrelated. With bivariate analyses (2 X 2 cross-classification and analysis of variance), lipid score, but neither that of sucrose or fiber, was consistently and significantly related to CHD mortality. However, with both higher and lower lipid scores, CHD mortality rates tended to be slightly (nonsignificantly) higher with higher sugar values and with lower fiber values.

Adult↗
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Can overnight urine replace 24-hour urine collection to asses salt intake?

Are overnight urine specimens adequate for characterizing the daily salt intake of individuals, i.e., can the overnight specimen replace the 24-hour specimen? Data from 142 male participants of an ongoing trial on the primary prevention of hypertension were used to examine this question with correlation analysis and quantile classification. Estimated correlation between the true mean 24-hour and the true mean overnight sodium excretion was 0.72. Furthermore, 67% of the individuals in the upper third of the distribution of true mean overnight urine sodium were also in the upper third of the distribution of true mean 24-hour sodium. Thus, these data are promising in regard to the use of overnight urine specimens for characterizing the salt intake of individuals. The number of overnight urine collections required to estimate accurately the correlation between an individual's true mean overnight urine sodium and a variable of interest (e.g., blood pressure) was calculated. Given the observed intra- and inter-individual variation, the data indicate that 14 measurements are needed to limit the diminution of the correlation coefficient to 10%.

Adult↗
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Variability in 24-hour urine sodium excretion in children.

How many 24-hour urine sodium measurements are adequate for characterizing a child's salt intake? Can overnight urine specimens accurately replace 24-hour collections for salt assessment? A sample of 73 6th-8th grade children was taken from two parochial schools in Chicago to investigate systematically these questions. Seven consecutive 24-hour-urine specimens were collected from each child. The estimated ratio of intra- to inter-individual variances was 1.94 for 24-hour-urine sodium. Based on this value, eight 24-hour specimens are necessary to limit to 10% the diminution of the estimated correlation coefficient between 24-hour-urine sodium and blood pressure. Six measurements are required to reduce to 0.01 the probability of misclassifying a child in tertile 1 versus tertile 3. The overnight specimens show a moderate consistency with the 24-hour collections in detecting children with high or low salt intake. For example 92% and 85% of children in the fifth quintile and the third tertile respectively of the true mean overnight sodium have their true mean 24-hour Na in the upper half of the distribution. These results suggest that in a large scale epidemiologic study, overnight specimens may be reasonable alternatives when 24-hour-urine sodium is practically very difficult to collect.

Adolescent↗
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A survey of patterns of nonpharmacologic care for hypertensive patients, including recommendations for their children.

To ascertain current approaches of physicians to nutritional-hygienic management of hypertensive patients and their children, a survey was done among a random sample of Chicago-area generalists, internists, and cardiologists. Thirteen items related to advice for patients; two for their children. Of 713 physicians holding M.D. degrees in the sample, 573 (80%) responded. For hypertensive patients, the great majority of physicians indicated that they advise weight loss, avoidance of salt use at table, no smoking, regular exercise, limitation of alcohol intake, and avoidance of stressful situations. Although 98% advised weight loss, a minority responded positively to reduction of carbohydrate and/or fat intake. Only 25% recommended limiting the salt use of children, and only 19% recommended taking the blood pressure of children of hypertensive patients. These data indicate that the majority of Chicago-area practitioners advocate nutritional-hygienic measures for their hypertensive patients. Only a minority, however, apparently advocate primary preventive approaches for the children of hypertensive patients.

Adult↗
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Abnormal red blood cell ion transport and hypertension. The People's Gas Company study.

A population-based survey of 134 white men, recruited from the Chicago People's Gas Company labor force, was carried out to examine the association between sodium-lithium (Na-Li) countertransport and hypertension. Of the 134 participants in this industry-sponsored periodic health examination, 64 were normotensive and 70 were either taking antihypertensive medications or had a systolic pressure greater than or equal to 140 or a diastolic pressure greater than or equal to 90 mm Hg. The hypertensives were older and more overweight. Countertransport was significantly higher in hypertensives than in normotensives. Among the three subgroups of hypertensives--untreated, borderline (140/90 to 160/95 mm Hg), untreated definite (over 160/95 mm Hg), and treated--an increase in countertransport was consistently observed, significant for the latter two groups. The relationship between countertransport and hypertension was independent of overweight, with countertransport being significantly related to both blood pressure and overweight. Altered ion transport may play an important role in the etiology and/or pathophysiology of hypertension.

Adult↗
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Effect of dietary sodium reduction on red blood cell sodium concentration and sodium-lithium countertransport.

A randomized, crossover trial was carried out on the effect of moderate sodium reduction on red-blood-cell sodium metabolism. The participants were healthy high school students (mean age = 16 years, n = 33). Changes in sodium-lithium countertransport and intracellular sodium concentration were evaluated 24 days after a decrease in dietary sodium from approximately 110 to 40 mEq per day. Dietary sodium restriction had no significant effect on either sodium-lithium countertransport or intracellular sodium concentration.

Adolescent↗
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Trends in mortality from cerebrovascular diseases in the United States, 1960 to 1975.

A long-term decline in death rates from cerebrovascular diseases in the United States accelerated in 1969, with a further increase in the rate of decline after 1972. This break in the pattern of the mortality curve for stroke was observed in all 4 major sex-color groups, and affected all age groups in which a significant number of stroke deaths occur. The decline for non-whites was relatively and absolutely greater than for the comparable white sex. If the 1960 rates had persisted in 1975, 87,600 more lives would have been lost to cerebrovascular diseases. Although there are no data documenting a declining prevalence of hypertension in the population, detection, treatment and control of hypertension have improved markedly over recent years. A concomitant decrease in the severity of epidemic respiratory infection may have contributed to the improvement in recorded death rates from stroke. Mortality from all major cardiovascular diseases has demonstrated a parallel downward trend. Continued emphasis on public health efforts to detect and treat hypertension and other known cardiovascular risk factors can be expected to result in further improvement in cardiovascular mortality.

Adult↗
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The urinary sodium/potassium ratio in children from southern Italy living in Cimitile: a case for concern.

The urinary sodium/potassium (Na/K) ratio was evaluated in 220 children aged 3-16 years living in Cimitile, a small town near Naples in Southern Italy by utilizing 24 hour urinary collections. The Na/K ratio averaged 3.79 +/- 1.68 and correlated significantly (p less than 0.001) with age, body weight and height but not with Body Mass Index (BMI). No difference was seen when data were analyzed by sex. Mean daily sodium excretion averaged 3.91 +/- 1.52 mM/Kg while potassium excretion averaged 1.17 +/- 0.54 mM.Kg. The Na/K ratio was higher than that observed in children studied in Israel, United Kingdom, USA, and the Federal Republic of Germany and is of the same magnitude of that previously reported in children born in Japan. This high Na/K ratio is a case for concern because of the risks connected with high Na/K ratio in urine.

Adolescent↗
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Population based data on age related excretion of creatinine sodium and potassium in children of Southern Italy--the Cimitile study.

This is a population based study on urinary excretion of sodium, potassium and creatinine in children from Southern Italy aged 3-16 years. Mean urinary creatinine excretion was 33 +/- 10 mg/kg. Mean sodium excretion was of 3.91 +/- 1.52 mM/kg. Urinary sodium, potassium and creatinine correlated with age, body weight, body mass index (BMI) and height and no difference was found in the comparison among sexes. The data point to an excessive sodium intake in these children and additionally claim for a reconsideration of urinary creatinine excretion in this age group.

Adolescent↗
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The coronary prone.

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Adult↗