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J Stamler

Publications and source records attributed to J Stamler.

At least 91 records · Page 5Linked to original sources
PubMed1996

Twenty-four hour urinary nitrate excretion in 48 populations from 30 countries: an ECP-INTERSALT collaborative study.

BACKGROUND: There is considerable interest in the possible role of nitrate in gastric carcinogenesis, but little information on nitrate intake around the world. This is the first study to give comprehensive standardised data on nitrate excretion as a marker of intake, using 48 worldwide population samples. METHODS: Urinary nitrate excretion has been shown to be a valid measure of nitrate intake in people under 50. This report presents data on 24-hour urinary nitrate excretion from urine collections obtained in the INTERSALT study, based on random samples of men and women aged 20-49 from each of 48 population samples in 30 countries. RESULTS: There was large variation in urinary nitrate excretion both within and between samples; within-sample (individual) distributions tended to be skewed towards higher values. Median values of the samples ranged from 0.42 mmol/day (Labrador, Canada) to 3.52 (Beijing, People's Republic of China) in men and 0.44 mmol/day (Colombia) to 3.44 (Beijing) in women. Overall, median values were higher in men than women by 11% on average (higher in men in 37 of 48 population samples). Comparison by geographical region of median values for men and women combined showed relatively low values in the samples in North America and Northern Europe (range 0.46-0.88 mmol/day), slightly higher values in Western Europe and Africa (0.68-1.11), and intermediate to high values in Southern Europe, Eastern and Central Europe and India (0.86-2.47). The highest median values were found in the Far Eastern samples (up to 3.48). Median values in the Central and South American samples ranged from 0.48 mmol/day (Colombia) to 1.37 (Xingu Indians of Brazil, and Argentina). CONCLUSIONS: For the first time, these data give standardized information on urinary nitrate excretion from different geographical regions of the world, and provide a basis for the further exploration of the role of nitrate in the aetiology of disease in human populations.

Adult↗
PubMed1996

Changes in average blood pressure and incidence of high blood pressure 1983-1984 to 1987-1988 in four population cohorts in the People's Republic of China. The PRC-USA Cardiovascular and Cardiopulmonary Epidemiology Research Group.

OBJECTIVE: To assess comparative changes in systolic and diastolic blood pressure and incidence of high blood pressure over 4 years, and factors related to these changes, in northern and southern, urban and rural adults in the People's Republic of China. SETTING: This is a prospective study of populations surveyed by standardized methods in 1983-1984 and 1987-1988 in north China, Beijing area steel mill workers and farmers, and south China, Guangzhou area shipyard workers and farmers. SUBJECTS: The subjects were 8805 men and women aged 35-54 years at baseline (1983-1984), of whom 7338 were non-hypertensive (systolic blood pressure < 140, diastolic blood pressure < 90 mmHg, not being administered antihypertensive drugs). MAIN OUTCOME MEASURES: The main outcome measures were 4-year changes in systolic and diastolic blood pressures and the 4-year incidence of high blood pressure in persons not hypertensive at baseline. RESULTS: At baseline, the average systolic and diastolic blood pressures were higher for Beijing than for Guangzhou cohorts. At resurvey the average systolic blood pressure had increased for seven of eight sex-city-setting cohorts (all but Guangzhou urban men). The Beijing urban cohorts had the greatest increases (men 6.2 mmHg, women 4.9 mmHg, slopes of 1.6 and 1.2 mmHg/year). The incidence of high blood pressure was higher for Beijing than for Guangzhou cohorts in all four comparisons (men and women, urban and rural). Beijing men, urban and rural, had the highest incidence rates (about 21%). In multiple logistic analyses by sex, variables significantly related to 4-year high blood pressure incidence were city, baseline systolic blood pressure and body mass index, change in weight, and, for men, baseline alcohol use and heart rate. CONCLUSION: Modifiable lifestyle traits, previously shown to be related to blood pressure and high blood pressure in cross-sectional studies, also relate to the incidence of hypertension.

Adult↗
PubMed1996

Sodium-lithium countertransport and blood pressure change over time: the Gubbio study.

Sodium-lithium countertransport activity in red blood cells relates to blood pressure (BP) and the prevalence of hypertension. This study investigated in adults the relation of sodium-lithium (Na-Li) countertransport to BP change from baseline to 6-year follow-up. In the Gubbio Population Study, 4210 men and women were 18 to 74 years old at baseline (1983-1986), and 3766 had a valid baseline Na-Li countertransport measurement; of these, 2729 were reexamined at 6 years of follow-up (1989-1992) and made up the study cohort. At baseline, data collection included age, height, weight, BP, pulse rate, drug treatment, alcohol intake, ratio of sodium to potassium in spot urine, plasma cholesterol, and Na-Li countertransport in red blood cells. At 6-year follow-up, data for age, BP, and drug treatment were collected as at baseline. From baseline, average BP declined for people on antihypertensive medication at follow-up and for those with baseline BP greater than or equal to 140/90 mm Hg (systolic/diastolic) and did not change or increased for the remaining participants. In quartile and correlation analyses controlled for sex, baseline BP, and antihypertensive treatment, BP change related significantly and directly to baseline Na-Li countertransport. In multiple linear regression analyses done for the entire cohort with control for other confounders, the regression coefficient of baseline Na-Li countertransport to BP change over time was positive and borderline significant. The Na-Li countertransport coefficient was positive and significant when analyses were done with the use of a categorical value of baseline Na-Li countertransport (quartile 4 and quartiles 1 through 3 combined). In both models, the Na-Li countertransport coefficient was the strongest for people with baseline BP greater than or equal to 120/80 mm Hg or for people with baseline age of 45 years or older. In conclusion, Na-Li countertransport significantly relates to BP change over time in adults.

Adolescent↗
PubMed1996

Fish consumption and stroke in men. 30-year findings of the Chicago Western Electric Study.

BACKGROUND AND PURPOSE: Evidence of a relationship of fish intake to stroke incidence or mortality is weak. This report examines the association of fish consumption with stroke. METHODS: A cohort of 2107 men aged 40 to 55 years from the Chicago Western Electric Study who were free of coronary heart disease and stroke through their first annual reexamination was investigated in relation to baseline fish intake and 30-year risk of fatal and nonfatal stroke. Data on baseline fish intake, categorized into four levels (> or = 35 g/d, 18 to 34 g/d, 1 to 17 g/d, and 0 g/d), were available for 1847 men. Average values of macronutrients and micronutrients from the first two examinations and major coronary and stroke risk factors were assessed in relation to fish consumption. Stroke mortality was ascertained from death certificates and nonfatal stroke from records of the Health Care Financing Administration. RESULTS: During 46,426 person-years of follow-up, 76 stroke deaths occurred. Men consuming > or = 35 g/d of fish (highest level) had a higher age-adjusted death rate from stroke (23.5 per 10,000 person-years) than men in the three other categories of fish consumption. Based on a Cox proportional hazards regression model with adjustment for age, systolic blood pressure, cigarette smoking, serum cholesterol level, diabetes, electrocardiographic abnormalities, and table salt use, hazards ratios (and 95% confidence intervals) for fish consumers compared with nonconsumers were 1.34 (0.53 to 3.41) for > or = 35 g/d, 0.96 (0.41 to 2.21) for 18 to 34 g/d, and 1.00 (0.43 to 2.33) for 1 to 17 g/d. Age-adjusted and multivariate analyses for fatal and nonfatal strokes (n = 222) yielded similar results. CONCLUSIONS: With stroke rates highest in the subgroup reporting highest fish intake, these data do not support the hypothesis of an inverse association of fish consumption with strokes.

Adult↗
PubMed1996

Socioeconomic differentials in mortality risk among men screened for the Multiple Risk Factor Intervention Trial: I. White men.

OBJECTIVES: This study examined socioeconomic differentials in risk of death from a number of specific causes in a large cohort of White men in the United States. METHODS: For 300 685 White men screened for the Multiple Risk Factor Intervention Trial between 1973 and 1975, data were collected on median income of White households in the zip code of residence, age, cigarette smoking, blood pressure, serum cholesterol, previous myocardial infarction, and drug treatment for diabetes. The 31 737 deaths that occurred over the 16-year follow-up period were grouped into specific causes and related to median White family income. RESULTS: There was an inverse association between age- adjusted all-cause mortality and median family income. There was no attenuation of this association over the follow-up period, and the association was similar for the 22 clinical centers carrying out the screening. The gradient was seen for many-but not all-of the specific causes of death. Other risk factors accounted for some of the association between income and coronary heart disease and smoking-related cancers. CONCLUSIONS: Socioeconomic position, as measured by median family income of area of residence, is an important determinant of mortality risk in White men.

Adult↗
PubMed1996

Socioeconomic differentials in mortality risk among men screened for the Multiple Risk Factor Intervention Trial: II. Black men.

OBJECTIVES: This study examined socioeconomic differentials in risk of death from a number of causes in a large cohort of Black men in the United States. METHODS: For 20 224 Black men screened for the Multiple Risk Factor Intervention Trial between 1973 and 1975, data were collected on median family income of Black households in zip code of residence, age, cigarette smoking, blood pressure, serum cholesterol, previous heart attack, and drug treatment for diabetes. The 2937 deaths that occurred over the 16-year follow-up period were grouped into specific causes and related to median Black family income. RESULTS: There was an inverse association between age-adjusted all-cause mortality and median family income. There was no attenuation of this association over the follow-up period, and the association was similar for the 22 clinical centers carrying out the screening. The gradient was seen for most of the specific causes of death, although the strength of the association varied. Median income was markedly lower for the Black men screened than for the White men, but the relationship between income and all-cause mortality was similar. CONCLUSIONS: Socioeconomic position is an important determinant of mortality risk for Black men. Even though Blacks lived in areas with substantially lower median family income than Whites, the association of income with mortality was similar for Blacks and Whites.

Adult↗
PubMed1996

Dietary beta-carotene, vitamin C, and risk of prostate cancer: results from the Western Electric Study.

Dietary factors are likely candidates for important determinants of prostatic cancer risk. Among the most investigated nutritional factors have been antioxidants. We evaluated dietary beta-carotene and vitamin C in relation to subsequent risk of prostate cancer in a prospective study of 1,899 middle-aged men. We combined prostate cancer cases diagnosed in the first 24 years of follow-up with incident cases identified from the Health Care Financing Administration hospitalization and outpatient files during an additional 6-year follow-up period. We obtained death certificates for all decedents. During the 30-year follow-up, prostate cancer developed in 132 men. There was no indication that consumption of beta-carotene or vitamin C was related to increased or decreased risk of prostate cancer. Relative risks for highest vs lowest quartiles of beta-carotene and vitamin C intake were 1.27 [95% confidence interval (CI) = 0.75-2.14] and 1.03 (95% CI = 0.59-1.60), respectively, after adjustment for age, number of cigarettes smoked per day, dietary cholesterol and saturated fat, alcohol consumption, total energy intake, and occupation. Associations between intake of these nutrients and risk of prostate cancer differed depending on whether the cancer was diagnosed during the first 19 years of follow-up or the next 11 years of follow-up. Overall survival over the 30 years of follow-up was positively associated with intake of beta-carotene and vitamin C.

Adult↗
PubMed1995

Dietary vitamin C and beta-carotene and risk of death in middle-aged men. The Western Electric Study.

In the Western Electric Company Study, carried out in Chicago, Illinois, data on diet and other factors were obtained in 1958 and 1959 for a cohort of 1,556 employed, middle-aged men. Nutrients included vitamin C and beta-carotene. An index that summarized combined intake of both nutrients was constructed. Mean intakes of vitamin C in the lowest and highest tertiles of the index were 66 and 138 mg/day; corresponding values for beta-carotene were 2.3 and 5.3 mg/day. A total of 522 of 1,556 men died during 32,935 person-years of follow-up, 231 from coronary heart disease and 155 from cancer. After adjustment for potentially confounding factors, relative risks (95% confidence intervals) associated with an increment of 19 points in the index (difference between means of the lowest and highest tertiles) were 0.60 (0.39-0.93) for cancer mortality, 0.70 (0.49-0.98) for coronary disease mortality, and 0.69 (0.55-0.87) for all-cause mortality. These results support the hypothesis that consumption of foods rich in vitamin C and beta-carotene reduces risk of death in middle-aged men.

Adult↗
PubMed1995

Comparison of five antihypertensive monotherapies and placebo for change in left ventricular mass in patients receiving nutritional-hygienic therapy in the Treatment of Mild Hypertension Study (TOMHS).

BACKGROUND: Increased left ventricular mass (LVM) by echocardiography is associated with increased risk of cardiovascular disease. Thus, it is of interest to compare the effects of both pharmacological and nonpharmacological approaches to the treatment of hypertension on reduction of LVM. METHODS AND RESULTS: Changes in LV structure were assessed by M-mode echocardiograms in a double-blind, placebo-controlled clinical trial of 844 mild hypertensive participants randomized to nutritional-hygienic (NH) intervention plus placebo or NH plus one of five classes of antihypertensive agents: (1) diuretic (chlorthalidone), (2) beta-blocker (acebutolol), (3) alpha-antagonist (doxazosin mesylate), (4) calcium antagonist (amlodipine maleate), or (5) angiotensin-converting enzyme inhibitor (enalapril maleate). Echocardiograms were performed at baseline, at 3 months, and annually for 4 years. Changes in blood pressure averaged 16/12 mm Hg in the active treatment groups and 9/9 mm Hg in the NH only group. All groups showed significant decreases (10% to 15%) in LVM from baseline that appeared at 3 months and continued for 48 months. The chlorthalidone group experienced the greatest decrease at each follow-up visit (average decrease, 34 g), although the differences from other groups were modest (average decrease among 5 other groups, 24 to 27 g). Participants randomized to NH intervention only had mean changes in LVM similar to those in the participants randomized to NH intervention plus pharmacological treatment. The greatest difference between groups was seen at 12 months, with mean decreases ranging from 35 g (chlorthalidone group) to 17 g (acebutolol group) (P = .001 comparing all groups). Within-group analysis showed that changes in weight, urinary sodium excretion, and systolic BP were moderately correlated with changes in LVM, being statistically significant in most analyses. CONCLUSIONS: NH intervention with emphasis on weight loss and reduction of dietary sodium is as effective as NH intervention plus pharmacological treatment in reducing echocardiographically determined LVM, despite a smaller decrease in blood pressure in the NH intervention only group. A possible exception is that the addition of diuretic (chlorthalidone) may have a modest additional effect on reducing LVM.

Antihypertensive Agents↗
PubMed1995

Lifestyle intervention: results of the Treatment of Mild Hypertension Study (TOMHS).

BACKGROUND: Questions regarding the efficacy of nonpharmacologic approaches for the treatment of stage 1 hypertension were addressed as part of the Treatment of Mild Hypertension Study (TOMHS), a 4-year, randomized clinical trial (N = 902). This report describes the lifestyle intervention program used in TOMHS, presents data on the lifestyle changes observed, and focuses on the effect of weight loss on blood pressure and blood lipid levels. METHODS: Participants were randomly assigned to receive either placebo or one of five different antihypertensive medications. All took part in a lifestyle intervention program to reduce weight and sodium and alcohol intake and to increase physical activity. RESULTS: Substantial changes from baseline levels were achieved for all lifestyle intervention variables. Mean weight change was -10.5 lb (-5.6%) at 1 year, -8.5 lb (-4.5%) at 2 years, -7.4 lb (-4.0%) at 3 years, and -5.7 lb (-3.0%) at 4 years. At 4 years, 70% of participants remained below baseline weight and 34% maintained a weight loss of 10 lb or greater. Mean change in urinary sodium excretion was -12.5 mmol/8 hr (-23%) at 1 year, -10.7 mmol/8 hr (-20%) at 2 years, -8.4 mmol/8 hr (-16%) at 3 years, and -4.6 mmol/8 hr (-9%) at 4 years. Alcohol intake declined by 1.6 drinks/week among drinkers at 4 years. Reported leisure physical activity increased by 86% at 1 year and remained 50% above baseline at 4 years. Beneficial changes in blood pressure and serum lipids were associated with these changes. CONCLUSIONS: These results support a role for lifestyle interventions as the initial treatment for stage 1 hypertension and demonstrate that such interventions can be successfully implemented in the clinical setting.

Aged↗
PubMed1995

Red blood cell sodium and potassium concentration and blood pressure. The Gubbio Population Study.

The relations of red blood cell sodium (RBC Na) and potassium (RBC K) concentrations to blood pressure and prevalence of hypertension were assessed for 1805 men and women, aged 25 to 74 years, who participated in the baseline examination of the Gubbio Population Study in north central Italy. In men, in univariate analyses, RBC Na concentration was not significantly related to systolic or diastolic blood pressure, while RBC K concentration was significantly and inversely related to blood pressure. In women RBC Na values correlated significantly and directly with systolic and diastolic pressure, but RBC K concentration was not significantly related to blood pressure. Results of the multivariate analyses indicated in men a significant independent and inverse relationship of RBC K concentration with hypertension and blood pressure, and in women a significant positive association of RBC Na concentration with hypertension. RBC Na did not relate independently to either systolic or diastolic blood pressure in men or women. Age-specific analyses suggested that the relationships between RBC K level and blood pressure in men and the relationship between RBC Na level and hypertension in women were stronger in older (age 55 to 74 years) compared to younger participants (25 to 54 years). These findings indicate that the associations of RBC Na and K concentrations and hypertension may be sex and age specific. The nature of these gender- and age-specific associations remains to be clarified. Prospective data are also needed for further clarification of the relation of intracellular Na metabolism to the etiology of hypertension.

Adult↗
PubMed1995

The relationship between dietary factors and serum lipids in Chinese urban and rural populations of Beijing and Guangzhou. PRC-USA Cardiovascular and Cardiopulmonary Research Group.

BACKGROUND: Serum cholesterol (TC) levels and coronary heart disease (CHD) are lower in China than in western countries. This report examines the role of diet in determining TC. METHODS: Data were collected as part of a cross-sectional study of 10,000 men and women, 35-54 years old, conducted in 1983-1984 in four areas in China. A 10% subsample was surveyed for eating patterns and measurement of blood lipids. Six one-day dietary recalls were collected on each participant. RESULTS: Mean daily intake of energy from fat was less than 30%. Mean Keys scores ranged from 20.4 to 32.6. In multivariable regression analysis controlling for age, body mass index (BMI), and alcohol, Keys score was statistically associated with serum TC. A 10-unit greater Keys score was associated with 6.3 mg/dl higher TC and 4.0 mg/dl higher low density lipoprotein cholesterol. CONCLUSIONS: We conclude that in China the relation of dietary factors to serum lipids is similar to that in populations having high serum TC levels.

Adult↗
PubMed1995

Heart rate and prostate cancer mortality: results of a prospective analysis.

Recent studies suggest that local levels of sympathetic nervous activity influence the growth of prostatic tissue. In several epidemiological studies, resting heart rate, an indicator of overall sympathetic activity, was positively associated with all noncardiovascular and cancer death among men. However, no previous analyses have focused on the specific relationship of heart rate to prostate cancer mortality. We studied 22,380 men enrolled in the Chicago Heart Association cohort from 1967-1973, who had heart rate (HR) determined by electrocardiogram. Mean length of follow-up (for mortality) was 19.2 years. We computed age-adjusted rates for prostate cancer death by variable of interest and fitted proportional hazards models to estimate relative risks (RRs) adjusted for potential confounders. In a model controlling for age, body mass index, blood pressure, serum cholesterol, smoking, postload plasma glucose, and years of education, the RR for a 10 beat/min higher HR was 1.26 (95% confidence interval = 1.04-1.51). Age-adjusted RRs across higher quintiles for HR were 1.00, 1.55, 1.85, 2.18, and 2.69 (P trend = 0.006). Survival curves indicated that the elevated risk was not confined to the early years of follow-up. Because little is known about factors that determine risk of prostate cancer death, these results could prove important even if due to an unmeasured etiological factor other than heart rate itself. The results are consistent with the hypothesis that local neurotrophic factors associated with sympathetic activity influence the progression of prostate cancer

Adolescent↗
PubMed1994

Alcohol and blood pressure: the INTERSALT study.

OBJECTIVES: To assess the relation between alcohol intake and blood pressure in men and women and in men at younger and older ages; to examine the influence of amount and pattern of alcohol consumption, as well as of acute effects, taking into account body mass index, smoking, and urinary sodium and potassium excretion. DESIGN: Subjects reported alcohol consumption for each of seven days before standardised blood pressure measurement, and whether they had consumed any alcohol in the 24 hours before measurement. SETTING: 50 centres worldwide. SUBJECTS: 4844 men and 4837 women aged 20-59. MAIN OUTCOME MEASURES: Effect of alcohol on blood pressure estimated by taking a weighted average of regression coefficients from centres. Acute effect assessed by examining mean differences in blood pressure of non-drinkers and of heavy drinkers who had and had not consumed alcohol in the 24 hours before measurement. Effect of pattern of consumption assessed by examining mean differences in blood pressure of non-drinkers compared with drinkers (i) whose intake was concentrated in fewer days or who were drinking more frequently, and (ii) whose alcohol intake varied little over the seven days or varied more substantially, as indicated by the standard deviation of daily consumption. RESULTS: Of the 48 centres in which some people reported consuming at least 300 ml/week of alcohol, 35 had positive regression coefficients linking heavy alcohol consumption to blood pressure. Overall, alcohol consumption was associated with blood pressure, significantly at the highest intake. After account was taken of key confounders, men who drank 300-499 ml alcohol/week had systolic/diastolic blood pressure on average 2.7/1.6 mmHg higher than non-drinkers, and men who drank > or = 500 ml alcohol/week had pressures of 4.6/3.0 mmHg higher. For women, heavy drinkers (> or = 300 ml/week) had blood pressures higher by 3.9/3.1 mmHg than non-drinkers. Heavy drinking and blood pressure were strongly associated in both sexes, and in men at both younger (20-39 years) and older (40-59 years) ages. In men who were heavy drinkers, episodic drinkers (those with great variation in daily alcohol consumption) had greater differences in blood pressure compared with non-drinkers than did regular drinkers of relatively constant amounts. CONCLUSION: The significant relation of heavy drinking (3-4 or more drinks/day) to blood pressure, observed in both men and women, and in younger and older men, was independent of and added to the effect on blood pressure of body mass index and urinary excretion of sodium and potassium. The findings indicate the usefulness of targeting those at high risk as well as the general population to reduce the adverse effects of alcohol on blood pressure.

Adult↗
PubMed1994

Ethnic differences in electrocardiographic left ventricular hypertrophy in young and middle-aged employed American men.

In the United States population, black men have higher prevalence rates of electrocardiographic (ECG) high QRS voltage, more ST-segment and T-wave abnormalities, and more ECG left ventricular hypertrophy (LVH) than do white men. Reasons for these differences have not been fully elucidated. The prevalence rate of ECG LVH and associated characteristics were compared in black and white men in the Chicago Heart Association Detection Project in Industry population study. Data were from 1,391 black men and 19,126 white men (age range 20 to 64 years) employed by 84 Chicago organizations. ECG LVH was defined by the presence of both high QRS (Minnesota code 3.3) and ST-T abnormality (code 4.1-4.3 or 5.1-5.3). Black men had a significantly higher prevalence rate of ECG LVH than did white men in each 15-year age group (15.9 vs 2.4, 14.6 vs 2.8, and 35.7 vs 12.5/1,000 in the 20- to 34-, 35- to 49-, and 50-to 64-year age groups, respectively; p < 0.01 for each comparison). Multiple logistic regression analyses indicated that systolic blood pressure and age were associated positively with ECG LVH (p < 0.01) in both black and white men. Men with history of hypertension and receiving drug treatment had a greater likelihood of having ECG LVH than did those with history of hypertension but not receiving drug treatment, possibly because those with more severe hypertension were more likely to have been prescribed medication. Serum cholesterol, cigarettes smoked/day, 1-hour post-load plasma glucose and education were not consistently related to ECG LVH.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗