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Biomedical subjects

K A Matthews

Publications and source records attributed to K A Matthews.

At least 91 records · Page 5Linked to original sources
PubMed1992

Hemostatic factors according to menopausal status and use of hormone replacement therapy.

The rise in cardiovascular disease (CVD) risk after menopause may be reduced by hormone replacement therapy (HRT) although the mechanism is unclear. Because little is known about the potential role of hemostatic factors, fibrinogen level and other coagulation parameters were measured in a study on the change in CVD risk factors through the climacteric (the Healthy Women Study). Of 239 subjects measured to date, 32 taking aspirin or other medications thought to alter coagulation were excluded from analyses. Results (adjusted for age and obesity) showed that women taking HRT had lower plasma concentrations of fibrinogen and higher levels of plasminogen and factor VIIc than did postmenopausal subjects not taking HRT. Pre- as compared with postmenopausal women had lower plasma levels of fibrinogen, factor VIIc, and antithrombin III. Adjusting for cigarette smoking did not change the findings. Thus, among women aged 49 to 55, selected hemostatic measures varied (within normal ranges) by menopausal status and were altered by HRT. These findings generally support a hypothesis of hemostatic change contributing to the increase of CVD after menopause. The fact that subjects taking HRT showed no increase in fibrinogen relative to premenopausal women is consistent with an observed decreased risk of CVD among women taking HRT, while the implication of an elevation in factor VIIc among these women is uncertain.

Antithrombin III↗
PubMed1992

Influence of age, sex, and family on Type A and hostile attitudes and behaviors.

We describe the influence of age, sex, and family on Type A and hostility indices that have been related to rates of coronary heart disease (CHD). The sample consisted of 120 girls and 95 boys (ages 6 to 18 years) and 141 women and 120 men (ages 31 to 62 years) from 142 families residing in an upper middle class community. Results showed little familial aggregation of Type A and hostility. Adults had higher Structured Interview (SI) Potential for Hostility ratings than did children, whereas children had higher Minnesota Multiphasic Personality Inventory (MMPI)-derived Hostility scores and SI Anger-In ratings than did adults. Male adults and male children had higher SI Potential for Hostility ratings and MMPI-derived Hostility scores than did their female counterparts. The heightened hostility of males may account, in part, for their heightened risk of CHD relative to females'.

Adolescent↗
PubMed1992

Pregnancy alters blood pressure responses to psychological and physical challenge.

The purpose of the study was to evaluate the effect of the substantial changes in female reproductive hormones that occur during normal pregnancy on cardiovascular responses to psychological and physical challenges. Twenty-one healthy normotensive women performed serial subtraction, mirror image tracing, and isometric handgrip exercise tasks prior to pregnancy and again during the second trimester of pregnancy. A control group of 34 healthy women who did not intend to become pregnant and were nonpregnant were also tested in the same protocol twice, 6-10 months apart. Results showed that the pregnant women exhibited a reduced diastolic blood pressure response to all three tasks, relative to their pre-pregnancy levels, whereas nonpregnant controls did not change in their diastolic blood pressure response across time. These results are consistent with the hypothesis that elevations in female reproductive hormones diminish blood pressure responses during challenge because of dampened sympathetic nervous system activity.

Adolescent↗
PubMed1992

Can physical activity mitigate the effects of aging in middle-aged women?

BACKGROUND: Aging is associated with an increased risk of women dying from coronary heart disease as well as from all causes combined. Alterations in the major biological risk factors for early coronary heart disease and all-cause mortality are frequently seen in aging. METHODS AND RESULTS: The present investigation tested the hypothesis that high levels of physical activity could protect against age-associated changes in biological risk factor levels. In the Healthy Women Study, 507 women were evaluated at study entry and 3 years later. Weekly physical activity level was measured at each examination via the Paffenbarger Physical Activity Questionnaire. During the 3-year period, women increased significantly in weight, blood pressure, levels of total and low-density lipoprotein cholesterol, triglycerides, and insulin and decreased significantly in levels of total high-density lipoprotein cholesterol (HDL-C) and HDL2-C. CONCLUSIONS: Consistent with the study hypothesis, women who reported higher levels of activity at baseline had less weight gain over time. Furthermore, women who increased their activity during the 3-year interval had the smallest increases in weight and tended to have the smallest decreases in total HDL-C and HDL2-C. The changes in lipids due to activity were largely independent of changes in body weight.

Aging↗
PubMed1992

Psychosocial factors and complications of IDDM. The Pittsburgh Epidemiology of Diabetes Complications Study. VIII.

OBJECTIVE: To investigate whether psychosocial factors are associated with diabetic complications. RESEARCH DESIGN AND METHODS: Questionnaires on quality of life, depressive symptomatology, and personality type were completed and a clinical assessment was performed. The study population was an incident cohort of childhood-onset insulin-dependent diabetic (IDDM) subjects whose duration of IDDM was greater than or equal to 25 yr (n = 175). RESULTS: Patients with macrovascular disease (P less than 0.01) or nephropathy (P less than 0.05) reported significantly poorer quality of life compared with those who were free from all complications. Patients with macrovascular disease also reported greater depressive symptomatology (P less than 0.05). Quality of life significantly deteriorated according to the presence of multiple (greater than or equal to 4) complications (P less than 0.001). Higher depression symptom scores were also related to the presence of greater than or equal to 4 complications (P less than 0.001). Those with multiple complications reported less type A behavior than those without any complications (P less than 0.05). CONCLUSIONS: This study shows that psychosocial differences exist according to both the number and the type of diabetic complications present. Because poorer quality of life and symptoms of depression may both result form complications, prospective follow-up is needed to clarify their temporal interrelationships, and to determine whether type A personality affords any protection against complications or is diminished as a result of developing complications.

Adult↗
PubMed1991

Premenopausal determinants of menopausal estrogen use.

METHODS: Characteristics related to subsequent use of estrogen replacement therapy were evaluated prospectively in a cohort of 541 healthy premenopausal women being followed through the menopausal transition. RESULTS: Among women who became menopausal during the follow-up period, the most striking premenopausal baseline differences between menopausal estrogen users and never users were that users tended to be thinner and more likely to report past oral contraceptive use than never users (P less than or equal to 0.05). Nonsignificant trends were also observed, with menopausal estrogen users having higher total high-density lipoprotein cholesterol and lower fasting insulin prior to estrogen use than the menopausal never users (P less than or equal to 0.10). Weaker trends included greater alcohol intake and past week kilocalorie expenditure and lower blood pressure levels among menopausal estrogen users than never users. CONCLUSIONS: Although these findings do not preclude the probable protective effect of estrogen therapy on coronary heart disease morbidity and mortality, they do suggest that slightly healthier women may take menopausal hormones.

Adult↗
PubMed1991

Potential for increasing high-density lipoprotein cholesterol, subfractions HDL2-C and HDL3-C, and apoprotein AI among middle-age women.

BACKGROUND: Studies have shown high-density lipoprotein cholesterol (HDL-C) to be a strong predictor of cardiovascular disease (CVD) risk. METHODS: Determinants of HDL-C and apoprotein AI concentrations were evaluated cross-sectionally in 1987 among 429 women, ages 45-54, from a population-based study of CVD risk factors through menopause (the Healthy Women Study, University of Pittsburgh). RESULTS: Subjects were healthy and not taking hormone replacement therapy. Results showed levels of HDL-C (mg/dl) to range from 23 to 117, HDL2-C from 0 to 53, HDL3-C from 16 to 66, and apoprotein AI from 87 to 204. Multivariate analyses which included age, cigarettes/day, alcohol intake (g/day), physical activity (Paffenbarger questionnaire), body mass index (BMI), and waist/hip ratio (WHR) showed that women who smoked greater than or equal to 20 cigarettes a day, reported little or no alcohol intake, expended less than 500 kcal/week, and were in the highest quintile of BMI and WHR had, on average, 33 mg/dl lower HDL-C than slender, nonsmoking women who drank moderately and exercised. HDL2-C showed a similar pattern, whereas the HDL3-C concentration had only a modest association with these factors. HDL-C was somewhat lower among women who had stopped menstruating than among premenopausal women. The apoprotein AI level was associated with alcohol intake (positively) and BMI (negatively). CONCLUSION: Theoretically, by raising their HDL-C by 10 mg/dl, women could reduce their CVD risk by as much as one-third (based on results from the Framingham Heart Study). As CVD is the leading cause of death among postmenopausal women, the potential impact of such a reduction in risk would be large.

Alcohol Drinking↗
PubMed1991

Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women.

The prevalence, incidence and correlates of urinary incontinence were studied in a community-based sample of 541 healthy, middle-aged women 42 to 50 years old. Participants were evaluated on 2 occasions approximately 3 years apart. Of the participants 58% reported urine loss at some time and 30.7% reported incontinence on a regular basis at least once per month. During 3 years the cumulative incidence of regular incontinence in previously continent women was 8.0%. Among those with regular incontinence 64.9% said the volume of loss was 1 or 2 drops, while 35.1% reported that they needed to change their garments. Only 25.5% of the patients had sought treatment. Continence status was significantly related to body mass index and race but not to patient age, parity, caffeine or alcohol intake, smoking, physical activity, prior gynecological surgery or several psychological variables. The results indicate that urinary incontinence is common among middle-aged women. That few seek treatment suggests a need for more information about women's attitudes toward incontinence and more attention to this problem by health care providers.

Adult↗
PubMed1991

Does the gender relevance of the stressor influence sex differences in psychophysiological responses?

Sex differences in psychophysiological responses to stress may be important to understanding sex differences in risk for coronary heart disease. This investigation tested the hypothesis that the gender relevance of the stressor influences the extent of sex differences in cardiovascular, neuroendocrine, and lipid responses during stress. Participants performed two tasks that were described as masculine oriented, feminine oriented, or not gender relevant. Although these descriptions influenced the participants' perceptions of the tasks, they did not influence the extent of sex differences in physiological responses in a manner consistent with the study hypothesis. Future directions for research are discussed regarding sex differences in psychophysiological responses.

Achievement↗
PubMed1991

Stress reactivity and exercise training in premenopausal and postmenopausal women.

Examined the influence of ovarian function on psychophysiological stress responses and determined if aerobic exercise reduced stress reactivity. Fifty premenopausal and postmenopausal women initially were subjected to a public speaking task and an ice-on-the-forehead procedure, during which time their blood pressure and heart rate were monitored and continuous blood samples were obtained. Subjects also underwent aerobic fitness evaluations with a maximum-exercise treadmill test. Subjects were then randomly assigned to a 12-week exercise program of either aerobic exercise (e.g., walking and jogging at a prescribed exercise intensity) or non-aerobic strength and flexibility training and were then reevaluated. Results indicated that postmenopausal women exhibited lower resting epinephrine levels but greater epinephrine reactivity to the speaking task compared to the premenopausal women. There were no differences between premenopausal and postmenopausal women with respect to cardiovascular or catecholamine responses during the cold challenge. Premenopausal and postmenopausal women also achieved comparable improvements in aerobic fitness. However, results of the mental stress testing were complex and provided only partial support for the role of aerobic exercise in reducing stress responses.

Arousal↗
PubMed1991

Psychological, biological and health behavior predictors of blood pressure changes in middle-aged women.

A long-standing hypothesis is that feelings of anger and anxiety increase the risk for essential hypertension. Most studies examining this hypothesis have been cross-sectional in design or undertaken with men only. We tested this hypothesis along with determination of the other behavioral and biological predictors of increases in systolic (SBP) and diastolic (DBP) blood pressure from baseline to a follow-up examination 3 years later in a prospective study of 468 middle-aged women whose blood pressure at the baseline examination was less than 140/90 mmHg. Analyses showed that increases in the Spielberger Trait Anger Scale between the baseline and 3-year follow-up examination, as well as Framingham Tension scores (a measure of anxiety) at baseline, independently predicted an increase in SBP (P less than 0.01). Other factors that independently predicted an increase in SBP were baseline fasting insulin, parental history of hypertension and increases in body mass index and in alcohol intake across the 3 years of follow-up. Increases in the Spielberger Trait Anger Scores independently predicted increases in DBP (P less than 0.02), as did black race, increases in body mass index and hematocrit and decreases in potassium intake. Although menopausal status and hormone replacement therapy were unrelated to changes in blood pressure, postmenopausal women on hormone replacement therapy did show significant increases in DBP in the univariate analysis. Anxiety at baseline, along with parental history of hypertension, baseline fasting insulin and baseline body mass index, predicted a later onset of hypertension, i.e. on pharmacologic treatment for hypertension, in the univariate analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Cross-sectional and longitudinal relationship of sodium-lithium countertransport to insulin, obesity and blood pressure in healthy perimenopausal women.

The objectives of this study were to assess the possible role of insulin as a regulator of red blood cell sodium-lithium countertransport and to examine the relationship of countertransport activity to change over time in insulin, blood pressure, and other variables. At baseline, countertransport was measured, and at baseline and after 2-3 years of follow-up, blood pressure, body mass index (BMI), lipids, fasting and two-hour plasma insulin and glucose were measured in 144 white healthy, premenopausal women, age 42-50 years. At baseline, using high and low categories of fasting insulin, triglycerides and BMI, countertransport was independently related to fasting insulin (P = 0.017), and triglycerides (P = 0.001), but not to BMI by analysis of variance. In similar analyses with fasting insulin, BMI, and countertransport, diastolic blood pressure was independently related only to countertransport (P = 0.003). Among the 73 who remained premenopausal after 2-3 year follow-up, baseline countertransport was significantly correlated with increases in fasting and two-hour insulin (r = 0.37, 0.38, P = 0.003, respectively), and these relationships remained significant after adjustment for change in BMI. Among subjects with high baseline countertransport, systolic blood pressure increased 5.6 mmHg compared with -2.2 mmHg with low countertransport, P = 0.001 after adjusting for baseline and change in BMI, triglycerides, and fasting and two-hour insulin. The data are consistent with a role for insulin and lipids in the regulation of sodium transport which may, in turn, play a role in blood pressure regulation. A relatively short follow-up in this healthy population suggests a relationship of baseline countertransport to changes in insulin metabolism, and blood pressure.

Adult↗
PubMed1991

Measuring adolescent satisfaction with nursing care in an ambulatory setting.

This descriptive study addresses the topic of patient satisfaction with nursing care. A convenience sample of adolescent females who attended health department family planning clinics in a southeastern city was surveyed to determine the level of satisfaction with care provided by clinic nurses. Data were collected using the Risser Patient Satisfaction with Nursing Care instrument (Risser, 1975) which had been used exclusively with adults. A primary purpose, therefore, was to test the instrument with a teenage population. Data analysis yielded descriptive statistics, frequency distributions, correlations and alpha reliability coefficients. Findings indicated that the teenagers were most satisfied with the technical-professional aspect of nursing care and least satisfied with the interpersonal-educational aspect. The Risser instrument was found to be highly reliable with this adolescent cohort.

Ambulatory Care↗
PubMed1991

Weight gain at the time of menopause.

We studied prospectively the weight change and the effect of weight change on changes in coronary heart disease risk factors in a population-based sample of 485 middle-aged women. All women were studied first in 1983 to 1984, when they were premenopausal and aged 42 to 50 years, and then restudied in 1987. Women gained an average of 2.25 +/- 4.19 kg during this 3-year period; 20% of women gained 4.5 kg or more, and only 3% lost 4.5 kg or more. There were no significant differences in weight gain of women who remained premenopausal and those who had a natural menopause (+2.07 kg vs +1.35 kg). Weight gain was significantly associated with increases in blood pressure and levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, and fasting insulin. Weight gain is thus a common occurrence for women at the time of menopause and is related to the changes in coronary heart disease risk factors observed during this period. Efforts to lose weight or to prevent weight gain may help to mitigate the worsening in coronary heart disease risk factors in middle-aged women.

Adult↗
PubMed1990

Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials.

OBJECTIVE: To determine the effects of lowering cholesterol concentrations on total and cause specific mortality in randomised primary prevention trials. DESIGN: Qualitative (meta-analytic) evaluation of total mortality from coronary heart disease, cancer, and causes not related to illness in six primary prevention trials of cholesterol reduction (mean duration of treatment 4.8 years). PATIENTS: 24,847 Male participants; mean age 47.5 years. MAIN OUTCOME MEASURES: Total and cause specific mortalities. RESULTS: Follow up periods totalled 119,000 person years, during which 1147 deaths occurred. Mortality from coronary heart disease tended to be lower in men receiving interventions to reduce cholesterol concentrations compared with mortality in control subjects (p = 0.06), although total mortality was not affected by treatment. No consistent relation was found between reduction of cholesterol concentrations and mortality from cancer, but there was a significant increase in deaths not related to illness (deaths from accidents, suicide, or violence) in groups receiving treatment to lower cholesterol concentrations relative to controls (p = 0.004). When drug trials were analysed separately the treatment was found to reduce mortality from coronary heart disease significantly (p = 0.04). CONCLUSIONS: The association between reduction of cholesterol concentrations and deaths not related to illness warrants further investigation. Additionally, the failure of cholesterol lowering to affect overall survival justifies a more cautious appraisal of the probable benefits of reducing cholesterol concentrations in the general population.

Aged↗