Biomedical subjects
Larry E Fields
Publications and source records attributed to Larry E Fields.
Absolute stroke mortality burden for non-Hispanic non-Latino whites was disproportionately higher than expected simply based on the US population in 2001.
BACKGROUND AND PURPOSE: The absolute burden of stroke is a major determinant of health care costs and should also be considered when developing and implementing effective health policy. This study evaluated the impact of specific racial-ethnic categorization on absolute stroke mortality burden and population percentages. METHODS: In this population-based analysis, 2001 US data was used to compute absolute values of population and stroke mortality burden for white and black, and other racial-ethnic groups. To test the effect of age-mix, values were age-adjusted using the 2000 US standard population. The z test statistic was computed and a 2-tailed P value of <0.05 was considered significant. RESULT: Whites comprised a majority of the 2001 absolute US stroke mortality burden and US population (86% and 82%, respectively). Surprisingly, nHnL whites comprised a much higher percentage of the absolute US stroke mortality burden than expected based on their percentage of the US population alone (81% and 69%, respectively; P<0.001). Age-adjustment indicated a contribution by age-mix, however, an age-independent residual component remained. CONCLUSIONS: Specific race-ethnicity categorization significantly influences comparisons of the proportion of absolute stroke mortality burden to the population proportion. Accordingly, appropriate caution and care are needed when estimating the societal impact of conditions such as stroke.
The burden of adult hypertension in the United States 1999 to 2000: a rising tide.
This study aims to estimate the absolute number of persons with hypertension (the hypertension burden) and time trends using data from the National Health and Nutrition Examination Survey of United States resident adults who had hypertension in 1999 to 2000. This information is vitally important for health policy, medical care, and public health strategy and resource allocation. At least 65 million adults had hypertension in 1999 to 2000. The total hypertension prevalence rate was 31.3%. This value represents adults with elevated systolic or diastolic blood pressure, or using antihypertensive medications (rate of 28.4%; standard error [SE], 1.1), and adults who otherwise by medical history were told at least twice by a physician or other health professional that they had high blood pressure (rate of 2.9%; SE, 0.4). The number of adults with hypertension increased by approximately 30% for 1999 to 2000 compared with at least 50 million for 1988 to 1994. The 50 million value was based on a rate of 23.4% for adults with elevated blood pressure or using antihypertensive medications and 5.5% for adults classified as hypertensive by medical history alone (28.9% total; P<0.001). The approximately 30% increase in the total number of adults with hypertension was almost 4-times greater than the 8.3% increase in total prevalence rate. These trends were associated with increased obesity and an aging and growing population. Approximately 35 million women and 30 million men had hypertension. At least 48 million non-Hispanic white adults, approximately 9 million non-Hispanic black adults, 3 million Mexican American, and 5 million other adults had hypertension in 1999 to 2000.
Mortality from stroke and ischemic heart disease increases exponentially with blood pressure.
Explore the source record for details and available documents.