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Biomedical subjects

M Feinleib

Publications and source records attributed to M Feinleib.

At least 73 records · Page 4Linked to original sources
PubMed1983

Prevalence of submitral (anular) calcium and its correlates in a general population-based sample (the Framingham Study).

To obtain epidemiologic information on submitral calcium, 2,069 subjects in the original Framingham Study cohort (mean age 70 +/- 7 years) and 3,625 of the offspring of the cohort and their spouses (mean age 44 +/- 10 years) with adequate echocardiograms were evaluated. Submitral calcium was detected in 162 (2.8%) of the 5,694 subjects; greater than 90% of the subjects with such calcium came from the 40% of the study group greater than 59 years of age. Women were more than twice as likely to have such calcium as men. Age in both sexes, systolic blood pressure in men, and obesity in women were significantly and independently associated with submitral calcium. There was a 12-fold excess of atrial fibrillation in subjects with (20 of 162, 12%) compared with those without (53 of 5,532, 1%) submitral calcium.

Adult↗
PubMed1983

Prevalence and correlates of posterior extra echocardiographic spaces in a free-living population based sample (the Framingham study).

To obtain epidemiologic information on extra echocardiographic spaces immediately posterior to the left ventricular free wall, 2,028 subjects in the original Framingham cohort study (mean age 70 +/- 7 years) and 3,624 of the offspring of the cohort (and their spouses) (mean age 44 +/- 10 years) with adequate echocardiograms were evaluated. Extra echocardiographic spaces were detected in 370 (6.5%) of the 5,652 subjects. The prevalence ranged from less than 1% in subjects in the 20- to 30-year age decade to greater than 15% for those in their 80s. Extra echocardiographic spaces tended to be more common in subjects who were older, female, obese, more hypertensive, and who had higher blood sugar levels and higher low density lipoprotein cholesterol levels (measured 8 years earlier). The high prevalence of extra echocardiographic spaces and the independent association with age (cohort and offspring), obesity (cohort and male offspring), and ventricular septal hypertrophy (cohort and male offspring) is compatible with at least 2 hypotheses among others that should be tested: (1) Subepicardial fat may often masquerade as pericardial fluid producing a posterior extra echocardiographic space, especially in obese elderly subjects. (2) Small posterior extra echocardiographic spaces may often be early markers of subclinical hypertensive heart disease.

Adolescent↗
PubMed1983

Risk factors for pulmonary embolism. The Framingham Study.

To assess potential long-term risk factors for major pulmonary embolism, 46 subjects from the Framingham Heart Study with autopsy-confirmed and clinically significant pulmonary embolism were identified in whom age, systolic blood pressure, cholesterol level, cigarette use, glucose level, Metropolitan relative weight, and varicose veins were ascertained at entry into the Study. These variables were compared among these 46 subjects, all 3,470 subjects in whom these variables were measured at the inception of the Study, and the 998 of these subjects who died within 26 years of follow-up. In multivariate analysis of subjects with autopsy-confirmed major pulmonary embolism and all subjects who died, only Metropolitan relative weight was significantly and independently associated with pulmonary embolism and only among women (p less than 0.001). These findings indicate that, in this cohort, increased adiposity in women is an important long-term factor for significant pulmonary embolism at autopsy. This raises the possibility that weight reduction in obese women may decrease the chances of pulmonary embolism.

Age Factors↗
PubMed1983

HDL-cholesterol in a sample of black adults: the Framingham Minority Study.

A group of 100 adult black residents of Framingham, MA were examined and their plasma lipids were determined by the Framingham Heart Study Lipoprotein Laboratory. The age range of the participants was 20-69 yr, and the mean age was 42 yr for both sexes. The mean plasma total cholesterol, HDL-cholesterol (HDL-C), and triglyceride (TG) values for the 45 black men were 184,37.2, and 78 mg/dl, respectively. The corresponding levels for the 55 black women were 192,50.4, and 49. Even after adjusting for obesity, alcohol intake, and cigarette use, the HDL-C levels among the blacks were significantly lower (p less than 0.001) than the levels for Framingham white men and women. This black sample is more highly educated than black groups previously studied, and appears to be as active as the Framingham white sample. We conclude that this black population has quite low HDL-C levels, and the results suggest that the lipoprotein distributions in this group differ from those previously reported for blacks.

Activities of Daily Living↗
PubMed1983

Social networks and coronary heart disease among Japanese men in Hawaii.

A group of 4653 men of Japanese ancestry living in Hawaii were studied for the association of measures of social networks with both the prevalence and incidence rates of coronary heart disease (Honolulu Heart Program, 1971-1979). Prevalence rates for myocardial infarction, angina, and total coronary heart disease were inversely associated with the social network scales in bivariate analyses with age, and in multivariate analyses including 12 other risk factors. With the incidence data, the associations were less evident. Bivariate analysis with age revealed inverse associations for nonfatal myocardial infarction and total coronary heart disease with only one of the social network scales. With multivariate analyses, there was no significant association of any subgroup of coronary heart disease with any scale, although there was a borderline association (p = 0.08) of nonfatal myocardial infarction with one scale. No individual question was significantly associated with either prevalence or incidence rates for coronary heart disease. There was also little evidence of reduced risk of incident coronary heart disease associated with the social network scale for men in high risk categories of serum cholesterol, blood pressure, and cigarette smoking.

Aged↗
PubMed1983

Spouse behavior and coronary heart disease in men: prospective results from the Framingham heart study. I. Concordance of risk factors and the relationship of psychosocial status to coronary incidence.

The relationship of social status and behavior type to the incidence of coronary heart disease was examined among husbands and wives in the Framingham Heart Study. Between 1965 and 1967, 269 spouse pairs, in which the husbands were 45-64 years of age, were administered an extensive psychosocial questionnaire. These pairs were followed over a 10-year period for the development of heart disease. Men married to women with 13 or more years of education were 2.6 times more likely to develop coronary disease than men married to women with a grammar school education (95% CI = 1.0-6.9). Incidence rates among husbands married to women employed outside the home were similar to rates among men married to housewives (15.1 vs. 16.1%, respectively). However, men married to women employed in white-collar jobs were over three times more likely to develop heart disease than those married to clerical workers, blue-collar workers, or to housewives (RR = 4.0, 5.4, and 2.9, respectively; p less than or equal to 0.004). The increased risk in husbands married to women educated beyond the high school level was observed only among men married to women employed outside the home. These effects were apparent regardless of the husband's social status or standard coronary risk factors. Further exploration of these associations revealed that higher-educated working wives whose husbands developed coronary heart disease were significantly more likely to have had a nonsupportive boss and fewer job promotions than wives of noncases.

Blood Pressure↗
PubMed1983

Spouse behavior and coronary heart disease in men: prospective results from the Framingham heart study. II. Modification of risk in type A husbands according to the social and psychological status of their wives.

Analyses of spouse data from the Framingham Heart Study indicated that the risk of developing coronary heart disease among Type A men, compared with Type B men, was modified by the behavior or social status of their wives. Between 1965 and 1967, 269 spouse pairs, in which the husbands were 45-64 years of age, were administered an extensive psychosocial questionnaire. These pairs were followed over a 10-year period for the development of heart disease. When Type A and Type B men were stratified by the social and personality characteristics of their wives, it was found that the differential rate of heart disease between Type A and Type B men was present only in situations where the wives' characteristics might be deemed stressful. Type A husbands were 2.5 times as likely to develop coronary heart disease as Type B husbands if married to women with 13 or more years of education, and had 3.5 times the coronary risk of Type B husbands if married to a woman employed outside the home. When spouses were stratified by behavior type, employed outside the home. When spouses were stratified by behavior type, the highest rates of coronary heart disease were among Type A men married to Type B wives (25%). This rate was over three times the rate among Type B men married to Type B wives (7.8%). When tests for interaction between the behavior type of husbands and characteristics of wives were calculated, significant effects were found among blue-collar men on all variables except wives' educational level. This indicates that Type A men in white-collar occupations are at higher risk of heart disease regardless of wives' characteristics; whereas, the effect of behavior type among men in blue-collar occupations was interrelated with and modified by wives' characteristics. These results were apparent regardless of the husbands' standard coronary risk factors.

Behavior↗
PubMed1983

Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study.

The relationship between the degree of obesity and the incidence of cardiovascular disease (CVD) was reexamined in the 5209 men and women of the original Framingham cohort. Recent observations of disease occurrence over 26 years indicate that obesity, measured by Metropolitan Relative Weight, was a significant independent predictor of CVD, particularly among women. Multiple logistic regression analyses showed that Metropolitan Relative Weight, or percentage of desirable weight, on initial examination predicted 26-year incidence of coronary disease (both angina and coronary disease other than angina), coronary death and congestive heart failure in men independent of age, cholesterol, systolic blood pressure, cigarettes, left ventricular hypertrophy and glucose intolerance. Relative weight in women was also positively and independently associated with coronary disease, stroke, congestive failure, and coronary and CVD death. These data further show that weight gain after the young adult years conveyed an increased risk of CVD in both sexes that could not be attributed either to the initial weight or the levels of the risk factors that may have resulted from weight gain. Intervention in obesity, in addition to the well established risk factors, appears to be an advisable goal in the primary prevention of CVD.

Adult↗
PubMed1983

On the feasibility of linking census samples to the National Death Index for epidemiologic studies: a progress report.

To test the feasibility of using large national probability samples provided by the US Census Bureau, a pilot project was initiated to link 230,000 Census-type records to the National Death Index (NDI). Using strict precautions to maintain the complete confidentiality of individual records, the Current Population Survey files of one month in 1973 and one month in 1978 were matched by computer to the 1979 NDI file. The basic question to be addressed was whether deaths so obtained are seriously underestimated when there is no Social Security Number (SSN) in the Census record. The search of the NDI file resulted in 5,542 matches of which about 1,800 appear to be "true positives" representing deaths, the remainder are "false positives." Of the deaths, 80 per cent would still have been detected without SSN in the Census record. The main reasons for missing deaths (false negatives) were discrepancies in the year of birth and in the given name. Assuming certain changes in the NDI matching algorithm, the 80 per cent figure could increase to 85 per cent or higher; however, this could also cause significant increases in the number of false positives. The National Heart, Lung and Blood Institute (NHLBI) and Census Bureau staff are currently developing a probabilistic method to eliminate false positives from the NDI output tape. The results of the pilot study indicate that a larger research project is clearly feasible.

Epidemiologic Methods↗
PubMed1983

Weight and hypertension.

Both excess weight and hypertension may contribute independently to increased risk of cardiovascular disease. Weight and blood pressure have been found to be associated in most studies in diverse populations. The increase or decrease of blood pressure with weight gain or loss suggests a causal relation, although the mechanism is uncertain. A correlation between blood pressure and weight can be identified early in life. This correlation coefficient increases to approximately 0.4 in young adults and then begins to decrease at older ages. It is likely that weight interacts with various factors controlling blood pressure at different points over a lifetime. The implications for prognosis or control of blood pressure at different ages may vary as well. Attention to minimizing weight gain at a particular period of life, such as in young adulthood, might have long-term beneficial effects in preventing subsequent hypertension or excess blood pressure increase with aging.

Adolescent↗
PubMed1983

Review of the epidemiological evidence for a possible relationship between hypocholesterolemia and cancer.

The evidence relating hypocholesterolemia to an increased risk of cancer is controversial. Although more than a dozen populations have been studied in prospective epidemiological investigations, there is relatively little consistency relating low serum cholesterol levels to future risk or mortality from cancer. Several studies have demonstrated a significant inverse relationship, but many others have failed to do so, and there is no ready explanation for the divergence of results. The data from dietary studies, both at the group level and at the individual level, indicate that, if anything, higher intakes of cholesterol appear to be related to cancer rather than lower levels. A potential role for vitamin A and for some genetic predisposition to cancer perhaps associated with lower cholesterol absorption and decreased degradation of cholesterol in the gut may possibly explain some of these inconsistencies. It is concluded that: (a) the available data do not substantiate any direct cause and effect relationship between low blood cholesterol levels and cancer. Rather, the data suggest that low cholesterol levels may serve as a "marker," possibly genetic, and in only small numbers of male individuals in any given population; (b) the data do not preclude, countermand, or contradict the current public health message which recommends that those with elevated cholesterol levels seek to lower them through diets lower in saturated fat and cholesterol.

Cholesterol↗
PubMed1982

Current strategies for explaining the decline in ischemic heart disease mortality.

Mortality from ischemic heart disease has declined sharply since the mid 1960's in the United States and several other industrialized nations. The causes of this decline have thus far not been established. Six major strategies for investigating determinants of ischemic heart disease mortality trends are discussed in this review: (1) analyses of mortality data; (2) morbidity surveillance; (3) surveillance of change in medical care; (4) surveillance of cardiovascular risk factors; (5) social and ecological surveillance; (6) experimental and quasi-experimental community approaches. The rationale, problems and limitations of each are discussed.

Adult↗