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Biomedical subjects

M Feinleib

Publications and source records attributed to M Feinleib.

At least 91 records · Page 5Linked to original sources

Predicting coronary heart disease in siblings--a multivariate assessment: the Framingham Heart Study.

The incidence of clinically recognized coronary heart disease and its relation to risk factors have been studied for 596 sibships in the Framingham Heart Study cohort. Only the 186 pairs of brothers were considered in the multivariate analysis, since the rate of coronary heart disease in women is low. Multiple logistic regression was performed by using endpoints of coronary heart disease as the dependent variable for the younger brother of the pair. Age, Metropolitan relative weight, systolic blood pressure, total cholesterol, cigarette smoking and endpoints of coronary heart disease for the older brother represent the independent variables. The incidence of myocardial infarction in the older brother is significantly related to myocardial infarction experience of the younger brother, even after the strong effects of total cholesterol, systolic blood pressure and cigarette smoking were controlled. These findings suggest that family history of myocardial infarction may be an important independent predictor of myocardial infarction, and suggest that familial aggregation for coronary heart disease may result from predisposition to disease, possibly genetic, that is not reflected in the measured levels of total cholesterol, systolic blood pressure or cigarette smoking.

Analysis of Variance↗

Acculturation and coronary heart disease among Japanese men in Hawaii.

A cohort of 4653 men of Japanese ancestry living in Hawaii, with traditional Japanese social and cultural lifestyles, were studied for the association of the prevalence and incidence of coronary heart disease (Honolulu Heart Program, 1971-1979). Two of four scales of acculturation were significantly associated with coronary heart disease prevalence independently of 11 other risk factors, but none of the acculturation scales were associated with incidence appeared to be mostly due to the inclusion of fatal cases in the incidence data, although other explanations are possible. Measures of acculturation were also significantly associated wih many of the other coronary heart disease risk factors in such a way that the more traditional Japanese men had lower serum cholesterol and uric acid, were less obese, more physically active, and smoked fewer cigarettes than the more westernized men. A comparison of bivariate and multivariate analyses indicated that some of acculturation scales were indirectly associated with coronary heart disease because of the confounding association with the other risk factors.

Acculturation↗

Genetic and environmental influences on pulmonary function in adult twins.

As part of the NHLBI Twin Study, pulmonary function tests were successfully administered to 127 monozygotic and 141 dizygotic white male twin pairs 42 to 56 yr of age. Values for forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were obtained using a standardized protocol for spirometry. Initial twin analyses showed significant genetic variance (p less than 0.001) for both FVC and FEV1, whether or not adjustments were made for individual differences in age and body size. After adjustment, heritability estimates were 0.91 and 0.77 for FVC and FEV1, respectively. Further analyses indicated that the observed heritability of FVC resulted from the effects of pack-years of smoking as well as from genetic factors related to body size. These findings suggest that there were no other significant genetic determinants of FVC. In contrast, heritability of FEV1 could not be explained by constitutional factors, such as height and weight, or by cigarette smoking or propensity for cardiopulmonary disease symptoms. Additional analyses were done based on frequency of twin contact, which served as an indirect measure of environmental similarity between cotwins. Results suggested that there was a shared environmental variation in FEV1, as well as genetic variation, that could not be attributed to subpopulation differences in measured characteristics. The findings of this study are consistent with theories of genetic influences on alveolar and airway development and argue in favor of early as well as adult environmental influences on pulmonary function.

Adult↗

Sex differences in declining cohort death rates from heart disease.

We examined cohort mortality from heart disease (HD) at ages 40 and over for White men and women in the United States between 1945 and 1975. For each successive birth cohort from 1886 to 1890 and 1906 to 1910, female HD mortality rates exhibit a continuous decline with parallel slopes which shows no sign of abating in recent years. Among men, cohort HD mortality rates were increasing prior to 1965; since 1965, there has been a reversal of prior trends, i.e., each successive cohort has shown a decrease in HD mortality rates. None of the various hypotheses put forward to explain the recent decline in HD mortality provides a cogent explantation for the differential effects in men and women.

Adult↗

The serum cholesterol-cancer relationship: an analysis of time trends in the Framingham Study.

Time trends in serum cholesterol were analyzed in the Framingham Study data to determine whether low serum cholesterol, which appears to be associated with increased cancer risk, can truly be called a precursor to the development of the disease. Serum cholesterol measured at base line was found to be associated with the risk of both fatal cancer and all cancers occurring in the subsequent 18 years in men (P less than 0.05). This inverse association seems particularly strong for colon cancer in men. Analysis of time trends in the Framingham data did not yield consistent results for all ages. Men 50--59 years old had a statistically significant lower serum cholesterol measured 16--18 years before cancer diagnosis. For men 60--65 years old, a statistically significant trend toward lower serum cholesterol was apparent as measurement was made closer to the time fo cancer diagnosis. Although the Framingham data are not conclusive, they do suggest that in some cancer cases where the serum cholesterol level was lower than that expected at as much as 16--18 years before cancer diagnosis, the depressed level was likely to be a precursor to the tumor growth. However, consistent with the metabolic consequences of tumor growth, the data show that in some cancer cases, serum cholesterol had decreased at measurements made close to the time of cancer diagnosis.

Adult↗

The British-Norwegian migrant study--analysis of parameters of mortality differentials associated with angina.

The prevalence of selected cardiorespiratory symptoms was ascertained by a common mail questionnaire for 73,884 men and women in the United States, Great Britain and Norway. The study groups were identified in the early 1960's and included 30,033 British and Norwegian migrants to the United States and 43,851 non-migrants who resided in Great Britain and Norway. The main study objectives were to contrast the morbidity and mortality experience of the migrant and non-migrant groups in the light of known national differences in mortality from cardiorespiratory diseases in the early 1960's. At that time, the U.S. had the highest death rates from coronary heart disease while Great Britain had the highest rates for lung cancer and for chronic non-specific lung disease. Norway had the lowest rates for all three rubrics. The prevalence of "angina" and other symptoms was ascertained for each of the study groups. Contrary to expectation, angina was reported much more frequently by persons remaining in Britain and Norway than by migrants to the United States. Mortality rates during the five years and responding to the symptoms questionnaire were determined and mortality patterns were evaluated according to the presence or absence of angina. Angina was found to be a strong predictor of cardiovascular mortality. In the absence of angina, it was observed that migrants had similar mortality rates to non-migrants regardless of country of origin. However, the British had higher mortality rates from cardiovascular and from non-cardiovascular causes than the Norwegians. The primary determinant of angina prevalence was found to be migration status. It is believed that this differential was determined primarily by selection of those who migrate, with the migrants to the U.S. being a healthier group than their counterparts remaining in the native country.

Adult↗

Type A behavior and the ten year incidence of coronary heart disease in the Framingham Heart Study.

This study explored the association between Type A behavior, as measured by a short questionnaire on time urgency and competitiveness, and the development of coronary heart disease (CHD). An assessment of Type A behavior in 750 women and 580 men, aged 45-64 years, participating in the Framingham Heart Study, took place between 1965 and 1969. Type A behavior was associated with a two-fold risk of developing CHD over the ensuing 10 years. Among all women, the relative risk (RR) was 2.0 with confidence limits = 1.2 to 3.3. Among housewives, CHD incidence rates were 2.5 times greater among Type A's compared to Type B's (p = 0.02). Type A working women were more than 1.5 times as likely to develop CHD as Type B's, although this was not significant at the 10 year follow-up. Among men employed in white-collar jobs, the RR was 2.4 with confidence limits = 1.1 to 5.7. Type A behavior was most strongly related to coronary diagnoses in which angina pectoris symptoms were present. Synergism between Type A behavior and other CHD risk factors is demonstrated. The findings suggest that assessment of Type A behavior can improve the prediction of incident coronary cases, independent of the standard coronary risk factors.

Age Factors↗

The filter cigarette and coronary heart disease: the Framingham study.

Long-term follow-up of the Framingham cohort for coronary heart disease (CHD) end-points has made it possible to test the hypothesis that those who smoke filter cigarettes are less likely to get clinical manifestations of CHD than those who smoke non-filter cigarettes. Men were classified at the 7th biennial examination (1963--64) according to whether they smoked filter or non-filter cigarettes. 58% of the cigarette-smoking men under age 55 at this examination smoked filter cigarettes. These men had slightly lower prior smoking exposure than smokers of non-filter cigarettes. Despite what seemed to be a favourable cigarette-smoking history, the filter-cigarette smokers did not have lower CHD incidence rates than non-filter smokers. This finding was unchanged even after multivariate logistic regression analysis to adjust for the slight differences in age, systolic blood pressure, and serum cholesterol between the two groups.

Adult↗

Cancer incidence by levels of cholesterol.

In 5,209 subjects studied for 24 years in Framingham, Mass, 691 cases of cancer were documented, with histological confirmation for 94%. Predetermined personal characteristics were tested for associations with subsequent occurrence of cancer at specific sites using multiple logistic regression. Significant associations of various cancer sites with cigarette smoking, alcohol use, education, height, weight, and parity agreed with other studies. Serum cholesterol level was inversely associated with incidence of colon cancer and with other sites only in men; these inverse associations were statistically significant after adjustment for age, alcohol consumption, cigarette smoking, education, systolic blood pressure, and relative weight. Associations may reflect effects of competing lethal diseases, underlying pathophysiological mechanisms that promote or inhibit development of cancer in men, biologic or social response to early and undiagnosed states of cancer.

Adolescent↗

A study of cardiovascular risk in heterozygotes for homocystinuria.

Early atherosclerotic-like lesions and thromboemobolic problems are prominent in homocystinuric patients. Recent evidence suggested that mild homocyst(e)inemia, such as is present in heterozygotes for homocystinuria due to cystathionine synthase deficiency, may cause a marked excess in early ischemic heart disease. To evaluate the risk due to mild homocyst(e)inemia, the frequencies of heart attacks and strokes in parents and grandparents of homocystinuric children were assessed in the present study. No statistically significant increases in the incidence of heart attacks or strokes were consistently detected. The data available are sufficient to virtually exclude an increase in the cardiovascular risk for homocystinuria heterozygotes of as much as fivefold compared to controls, and to make very improbable a relative risk of as much as threefold. Less than 5% of homocystinuria heterozygotes are likely to have a fatal or nonfatal heart attack by age 50. These results fail to suggest that mild homecyst(e)inemia is an important contributory factor in the overall incidence of cardiovascular disease.

Adult↗