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Biomedical subjects

M Feinleib

Publications and source records attributed to M Feinleib.

At least 145 records · Page 8Linked to original sources
PubMed1976

Community surveillance for coronary heart disease: the Framingham Cardiovascular Disease survey. Comparisons with the Framingham Heart Study and previous short-term studies.

It appears likely that intervention trials on a community scale against one or more coronary heart disease risk factors will begin in the near future. Prerequisite to the evaluation of the effectiveness of these trials is the accurate determination of coronary heart disease incidence rates. The Framingham Cardiovascular Disease Survey was undertaken to test the hypothesis that a short-term surveillance study of a defined population can generate accurate incidence rates for at least some categories of cardiovascular disease and that these rates are comparable with those obtained by longitudinal survey of the same population. In conjunction with the 1970 U.S. census, a 1 year survey was made of all new coronary heart disease events occurring in the town of Framingham, Mass. Surveillance was performed by several methods that were intentionally overlapping. During the study period, 244 coronary heart disease events occurred. Despite the relatively small size of the population, many of the well established epidemiologic characteristics of this disease were evident. The rates obtained by the cardiovascular disease survey were comparable with those obtained by the Framingham Heart Study, for the harder end points of myocardial infarction and death from coronary heart disease, but much smaller for the softer end point of angina pectoris, especially in women. These data and those from similar studies indicate that periodic short-term surveillance studies of target populations of major intervention programs can provide an economic method of generating incidence data for the evaluation of the impact of such programs on myocardial infarction and death from coronary heart disease.

Age Factors↗
PubMed1976

Genetic variance in blood pressure.

The National Heart and Lung Institute Twin Study has examined 514 white adult male twin sets aged 42-56 with respect to blood pressure. The data were analyzed by a method of Christian et al. which eliminates possible biases in estimated genetic variances that could result from different total variances in MZ and DZ twins. Results of the test for the presence of genetic variance indicate that both systolic and diastolic blood pressure are to a considerable extent genetically controlled with an estimated heritability of 0.8 for systolic and 0.6 for diastolic pressure. Although these findings are at variance with some previous reports, it is thought that much of the discrepancy results from application of different analytic techniques, not in the data themselves. The application of these findings to our understanding of hypertension epidemiology and community hypertension control programs are discussed.

Adult↗
PubMed1976

Genetics of plasma cholesterol and triglycerides: a study of adult male twins.

Fasting plasma triglycerides and cholesterol, as well as cholesterol in very low density, low density and high density lipoproteins, were measured in 250 MZ and 264 DZ adult male twin pairs. A new method was used to choose an estimate of genetic variance. This includes an estimate of genetic variance for use when the total variances of MZ and DZ twins are unequal. DZ twins had greater total variance for cholesterol. When genetic variance was estimated by subtracting the within-MZ-sets mean square from the within-DZ-sets mean square, all of the lipids had significant estimates of genetic variance; however, when genetic variance was estimated by a method designed to correct bias due to unequal total variances of MZ and DZ twins, only triglycerides had significant genetic variance. The heritability of plasma triglycerides was calculated to be 0.68.

Adult↗
PubMed1976

Heritability study on size of the physiologic cup of the optic nerve head: a summary report.

Cupping of the optic nerve head is regarded as one of a triad of diagnostic signs associated with glaucoma. This study was undertaken to assess the role of genetic factors in determining size of the physiologic cup of the normal optic nerve head, as measured by a horizontal cup/disc ratio. This is important to our ultimate understanding of the determinants of pathologic change. Horizontal cup/disc ratio was estimated in a sample of 37 MZ and 26 like-sex DZ twin pairs aged 15 years and older. Differences between MZ and DZ samples with respect to intrapair variance and intraclass correlation coefficient were highly significant. This finding of high heritability for measurements of cup diameter is in contrast to low heritability estimates found in a companion investigation on heritability of the effect of corticosteroids on intraocular pressure.

Adolescent↗
PubMed1976

Heritability of personality and behavior pattern.

As part of the National Heart and Lung Institute multicenter study of twins, 190 twin pairs (93 MZ, 97 DZ) residing in California and aged 44-55 years were comprehensively studied for all risk factors for coronary heart disease and for Behavior Pattern Type A or B. Psychological tests included MMPI, CPI, 16 Cattell PF, Gough Adjective Check List (ACL), Thurstone Temperament Schedule (TTS). Heritability at statistically significant levels was found only for scales of TTS. Twelve scales of ACL and five scales of TTS showed significant correlations with Behavior Pattern Type A-B as well as with several risk factors, including blood pressure and serum lipids. Multiple regression equations were constructed for those characteristics accounting for significant and unique portions of the total variance of Type A-B Behavior. The use of certain scales of ACL and TTS may provide a new questionnaire for screening purposes in the assessment of Behavior Pattern Type A-B.

Behavior↗
PubMed1976

Daily variation in USA mortality.

Daily variation in each of several major causes of death in the United States during the period 1962-1966 is described by annual graphs showing deaths chronologically and by frequency distribution of deaths per day. The most significant sporadic factors affecting mortality in the 5 years studied appeared to be the influenza epidemic in 1963 and the unusually hot weather occurring in mid-1966. Deaths were also studied by day of the week and by holiday. Significant and consistent variations were found for violent deaths and those due to coronary heart disease.

Coronary Disease↗
PubMed1976

Delay in the prehospital phase of acute myocardial infarction. Lack of influence on incidence of sudden death.

Prehospital delay is considered to be an important cause of out-of-hospital coronary mortality. Behavior of patients and physicians in response to the symptoms of myocardial infarction (MI) or impending out-of-hospital death (OHD) was studied for 107 consecutive acute coronary events in Framingham, Mass. Delay due to inappropriate patient behavior was the most important component of total delay. Delay related to patient-physician contact occurred in two thirds of MI cases and was more than 30 minutes in half of these. Office visits and inappropriate triage by nurses and receptionists were important factors in physician delay. However, 60% to 75% of OHDs occur so rapidly that their prevention by reduction of prehospital delay seems impossible. A strategy for reduction of delay that might be of benefit in preventing some of the remaining OHDs is described.

Acute Disease↗
PubMed1975

Size of the physiologic cup of the optic nerve head. hereditary and environmental factors.

This study provides a quantitative assessment of heritability of size of the normal physiologic cup when estimated as a continuous variable. A horizontal cup-disc ratio was estimated clinically among a sample of 37 pairs of monozygotic (MZ) and 26 pairs of like-sexed dizygotic (DZ) twins. Differences in intrapair variance and intraclass correlation coefficient between the MZ and the DZ samples were large and highly significant, and suggest that inheritance plays a major role in determining diameter of the normal physiologic cup. Values of heritability index (Hl, an estimate of the proportion of variance within pairs explained by genetic factors) ranged from 0.60 to 0.80 by various computational methods employed.

Adolescent↗
PubMed1975

Solar activity and mortality in the United States.

Mortality from all causes, from coronary heart disease, and from stroke in the US was studied in relation to solar activity as measured by the geomagnetic index, Ap, on a daily basis for the years 1964-66 and on a monthly basis for the years 1964-71. The data did not support previous assertions by Soviet researchers of an association between solar activity and cardiovascular mortality.

Astronomical Phenomena↗
PubMed1975

Concordance for coronary risk factors among spouses.

Values for several coronary risk factors, including systolic and diastolic blood pressure, serum cholesterol, triglycerides, blood glucose, uric acid, hemoglobin, weight, vitral capacity and cigarette smoking have been found to be similar among spouses in the Framingham Study. However, longitudinal analyses show that this spouse concordance does not increase over a twelve-year observation period, suggesting that it has arisen through the marriage of similar people rather than through the sharing of a common marital environment. Apparent conflicts between cross-sectional and longitudinal findings have been resolved by showing that spouses who were concordant at the begining of the study are more likely to survive to later exams, while discordant spouse pairs tend to be dissolved through the death of one of their members.

Adult↗
PubMed1975

Prodromata of myocardial infarction and sudden death.

A sample of 160 hospitalized, acute myocardial infarction patients and 138 individuals who died prior to hospitalization from acute coronary heart disease were studied to determine the incidence and duration of prodromal symptoms and action taken to cope with the symptoms. Seventy percent of the in-hospital subsample (IHS) and 64% of the out-hospital subsample (OHS) reported prodromata. The OHS reported a significantly longer median duration of symptoms than the IHS (29 versus 10.5 days). Sixty-seven percent of the IHS reported new or accelerated anginal symptoms as the most frequently occurring symptom, in contrast to 35% for the OHS. Twenty-seven percent of the IHS and 36% of the OHS consulted a physician about symptoms. Individuals in both subgroups, especially chronically diseased patients, considered their symptoms manageable. Likewise, when contacted, their physicians may have viewed these symptoms as manageable. Patients with a high risk of myocardial infarction and sudden death were significantly more likely to have consulted physicians during the prodromal phase than low-risk patients. A clearly delineated prodromal syndrome is needed so that both lay and medical communities can effectively respond to and intervene during the prodromal phase of acute myocardial infarction and sudden cardiac death.

Acute Disease↗