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Biomedical subjects

R Beaglehole

Publications and source records attributed to R Beaglehole.

At least 55 records · Page 3Linked to original sources
PubMed1994

The worldwide problem of stroke.

Cardiovascular disease is the leading cause of death worldwide with almost one third of all cardiovascular deaths ascribed to stroke. In contrast to coronary heart disease, most of the strokes occur in developing countries; China alone has about 1 million deaths from stroke each year. From a global perspective the stroke situation is changing rapidly, and considerable progress has been made in documenting the changes in stroke mortality. Despite the favorable trends in stroke mortality in many countries, stroke will become an increasingly important health problem as the world's population continues to age.

Aged↗
PubMed1994

The effect of exercise episode duration on blood pressure.

OBJECTIVE: To investigate the effect on blood pressure for 10-min compared with 40-min episodes of physical activity for 4 days. DESIGN AND METHODS: The design used a randomized crossover trial of two exercise episode durations, involving 17 subjects, which were performed in a university setting. The intervention was exercise on a stationary bicycle for four consecutive days, at 50% of maximal oxygen uptake (determined by heart rate), for episode durations of 10 or 40 min. A rest period of 10 days followed before exercise for the alternative duration was performed. The main outcome measure was blinded assessment of blood pressure 24 h after the last exercise episode. RESULTS: Significant reductions were found in systolic and diastolic blood pressure after 4 days of 40 min but not after 4 days of 10 min stationary cycling. The reduction in blood pressure was significant for both systolic and diastolic blood pressure for 4 days of 40 min of exercise episodes. CONCLUSION: Exercise of moderate intensity on a stationary bicycle for 10 min for 4 days is not effective in lowering blood pressure in comparison with the same exercise for 40 min for 4 days. The experimental design employed in the present study has potential for monitoring the effects of exercise on blood pressure.

Blood Pressure↗
PubMed1993

Changes in stroke incidence and case-fatality in Auckland, New Zealand, 1981-91.

The explanation for the substantial decline in stroke death rates can be investigated only by measuring trends in stroke incidence and case-fatality. Two community-based studies carried out in Auckland, New Zealand, in 1981 and 1991 used comparable methods and definitions, met criteria for well-designed studies, and had the power to detect small changes in incidence and case-fatality rates. 703 events (representing 50% of all strokes) were registered in 1981 and 1735 events in 1991. 521 (74.1%) and 1255 (72.3%) events in 1981 and 1991, respectively, were first-ever (in a lifetime) strokes. Although there was no change in overall stroke incidence between 1981 and 1991, there were changes in age and sex groups. The incidence rate among women younger than 75 years rose by a fifth (rate ratio 1.23 [95% CI 1.04-1.47]), whereas that in men of 75 years and older fell by a third (rate ratio 0.67 [0.54-0.82]). The 28-day case-fatality declined from 27.1 (21.7-32.6)% to 21.9 (18.1-25.7)% in men and from 37.6 (31.8-43.5)% to 25.8 (22.3-29.4)% in women from 1981 to 1991, but the decline was not statistically significant in any age or sex group. These findings suggest that we need to reappraise strategies for the prevention of stroke and assess the implications of improved survival in elderly stroke patients.

Adolescent↗
PubMed1993

Trends in medical management of acute myocardial infarction, Auckland 1983-90.

AIMS: To examine changes in the medical management of acute myocardial infarction in the Auckland region between 1983 and 1990. METHODS: 6190 patients aged 25-64 years with myocardial infarction were identified utilising a population based register, the ARCOS study. Data were collected on resuscitation attempts, transportation to hospital, coronary care unit (CCU) stay and medication use before and during the CCU stay. RESULTS: The median time delay between onset of symptoms and arrival at the CCU decreased by approximately 7 minutes per year. The average length of CCU stay decreased from 2.9 to 2.7 days and there were between hospital variations in length of CCU stay. The most striking change in drug therapy before the event was the increase in the use of antiplatelet agents from 5% in 1983 to 18.3% in 1990. There was also a big increase in the proportion of patients using antiplatelets (3.5 fold) and thrombolytic drugs (5.5 fold) during the CCU stay, in 1990, 50% of patients received thrombolytic agents and 56% received antiplatelet agents. CONCLUSION: The use of drugs of proven benefit could be further increased although it appears that major improvements in mortality rates will come primarily from primary prevention.

Adult↗
PubMed1992

Does recent alcohol consumption reduce the risk of acute myocardial infarction and coronary death in regular drinkers?

This study, conducted in Auckland, New Zealand, over 2 years from March 1986, used a case-control design to investigate the hypothesis that alcohol acutely increases the risk of both nonfatal myocardial infarction and coronary death in the 24 hours after drinking, among regular drinkers. The nonfatal myocardial infarction analyses included 278 male and 60 female cases identified from a population-based coronary heart disease surveillance program and 458 male and 266 female controls randomly selected from the same population matched by age and sex. In the coronary death analyses, 172 male and 16 female coronary death cases from the same surveillance program and a population-based sample of 294 males and 165 females who were age and sex matched were examined. Information on alcohol consumption in the 24 hours before the coronary event in cases and a comparable 24-hour period in controls was collected. Study subjects all drank alcohol regularly at least once per month and were aged 25-64 years. Controls were more likely than cases to report a drinking episode in the 24-hour period examined in both sexes and for fatal and nonfatal disease. After controlling for possible confounding, the authors found that drinkers had a consistently lower estimated risk of both fatal and nonfatal coronary heart disease than participants reporting no alcohol in the previous 24 hours. The odds ratios ranged from 0.75 (95% confidence interval 0.62-0.90) for nonfatal myocardial infarction in men to 0.46 (95% confidence interval 0.19-1.10) for coronary death in women. There were no clear differences in estimated acute risk among those who drank one or two drinks, three or four drinks, or more than four drinks in the 24-hour period. These findings suggest that, contrary to previous speculation, alcohol consumption may acutely reduce coronary heart disease risk.

Adult↗
PubMed1992

Does physical activity lower blood pressure: a critical review of the clinical trials.

This review critically appraises 22 recent articles of trials of physical activity, as a means of reducing blood pressure. The quality of the literature remains poor and of the 13 controlled trials of habitual activity only one did not have a major design fault. Overall, blood pressure was reduced by physical activity in both hypertensive and normotensive persons. This effect was independent of weight loss and in some studies blood pressure reduction occurred in the presence of weight gain. The average reduction in the better designed studies was approximately 6-7 mmHg for both systolic and diastolic blood pressure which compares favourably with studies of pharmacological treatment. The better designed studies reported smaller reductions than studies with poorer design. All activities, including circuit weight training, lowered blood pressure and daily activity produced greater blood pressure reduction than when performed three times per week. It is concluded that physical activity has an independent capacity to lower blood pressure.

Adolescent↗
PubMed1992

Alcohol, cardiovascular diseases and all causes of death: a review of the epidemiological evidence.

This paper reviews the epidemiological evidence on the association of alcohol consumption with the major cardiovascular diseases (hypertension, stroke and coronary heart disease), and all causes of death. The focus is on light and moderate consumption and several important methodological issues are apparent with the epidemiological evidence on alcohol and mortality. The epidemiological data justify the following recommendations on alcohol consumption. The evidence does not support the unqualified claim that light and moderate drinking confers overall health benefits. However, in persons over 35 years of age, there is no consistent evidence that daily consumption of up to 2-3 drinks in men or up to 1-2 drinks in women increases the risk of dying. Non-drinkers should not be encouraged to change their drinking status. The consumption of more than 2-3 drinks per day in men and more than 1-2 drinks per day in women should be actively discouraged. Further research on the effects of light and moderate alcohol consumption on cardiovascular disease and all causes of death are required, particularly in young people, women and the elderly.

Journal Article↗
PubMed1992

The development and evaluation of Basic Epidemiology: Student's Text.

This paper describes the development and evaluation of a World Health Organization book Basic Epidemiology: Student's Text. This book was a response to a need identified by members of the WHO Global Environmental Epidemiology network. A draft was commented on by members of the Network and then at an editorial meeting. Two thousand copies of a pre-publication version were prepared and this version was formally evaluated by 13 teachers of introductory courses of epidemiology and less formally by members of the Epidemiology Network. A high response was received to the evaluation questionnaires; 45% of the students rated the test overall as 'very useful' and another 54% as 'useful'; many useful comments were received and were incorporated into the final version which will be published by WHO in 1993.

Attitude of Health Personnel↗