Orally administered enalapril for infants with congestive heart failure: a dose-finding study.
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Biological Availability↗
Biomedical subjects
R M Lauer
Publications and source records attributed to R M Lauer.
The relation between ponderosity and coronary risk factors in children and their relatives. The Muscatine Ponderosity Family Study.
A family study was conducted in Muscatine, Iowa in 1984-1985 to evaluate the relation between ponderosity in children and coronary risk factor levels in these children and in their family members, and the genetic contribution to familial clustering of levels of ponderosity (body weight relative to height). Four groups of probands were selected from the 1,783 students who participated in three consecutive biennial school surveys. A random group (n = 70), a random sample of students from the entire pool; a lean group (n = 72), students in the lowest quintile of relative weight on all three surveys; a gain group (n = 70), students who gained at least two quintiles of relative weight over the four-year period; and a heavy group (n = 72), students in the highest quintile of relative weight on all three surveys. The parents, siblings, a related aunt or uncle, and a first cousin of these probands were also examined. The data show that levels of high density lipoprotein (HDL) cholesterol, apolipoproteins A-1 and B, and systolic blood pressure in heavy group probands are consistent with increased coronary risk. This same association exists among the relatives with excess ponderosity. Levels of body mass index in the mothers, fathers, and siblings cluster with the levels in the probands, and genetic differences among persons explain 36-52 per cent of the variability in body mass index across the range of ponderosity represented by the probands and their relatives. While the contribution from genes is strong, these data suggest that the contribution from environmental factors is equally as important.
Adolescent↗
Predicting adult cholesterol levels from measurements in childhood and adolescence: the Muscatine Study.
2,446 subjects initially examined at ages eight to 18 years were reexamined as young adults at ages 20-25 years or 26-30 years. Measurements of cholesterol, height, weight, and triceps skinfold thickness were obtained during childhood. Lipids, lipoprotein fractions, family history as well as medication, alcohol, and tobacco use were determined during the adult examination. Elevated levels of cholesterol during childhood were associated with elevation in adult life. On average, of children found to have cholesterol levels greater than or equal to the 90th percentile for their age and gender, on a single measurement 43% remained above the 90th percentile, 62% remained above the 75th percentile, and 81% remained above the 50th percentile. Obesity acquired in adolescence and the young adult years, oral contraceptive use, and cigarette smoking had deleterious effects upon adult cholesterol levels and lipoprotein fractions.
Adolescent↗
Childhood risk factors for high adult blood pressure: the Muscatine Study.
In adult populations, elevated blood pressure is related to the development of occlusive atherosclerosis, stroke, and renal disease. The significance of blood pressure levels in childhood, unless extremely elevated, has not been related to disease outcomes. In this study, the risk of high blood pressure in young adult life is evaluated based on the observations of blood pressure and other factors made during the school-aged years. Subjects, 2445 in number, were first observed at ages 7 through 18 years and again between 20 and 30 years. During childhood, measurements of blood pressure, height, and weight were made in alternate years. At adult ages, the same measurements were again made and a health questionnaire was administered. According to the data, adult blood pressure is correlated with childhood blood pressure, body size, and change in ponderosity from childhood to adult life. Adult ponderosity is related to childhood ponderosity, and those who are most obese as adults show the greatest increase in weight for height from their childhood years. These observations suggest that strategies to prevent the acquisition of excess ponderosity during adolescence may be useful in preventing adult hypertension.
Adolescent↗
Consistency of blood pressure levels in children.
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Adolescent↗
Prevalence and predictors of smokeless tobacco use: Iowa's program against smoking.
Data from surveys of adolescents were analyzed so that we could determine the prevalence of smokeless tobacco use and identify and compare the concurrent correlates of its use and cigarette smoking. Panel data from seventh through eleventh and eighth through twelfth graders between 1980 and 1984 and cross-sectional data from seventh graders in 1980 and 1985 suggest that boys are more likely to use SLT than are girls and that the boys' use has increased with age and over time. Concurrent correlates of seventh-grade boys' and girls' SLT use and cigarette smoking were identified with discriminant analyses. Predictors of smokeless tobacco use were compared with those of weekly smoking for boys and girls separately. Predictors of use by boys were also compared with those by girls. Trying alcohol and the other form of tobacco were the only predictors that related to the use of either form by boys and girls. Differences among other predictors were noted and their implications for prevention are discussed.
Adolescent↗
Left ventricular mass and exercise responses predict future blood pressure. The Muscatine Study.
Increased blood pressure and left ventricular mass are associated with increased morbidity and mortality in adults with coronary heart disease. To define the predictors of subsequent childhood blood pressure and left ventricular mass, serial echocardiograms and blood pressure responses during exercise were studied in 274 children aged 6 to 15 years, whose systolic blood pressures were in the high, middle, or low range. Persistence of rank order for left ventricular mass and blood pressure, at rest and during exercise, was maintained over a mean follow-up period of 3.4 years, with correlations ranging from 0.33 to 0.44. Subsequent systolic blood pressure was best predicted from initial resting and maximal exercise systolic blood pressures and left ventricular mass. Subsequent left ventricular mass was best predicted from initial left ventricular mass and maximal exercise diastolic blood pressure, but resting systolic blood pressure did not add to this latter prediction. Since left ventricular mass relates best to exercise blood pressure and not to resting blood pressure, left ventricular mass may provide an integrated view of the effects of blood pressure both at rest and during stress. We speculate that increased left ventricular mass in childhood may be an important predictor of subsequent hypertension and its consequences.
Adolescent↗
Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study.
A group of 2,446 subjects initially examined at 8 to 18 years of age were reexamined as young adults of 20 to 25 or 26 to 30 years of age. Measurements of cholesterol, height, weight, and triceps skinfold thickness were obtained during childhood. Lipids, lipoprotein fractions, and family history, as well as medication, alcohol, and tobacco use, were determined during the adult examination. Elevated levels of cholesterol during childhood were associated with elevation in adult life. Obesity acquired in adolescence and the young adult years, oral contraceptive use, and cigarette smoking had deleterious effects on adult cholesterol levels and lipoprotein fractions.
Adolescent↗
Adolescent cigarette use: the relationship between attitudes and behavior.
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Adolescent↗
Balloon dilation valvuloplasty of bioprosthetic valves in extracardiac conduits.
Six patients, aged 8 to 20 years, with valved right ventricle to pulmonary artery conduits were catheterized for balloon dilation valvuloplasty of stenotic and calcified bioprosthetic valves. Conduit stenosis was severe in all cases, with peak-to-peak systolic pressure gradients of 62 to 100 mm Hg (mean 79 mm Hg) and right ventricular systolic pressures of 87 to 115 mm Hg (mean 100 mm Hg). Three patients had good results, with residual peak-to-peak systolic pressure gradients of 20, 25, and 35 mm Hg. In two other patients, repeated balloon rupture before full inflation occurred, and residual gradients were high (55 and 60 mm Hg). One patient had substantial proximal and distal conduit obstruction in addition to valvular stenosis, and balloon dilation valvuloplasty was not attempted. No complications occurred in five patients; one patient required iliac vein exploration to remove an avulsed balloon fragment. Balloon dilation valvuloplasty can relieve bioprosthetic valve stenosis and postpone conduit replacement in some patients.
Adolescent↗
Mothers remember birthweights of adolescent children: the Muscatine Ponderosity Family Study.
The mothers of 127 adolescents living in Muscatine, Iowa were asked at the time of a clinic examination to recall their child's birthweight in pounds and ounces. For comparison, the hospital-recorded birthweight was obtained for each child. On the average, mothers underreported their child's birthweight by 1.3 oz. Sixty of 127 (47%) mother-reported birthweights were the same as those from hospital delivery records; 12% of the mothers overreported the birthweight by at least 5 oz and 17% underreported by at least that amount. The age of the mother and number of biological children were related to the ability to recall the birthweight exactly. The mean age of the children, and thus the average length of the mother's recall, was 16.1 years. Neither the length of recall, nor the mother's education, her current body size, or the current body size of the child were related to recall ability. However, mothers who overreported their child's birthweight were significantly shorter and lighter and their children tended to be taller and heavier, when compared to the mothers who underreported and their children. When the degree of agreement found in our study between reported and recorded birthweight exists, the effect of using reported rather than recorded birthweights in an epidemiological investigation is sufficiently small to allow inferences to be made regarding the relationship between birthweight and body size at mid-adolescence.
Adolescent↗
Enhanced forearm blood flow during mental stress in children of hypertensive parents.
This study compared changes in forearm blood flow, forearm vascular resistance, blood pressure, and heart rate elicited by mental stress (mental arithmetic) in 12 adolescents with a hypertensive parent and 13 age-matched adolescents with normotensive parents. The two groups did not differ in resting forearm blood flow, forearm vascular resistance, heart rate, or blood pressure. During mental stress, children with a family history of hypertension had a significantly greater increase in forearm blood flow than did children of normotensive parents (+37.5 +/- 8.0 vs +12.8 +/- 7.5%; p less than 0.05) and a trend toward reduced forearm vascular resistance (p = 0.08). Mental stress significantly increased systolic blood pressure (p less than 0.0001), diastolic blood pressure (p less than 0.001), and heart rate (p less than 0.03) in both groups. The blood pressure and heart rate responses to stress were not significantly different between groups. There was no evidence of a prolonged response or a different pattern of recovery in children with a family history of hypertension. This study indicates that regional blood flow responses underlying similar blood pressure increases during mental stress may be different in adolescents with and without a family history of hypertension.
Adolescent↗
The short-term effects of competition and rewards in an adolescent smoking prevention program.
This study evaluated whether interventions involving competition and rewards would enhance a school-based educational curriculum on tobacco use. Written pre- and post-tests were used to assess the relevant knowledge of 1068 seventh grade students in three comparable communities. The students' smoking beliefs, intentions, and behavior were assessed by questionnaires before and after the educational unit. Students in two communities participated in interventions designed to enhance knowledge acquisition, social activism, and non-use of tobacco; students in one community served as controls. Students in competitive and control communities did not differ prior to intervention. The interventions influenced respondents' concern about their health and the health of their family and friends and increased the likelihood that they would associate smoking with maturity and short-term bad effects, regardless of their pre-intervention smoking behavior. Experimenters' and regular smokers' knowledge about smoking and its consequences, and concern about the amount of substance use in their town were increased by the competitions. The competitions were also more likely to reduce their intentions to smoke. The interventions did not affect smoking behavior. Fortunately, competition losers and winners were not differentially affected by the interventions.
Adolescent↗
Atrial septal defects that present in infancy.
The diagnosis of isolated secundum atrial septal defect (ASD) in infancy is uncommon. We studied 26 infants with ASD confirmed at cardiac catheterization. Of these, nine were born prematurely, 15 presented with symptoms of congestive heart failure, and only three were noted to have the clinical features of an ASD in spite of large left to right shunts. All but two patients responded to medical management. Spontaneous closure of the ASD was documented in 39% (ten) of the patients at ages ranging from 2 to 8 years. Twelve patients underwent surgical closure at a mean age of 4 years. No variables at presentation were predictive of subsequent spontaneous closure. In view of the high rate of spontaneous closure and the success of medical therapy, most infants with symptomatic ASD may be managed medically, allowing sufficient time to observe whether spontaneous closure will occur.
Blood Pressure↗
Familial aggregation of type A behavior.
This research examined the relationship of children's Type A behavior pattern, as measured by the Matthews Youth Test for Health, to parents' Type A behavior pattern, as measured by the Jenkins Activity Survey, Form C. A total of 115 families with boys and 106 families with girls enrolled in the fourth through sixth grades participated. There were no significant correlations between the Pattern A scores of fathers and those of their children, but there was evidence for a maternal influence on the development of children's Type A behavior. The results are compared with results from studies of familial aggregation previously reported in the literature.
Aggression↗
Aggregation of blood pressure in the families of children with labile high systolic blood pressure. The Muscatine Study.
The aggregation of systolic blood pressure, diastolic blood pressure, and heart rate is compared among the relatives of three groups of index children: children with low systolic blood pressure (less than the 5th percentile), middle range systolic blood pressure (between the 5th and 95th percentiles), or labile high blood pressure (above the 95th percentile when first sampled but below the 95th percentile when resampled four to six months later). Both systolic and diastolic blood pressures aggregate more strongly in the families of children with labile high systolic blood pressure than in the families of children with middle or low range systolic blood pressure. The degree of aggregation of heart rate does not differ among the three groups. Since blood pressures aggregate so strongly in families of children with labile high systolic blood pressure, study of these children and their families may yield important information about the etiology of hypertension.
Adolescent↗
Changes in ponderosity and blood pressure in childhood: the Muscatine Study.
This paper describes the association between longitudinal changes in blood pressure and changes in measures of ponderosity. Between 1971 and 1981, 2,925 Muscatine, Iowa schoolchildren were measured at least once between ages 6 and 15 years and again between ages 15 and 18. The study shows that change in ponderosity is associated with change in blood pressures; children whose ponderosity decreases relative to their peers usually exhibit a similar drop in their systolic and diastolic blood pressures, while children who gain in ponderosity show a similar gain in their blood pressures. The magnitude of change in blood pressure is related to amount of ponderosity gain or loss and does not depend on initial blood pressure. These data suggest that for obese children weight loss might be an effective method for reducing their blood pressure.
Adolescent↗
Social disaffection, friendship patterns and adolescent cigarette use: the Muscatine Study.
This study was undertaken to determine if adolescent social disaffection with school and family not only would be a significant predictor of cigarette use but would explain a significant amount of the association with friends who smoke. Eleven hundred and eighty ninth-12th grade students in Muscatine, Iowa, were surveyed in Spring 1984. Multiple regression analyses indicated several social disaffection variables were significant predictors of association with friends who smoke, explaining 20% of the variance. The combination of association with friends who smoke and social disaffection variables explained 48% of the variance in adolescent cigarette smoking. Variables related to adolescents' participation in school and related activities suggest prevention programs should recognize the impact of social disaffection on adolescents cigarette use.
Adolescent↗