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T A Pearson

Publications and source records attributed to T A Pearson.

At least 109 records · Page 6Linked to original sources
PubMed1994

Characteristics of a hypothetical group of hospital controls for a case-control study.

In case-control studies in which cases are ascertained from hospitals, controls are frequently chosen from among patients with other diseases at the same hospitals. This study was undertaken to examine the extent to which a hospital control group is representative of the population to which inferences are made. A hypothetical hospital control group was assembled consisting of 233 men and women aged 40-74 years who were surgical inpatients at the two hospitals in Otsego County, New York, in 1990. The characteristics of this group were compared with the characteristics of 15,563 men and women aged 40-74 years who participated in a privately conducted health census in the same county in 1989 with the use of health-related data collected in the census. In this rural setting, only small differences were found between the hospital control group and the census population on most of the measures considered, including demographic characteristics, certain health behaviors, and the prevalence of common conditions. However, the female hospital controls were more likely to be overweight than the females enumerated in the census, and the men were more likely to have ever smoked cigarettes. These differences were large enough to lead to different interpretations about the strength of the associations between these variables and case-control status.

Adult↗
PubMed1994

Task Force 4: The relationship between cardiovascular specialists and generalists.

1. An imbalance between generalists and cardiovascular subspecialists exists that will require decades to correct. We question the validity of the 50:50 generalist/specialist ratio in view of current practice patterns for cardiology. 2. There has been a large increase in the number of cardiovascular specialists in the past 30 years that will continue if training programs remain at their current size. 3. Cardiovascular specialists provide a substantial amount of inpatient care, care to older patients and care to those with cardiovascular symptoms, although generalists actually provide the majority of office-based cardiovascular care. 4. A significant portion of cardiovascular specialist care can be classified as comprehensive care to patients with and without cardiovascular disease. 5. Most generalists and cardiovascular specialists do not perceive a need for additional cardiovascular specialists. 6. Many providers perform cardiovascular procedures at levels below the recommended threshold for maintenance of clinical competence. 7. Managed care may result in a reduced demand for cardiovascular specialists. 8. If cardiovascular specialists provide general care, it may not be assumed that previous training prepares them for generalist practice. 9. The appropriate boundaries of cardiovascular care between generalists and cardiovascular specialists are indistinct. They are defined somewhat by the training programs from which the generalists graduate. 10. Many generalists have deficiencies in basic skills in clinical cardiology. 11. Desirable interactions between generalists and cardiovascular specialists involve referral of patients in both directions to the provider who can give care to a given patient, at a given time, with the best outcome and lowest cost.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiology↗
PubMed1994

Coffee intake and coronary heart disease.

We examined the risk of coronary heart disease (CHD) associated with coffee intake in 1040 male medical students followed for 28 to 44 years. During the follow-up, CHD developed in 111 men. The relative risks (95% confidence interval) associated with drinking 5 cups of coffee/d were 2.94 (1.27, 6.81) for baseline, 5.52 (1.31, 23.18) for average, and 1.95 (0.86, 4.40) for most recent intake after adjustment for baseline age, serum cholesterol levels, calendar time, and the time-dependent covariates number of cigarettes, body mass index, and incident hypertension and diabetes. Risks were elevated in both smokers and nonsmokers and were stronger for myocardial infarction. Most of the excess risk was associated with coffee drinking prior to 1975. The diagnosis of hypertension was associated with a subsequent reduction in coffee intake. Negative results in some studies may be due to the assessment of coffee intake later in life or to differences in methods of coffee preparation between study populations or over calendar time.

Adult↗
PubMed1994

Effects of a milk chocolate bar per day substituted for a high-carbohydrate snack in young men on an NCEP/AHA Step 1 Diet.

This study compares the plasma cholesterol response with the isoenergetic substitution of a milk chocolate bar (46 g) given daily for a high-carbohydrate snack in healthy young men on a Step 1 Diet. Normocholesterolemic men (n = 42) were fed a Step 1 Diet for 21 d (run-in diet) followed by a 27-d experimental period during which they consumed the same diet plus either a milk chocolate bar or a high-carbohydrate snack; after this they consumed the run-in diet for 21 d followed by the other snack for 27 d. When subjects consumed a milk chocolate bar instead of the high-carbohydrate snack, high-density-lipoprotein (HDL) cholesterol was 0.08 +/- 0.03 mmol/L higher (P < 0.01) and plasma triglycerides were 0.06 +/- 0.03 mmol/L lower (P < 0.05). Substitution of a milk chocolate bar for a high-carbohydrate snack did not adversely affect the low-density-lipoprotein-(LDL) cholesterol response to a Step 1 Diet despite an increase in total fat and saturated fatty acid content of the diet. This response may be due to stearic acid.

Adult↗
PubMed1994

Self-reported physical activity in a rural county: a New York county health census.

OBJECTIVES: Few studies have described physical activity in rural populations. This study describes the frequency, types, and correlates of physical activity in 29,304 free-living adults in a rural county in New York State. METHODS: Self-reported responses about regular physical activity (maintained long enough to work up a sweat) were analyzed from a private household census of Otsego County with an 86.6% response rate. RESULTS: This survey categorized 46.2% of county residents as sedentary. Walking, the most frequent choice of activity (62% of the women, 36% of the men), increased in frequency with age of respondents whereas cycling, jogging, aerobics, team sports, and swimming (listed in rank order of frequency) generally tended to decrease in frequency with age. Farmers demonstrated an increased amount of "sweat activity" compared with persons in most other occupations. CONCLUSIONS: This descriptive study of physical activity in a rural county shows that sedentary lifestyle is of high prevalence. The high frequency of walking and the gender differences in both the levels and choice of activity suggest that further research and public policy recommendations focus on these issues.

Adolescent↗
PubMed1994

Challenges to implementing the current pediatric cholesterol screening guidelines into practice.

OBJECTIVE: The Expert Panel on Blood Cholesterol Levels in Children and Adolescents of the National Cholesterol Education Program (NCEP) recommends selective screening of children for high blood cholesterol. We determined the number of children, who, according to the guidelines, should be targeted for cholesterol screening. DESIGN: Population survey. SETTING: Permanent household residents in Otsego County, NY. PARTICIPANTS: Total population-based sample of 17,444 households (86.6% response rate) including 44,565 participants, of whom 10,457 were children, aged 2 through 19 years. MAIN OUTCOME MEASURES: Percent of children qualifying for cholesterol screening under the NCEP Children's Panel guidelines. RESULTS: Children from two-parent families were more likely to have known family history of coronary heart disease (CHD) before 60 years of age (41.8% vs 25.8%, P < .001), and twice as likely as children from single-parent families to have known parental hypercholesterolemia (18.8% vs 9.5%, P < .001). Only 39% of parents reported having had their cholesterol level checked; they were better educated and more likely to have health insurance. Parents with a first-degree relative with CHD before 60 years of age were more likely to report having their cholesterol level checked and to report a high cholesterol level. We calculated that 27% of children (18% of children from single-parent households and 29% of children from two-parent households) would report a known family history of premature CHD (ie, CHD before 55 years of age) and qualify for lipoprotein analysis, and that 11% of children would qualify for total cholesterol screening because of known parental hypercholesterolemia without a family history of premature CHD. Thirty-five percent of children had incomplete or unavailable family health history and/or unknown parental cholesterol status. CONCLUSIONS: In this population, 38% of children would be targeted for cholesterol screening, exceeding the estimate of the NCEP Children and Adolescents Panel. The selection process, however, would tend to miss children from single-parent families, children with incomplete family health history, and children whose parents have not had their cholesterol levels measured. The currently recommended pediatric cholesterol screening policy needs to be evaluated further in additional communities and population settings. Alternative cholesterol screening strategies are needed when family health history is incomplete and/or parental cholesterol status is unknown.

Adolescent↗
PubMed1993

Identification and management of heterozygous familial hypercholesterolemia: summary and recommendations from an NHLBI workshop.

Heterozygous familial hypercholesterolemia (hFH) is one of the most common monogenic disorders with serious health consequences, affecting approximately 1 in 500 persons in the United States. Persons with hFH generally manifest elevations of low density lipoprotein (LDL) cholesterol throughout their lives and have a markedly increased risk of death from coronary artery disease. The hypercholesterolemia of hFH is responsive to medication and diet, and, if detected early, aggressive LDL cholesterol control may prevent or substantially delay cardiovascular disease. However, evidence suggests that many persons with hFH are undetected and inadequately treated. On July 20-21, 1992, the National Heart, Lung, and Blood Institute sponsored a workshop to assess the current understanding of the diagnosis and management of hFH, to emphasize recommendations for identification and management that are known to be effective, and to identify opportunities and needs for intervention and research.

Heterozygote↗
PubMed1993

Diagnosis and case finding in familial hypercholesterolemia.

Heterozygous familial hypercholesterolemia (hFH) is known to be associated with a high risk for development of coronary disease. However, several issues still remain as to whether this condition merits a special approach to diagnosis and case finding. It appears that hFH meets the World Health Organization criteria as a condition worthy of a screening program. However, none of several current strategies appears to be successful in the identification of even a majority of hFH cases. These strategies include community-wide programs to test everyone for total serum cholesterol levels, the testing of first degree family members of hFH patients or family members of patients with coronary disease at age < or = 55 years, or even the screening of patients with premature vascular events. The barriers for patients and physicians to carry out screening recommendations need to be identified and removed, including the need to sensitize primary care providers about the importance of identifying those with hFH.

Humans↗
PubMed1993

Comparison of the effects of diets rich in stearic acid versus myristic acid and lauric acid on platelet fatty acids and excretion of thromboxane A2 and PGI2 metabolites in healthy young men.

The present study compared the effects of diets rich in stearic acid (C18:0) versus one high in lauric and myristic acid (C12:0, C14:0) on platelet phospholipid fatty acid levels and concentrations of urinary thromboxane B2 (TXB2) and 6-keto-PGF1 alpha, which are stable metabolites of thromboxane A2 (TXA2) and PGI2 and indicators of cardiovascular hemostasis. A diet high in dairy butter (B) was the source of C12:0 and C14:0; C18:0 was provided by diets high in cocoa butter (CB), milk chocolate (CHOC) or CB+B in a 4:1 ratio (MIX). A randomized, crossover double-blind experimental design was used. Experimental subjects (n = 15) consumed each diet for 26 days, with a 1-month washout period between each experimental period. Urine and blood were collected from each subject at the beginning and end of each dietary period. Urinary TXB2 and 6-keto-PGF1 alpha were analyzed by radioimmunoassay (RIA). There were no effects of diet on the 24-hour excretion of either metabolite or on the ratio of 6-keto-PGF1 alpha/TXB2, even though there were significant changes in the eicosanoid precursor, arachidonic acid (C20:4n-6), in platelet phospholipids. C20:4n-6 levels increased (44.8% +/- 1.0% to 47.1% +/- 1.3%; P < .05) in the phosphatidylethanolamine phospholipid subclass in subjects on the B diet and decreased in the phosphatidylcholine subclass on the CB diet (16.5% +/- 1.0% to 14.2% +/- 1.1%; P < .05) compared with baseline values.(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗
PubMed1993

The role of fatty acid saturation on plasma lipids, lipoproteins, and apolipoproteins: I. Effects of whole food diets high in cocoa butter, olive oil, soybean oil, dairy butter, and milk chocolate on the plasma lipids of young men.

The present studies were conducted to evaluate the cholesterolemic effects of whole-food diets high in stearic acid. In study no. 1, normocholesterolemic young men were fed diets high in stearic acid provided by cocoa butter (CB); oleic acid provided by olive oil (OO); linoleic acid provided by soybean oil (SO); and myristic acid (and lauric acid) provided by dairy butter (B). In study no. 2, different subjects with similar baseline characteristics were fed diets high in stearic acid provided by milk chocolate (C), CB, CB+B (4:1, MIX), and myristic (and lauric) acid provided by B. Both studies used a randomized, crossover, double-blind experimental design, and experimental subjects (n = 18 for study no. 1 and n = 15 for study no. 2) in each study consumed every diet for 26 days with a 1-month wash-out period between each experimental period. The diets provided 37% of calories from fat, of which 81% was provided by the test fat. Ten ounces (280 g) C was provided daily by the C diet. In study no. 1, the B diet was hypercholesterolemic, whereas the SO diet was hypocholesterolemic, compared with the other diets. The OO and SO diets were hypocholesterolemic compared with the CB diet. Low-density lipoprotein (LDL) cholesterol levels, in general, paralleled the changes in plasma total cholesterol levels. SO significantly decreased apolipoprotein (apo) B levels compared with the other diets. Plasma very-low density lipoprotein (VLDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and apo A-I levels were unaffected by the experimental diets.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The role of fatty acid saturation on plasma lipids, lipoproteins, and apolipoproteins: II. The plasma total and low-density lipoprotein cholesterol response of individual fatty acids.

Regression analyses were performed on individual data from our two previous clinical investigations to establish the cholesterolemic effects of individual fatty acids. Our principal objective was to determine the effects of stearic acid on plasma total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol levels. Our second objective was to determine the variation in the cholesterolemic response of individuals to changes (delta) in the major dietary fatty acids. The best-fitting linear regression equations relating delta TC and delta LDL (mg/dL) were as follows: delta TC = 2.3 delta C14:0 + 3.0 delta C16:0 - 0.8 delta C18:0 - 1.0 delta polyunsaturated fatty acids (PUFA) and delta LDL = 2.6 delta C14:0 + 2.9 delta C16:0 - 0.5 delta C18:0 - 0.7 delta PUFA, where delta fatty acid = change in intake expressed as percent of calories. Based on these equations, in which stearic acid has a significant, negative regression coefficient, and the other regression models analyzed, it appears that stearic acid has an independent cholesterol-lowering effect. Using the equation we developed, 75% of the actual cholesterolemic responses were within +/- 10 mg/dL of the predicted response. In summary, we have developed a predictive equation (similar to those developed by both Keys and Hegsted) to estimate changes in plasma TC and LDL cholesterol levels of young men in response to changes in dietary fatty acids. However, our predictive equation separates stearic acid from the other long-chain saturated fatty acids (SFA) and indicates that it has an independent cholesterol-lowering effect. Thus, stearic acid is a unique long-chain SFA because of its effect on plasma cholesterol level.

Apolipoproteins↗
PubMed1993

Validity of cardiovascular disease risk factors assessed by telephone survey: the Behavioral Risk Factor Survey.

The Behavioral Risk Factor Surveillance System (BRFSS) collects telephone interview data on behaviors for the leading causes of premature death and disability. Its validity has never been adequately studied. The authors replicated BRFSS methodology to validate self-reported cardiovascular disease (CVD) risk factors. Nine-hundred and eleven subjects from three upstate New York counties were interviewed between 1/89 and 5/90. Interviewees were offered physical examinations and laboratory testing for CVD risk factors; 282 men and 344 women participated. The authors studied validity by comparing objectively measured to self-reported CVD risk factors. Sensitivities for self-reported hypertension, hypercholesterolemia, obesity, smoking, and diabetes were: 43, 44, 74, 82 and 75%, respectively. Only smoking sensitivity differed by gender: men, 77%; women, 86%. Specificity was > 85% for all risk factors, except hypercholesterolemia in men (75%). Prevalence was underreported for hypertension, hypercholesterolemia, obesity, and smoking by 43, 50, 25 and 17%, respectively. Results suggest telephone survey research includes physiologic measurements for blood pressure, cholesterol, height, weight, and smoking to validate self-reported CVD risk factors. When this is impossible, results such as these can be used, in similar samples, to correct risk factor prevalence rates from telephone surveys for misclassifications.

Adult↗