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Biomedical subjects

U Keil

Publications and source records attributed to U Keil.

At least 163 records · Page 9Linked to original sources
PubMed1988

The cardiovascular risk factor profile in the study area Augsburg. Results from the first MONICA survey 1984/85.

The main objective of the first survey was the investigation of the prevalence and distribution of hypertension, hypercholesterolemia and cigarette smoking in the study area. The data-collection phase lasted from October 1984 to May 1985. A two-stage cluster sample of 5312 persons of German nationality was drawn from a population of 282,279 inhabitants, aged 25-64. The data were gathered through interview, physical examination and self-administered questionnaire. A response of 79% was achieved. Sixteen percent of men and 10% of women had high blood pressure (BP) values (greater than or equal to 160/95 mmHg). Only 16% of male and 34% of female hypertensives had controlled BP values. The prevalence of hypercholesterolemia (greater than or equal to 6.72 mmol/L = greater than or equal to 260 mg/dl) was 26% in men and 22% in women. Forty percent of men and 22% of women reported they were current cigarette smokers. Among participants, aged 25-44, cigarette smoking was the most prevalent risk factor in men and women. Thirty-seven percent of men and 52% of women, aged 25-64, had none of the three major risk factors.

Adult↗
PubMed1988

B-scan ultrasound examination of the carotid arteries within a representative population (MONICA Project Augsburg).

As part of the MONICA project carried out in Augsburg, 1388 male and female subjects, aged 25 to 65 years, participated in a B-scan ultrasound examination of the carotid arteries. The segments of the carotid arteries examined on both sides of the neck were the A. carotis communis, the A. carotis interna, and A carotis externa. As a result plaques were found in 330 subjects (23.9%). The presence of plaques in subjects is strongly correlated to age (increasing trend in both sexes, P less than 0.001) and the process of establishing plaques starts in men earlier than in women (P less than 0.01). For both sexes a different correlation structures is found for the relationship of cardiovascular risk factors to presence of plaques as well as to number of plaques in the carotid arteries. In men, total cholesterol (P less than 0.05) and personal history of diabetes, myocardial infarction, and stroke (P less than 0.01) were positively correlated with the presence of plaques while HDL/total cholesterol ratio shows a negative correlation (P less than 0.01). In women, none of the analyzed risk factors is found to correlate significantly with the presence of plaques. Regarding the number of vessels with plaques, a consistent and significant relationship with both hypertension and total cholesterol is seen in males and with hypertension in females. Comparing the different factors analyzed, age is obviously much more related to the occurrence of plaques than all the other risk factors together. Age is followed by a decrease in HDL cholesterol and, at a much lower level, by hypertension and smoking.

Adult↗
PubMed1988

[The myocardial infarct status of a South German population: results of the Augsburg myocardial infarct register l985].

The Augsburg Myocardial Infarction Register recorded in 1985, 999 coronary events (734 men, 265 women) occurring in 25-74-year-old residents of the city of Augsburg and the counties of Augsburg and Aichach-Friedberg (study population: 156,489 men and 171,093 women). On average, 444 men and 138 women per 100,000 of the population suffered an acute myocardial infarction (AMI) in 1985. The risk of morbidity increased with age in both men and women, but gained significance for women only after their 55th year of life. The 28-day case fatality was 54% for male AMI cases and 66% for females; 34% of the AMI patients died without ever reaching a hospital. Cardiopulmonary resuscitation (CPR) was attempted by a physician in one-in-three of these out-of-hospital deaths. Although one of two out-of-hospital deaths occurred in the presence of a medical lay person; lay CPR was the exception. Broader population education in CPR techniques may thus constitute one method of reducing the number of early AMI deaths. The median prehospital time for interviewed hospital patients (66%) was 5 h, and approximately 2 h for patients with systemic thrombolysis (n = 71). The combination of fatal coronary events from the official cause-of-death statistics and the results from the Augsburg register were used to estimate AMI morbidity for the whole of the FRG in 1985. This leads to an expected morbidity of 210,000 AMI, of which 141,000 AMI will be fatal (both sexes).

Adult↗
PubMed1987

Comparison of psychotropic drug intake in two populations in West Germany. Results from the Munich Blood Pressure Study 1980/81 and the Luebeck Blood Pressure Study 1984.

Psychotropic drug intake was assessed in participants aged 30-69 years of two identically designed studies (cross-sectional studies based on random samples), the Munich Blood Pressure Study (MBS I 1980/81) and the Luebeck Blood Pressure Study (LBS 1984). A similar increase of drug intake with age and a preponderance of women among drug users were found in both study samples. On the basis of the total drug consumption, which was not substantially different in the two population samples, it is argued that the statistically significantly lower prevalence rate for benzodiazepine use found in the LBS, compared with the findings of the MBS I, suggests a real decline over time and cannot be merely explained by possible regional differences in prescription behavior. This finding is of importance within the context of the ongoing discussion on increasing dependence on benzodiazepine drugs.

Antihypertensive Agents↗
PubMed1986

Treatment of hypertension. Patterns of drug utilization in a metropolitan population.

In the Munich Blood Pressure Study (MBS), a cross-sectional study (MBS I) with follow-up (MBS II) of a random sample of 3,198 citizens aged 30-69 (response rate, 69.3%), treatment and control of hypertension were examined. Of the actual hypertensives 59% (221) in MBS II (373) were on drug treatment and about two-thirds (150) of those being treated had controlled blood pressure (BP). Women's BP was better controlled than men's. Of the 221 treated hypertensives 85% (188) received types of drugs or drug combinations which were in accordance with the recommendations of the German Hypertension League. However, this did not apply to the prescribed dosages of the various drugs. Of the treated hypertensives 52% were either on a diuretic, on a beta-blocker, or on a combination of both drugs. Rauwolfia alkaloids combined with a diuretic were given to 27%. In 79% of the participants who had received a beta-blocker either alone or in combination with other antihypertensive agents and who still had high BP values, the prescribed beta-blocker dosage was below the recommended daily dose. Fatigue was the most frequently reported symptom, possibly attributable to antihypertensive drug treatment. Electrocardiographic signs of left ventricular hypertrophy were found less frequently in controlled hypertensives, in comparison to treated but uncontrolled hypertensives or untreated hypertensives.

Adrenergic beta-Antagonists↗
PubMed1985

Screening for hypertension: results of the Munich Blood Pressure Program.

The Munich Blood Pressure Program (MBP) is a community hypertension control program for the metropolitan area of Munich. It tries to improve "incidental screening" in doctors' offices in the city through continuing education programs for physicians and auxiliary personnel and, in addition, emphasizes worksite screening to bring high-risk hard-to-reach groups under treatment and control. Blood pressure (BP) is measured at the worksite under standardized conditions. Those with values greater than or equal to 140 mm Hg systolic BP and/or greater than or equal to 90 mm Hg diastolic BP at the first visit have BPs measured again within 1-5 days. If their BP values are still elevated, they are referred to their family physicians for further assessment. At the same time, they are given a postage-paid card on which their doctors are asked to note the BP value measured in their offices. This postcard is returned to the MBP for evaluation. A computer-based reminder system informs all MBP participants at certain time intervals to have their BP checked. The text of the letters and the time interval between them depend on the most recent BP and treatment status data available to the MBP. In 1983, screenings were performed in seven firms. Participation rates of up to 57% were achieved for this entirely voluntary examination (3,948 participants). Age- and sex-specific prevalence rates (for the pooled data of the seven firms) were similar to those of a random sample of the Munich population (Munich Blood Pressure Study I). Seventy-four percent of those with elevated BP at first visit participated in the remeasurement at a second visit. Only 58% of these showed elevated BP values the second time. More than half (n = 101) of those second-visit hypertensives (greater than or equal to 160/95 mm Hg; n = 183) returned at least one completed postcard. The examining physician confirmed the hypertensive BP values in 60 of those cases. Of the 101, 57 were under treatment, 19 controlled and 38 uncontrolled. The follow-up period considered here lasted until May 1984 and varied from 5 to 15 months according to the date of screening in the respective firm. Only the first returned card has been evaluated thus far.

Adult↗
PubMed1985

Oral contraceptive use and blood pressure in a German metropolitan population.

The relationship between blood pressure (BP) and oral contraceptive (OC) use in women has been examined with the data from the Munich Blood Pressure Study (MBS), a cross-sectional study with follow-up of a random sample of 3198 Munich citizens aged 30-69 (response rate 69.3%). Multiple linear and logistic regression analyses were run with BP as the dependent variable and age, OC use, obesity, alcohol consumption, and smoking habit as the independent variables. All second and third order interactions between the independent variables were tested during a backward stepping procedure. OC use appeared as a significant main effect in most of the analyses. The coefficient of the OC variable was about 3 in the linear regression analyses for both systolic BP and diastolic BP, indicating an increase of about 3 mmHg in the systolic and diastolic BP of the OC users. An analysis of the change in BP after one year in relation to change in OC user status has also been made. It was observed that women ceasing to use OC had a clear decrease in BP while those starting to use OC had on average an increase in BP.

Adult↗
PubMed1984

[Quality assurance and quality control of blood pressure measurements. Experiences with the Munich blood pressure study].

More than 12 000 blood pressure measurements were taken in the Munich Blood Pressure Study (MBS). The reliability of these blood pressure measurements is reported. After consideration of possibilities for systematic and random measurement errors we present methods used in the MBS to control and assess the quality of the blood pressure readings over a long period of time: measures for standardizing the recording conditions and procedures; training and testing of the field staff using audio tape-recording and simultaneous measurements with a double stethoscope; analysis of inter- and intraobserver-variation relative to that of reference measurements; analysis of observer preferences for certain terminal digits. With the application of these methods one can indeed successfully reduce observer variability to a tolerable amount even over a considerable period of time.

Blood Pressure Determination↗
PubMed1984

[Office visits and physical well-being of hypertensive patients. Results of the Munich blood pressure study].

The relationship between the frequency of physician visits, self-reported health of hypertensives and the awarenes, treatment and control of hypertension has been investigated, using data from the Munich Blood Pressure Study I (1980/81), a study with 2216 participants of a random sample of the adult population of Munich (30-69 y.). As hypothesized, the chance of detecting and treating high blood pressure increased with the frequency of physician visits. However, frequent physician visits did not guarantee an effective treatment of hypertension. 33% of the treated hypertensives who visited their physicians more than ten times in the preceding year failed to show normotensive or borderline blood pressure values. Additionally it could be seen that the awareness, treatment and control of hypertension was closely related to the number of self-reported chronic diseases and self-reported physical well-being. A relationship between social variables and treatment status was only observed for men: among hypertensive men, the proportion who were treated increased with the number of years of education but decreased with the number of household members.

Adult↗
PubMed1984

[Epidemiology of digitalis medication. Results of the Munich blood-pressure study].

As part of a blood-pressure survey in Munich, some of its inhabitants aged 30-69 years were asked by questionnaire about any digitalis medication. Chemically defined glycosides were taken by 127 of 1827 persons (7%), two-thirds of them older than 60 years, for clinically compensated chronic heart failure. Using the equation of Cockcroft and Gault to calculate creatinine clearance, it was below 80 ml/min and thus indicative of early impairment of renal function in more than 50%. In 44% the prescribed daily dose of glycoside corresponded to the calculated maintenance dose, 29% had less and 27% had taken more. None had clinical signs of digitalis intoxication. ECG changes possibly due to digitalis were much less common than had been expected. Sinus rhythm was present in 93%. More than 50% did not know why they were taking digitalis and 80% were taking two or more drugs at the same time. Since more than half had signs of early renal function impairment, creatinine clearance should be taken into account when determining the dosage of a digoxin preparation especially in elderly patients; alternatively, digitoxin should be prescribed. The survey also showed that a large number of persons on glycoside medication did not take the drug regularly.

Acetyldigoxins↗
PubMed1981

[Epidemiology of hypertension risks: of no consequence to the German Federal Republic? (author's transl)].

A widely based epidemiologic research on hypertension has led to successful action programs abroad: e.g. the incidence of hypertension fell by about 50% in North Karelia, Finland, and in the USA the life expectancy rose by 1.5 years. Against the background of international scientific agreement both the Conference for Security and Cooperation in Europe and the World Health Organization have awarded hypertension the highest priority for European cooperation. In the Federal Republic there is a great backlog; the responsible politicians are called upon to set a new course.

Adult↗