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PubMed2000

Predictors of eating disorder scores in children ages 6 through 14: a longitudinal study.

The objective of this study was to identify variables that predict higher eating disorder scores in non-clinical boys and girls ages 6 through 14. Two hundred sixteen children participated and were tested annually for 3 years. A TV-video procedure was used to measure the accuracy of body size judgments. Variables examined included demographic, familial, sociocultural, social, esteem, and clinical variables. Predictors of higher eating disorder scores for both sexes included height and weight, children's perceptions of parental concerns about their body size, low body esteem, and depression. For girls only, a larger perceived body size and smaller idealized body size were also predictors. Teasing was a predictor for boys only. An analysis of longitudinal changes suggests that low body esteem becomes a significant factor around age 9, depression emerges as a predictor at age 10, and body size judgments in perceived and ideal sizes at ages 11 and 12. Changes over 2 years in individuals' weight and height, teasing, body dissatisfaction, and eating disorder scores were also found to predict higher eating disorder scores.

Adolescent↗
PubMed1999

Changes in family functioning for stroke rehabilitation patients and their families.

This study charted changes over time in the family functioning of a group of stroke rehabilitation patients and their families. Participants were 60 12-month stroke survivors who had undergone an inpatient rehabilitation programme, 46 spouses, and 25 other family members. Participants were assessed at the time of admission to and discharge from rehabilitation, and 6 and 12 months after discharge. The study was undertaken in the rehabilitation unit at Repatriation General Hospital, in Adelaide, South Australia. Family functioning was assessed using the McMaster Family Assessment Device, and functional outcome was monitored with the competence scale of the Australian ADL Index. Longitudinal change in family functioning was observed in problem solving, family communication, role definition, behaviour control, and affective involvement. There were no significant differences between the family functioning ratings provided by patients and their spouses. It is important that consideration be given to means by which the increase in family dysfunction following stroke can be addressed.

Activities of Daily Living↗
PubMedDate not supplied

Decline in learning ability best predicts future dementia type: the Freedom House Study.

The authors studied longitudinal change in learning efficiency as a predictor of future dementia type among healthy, well-educated, noninstitutionalized elderly retirees. Serial assessments of memory were obtained using the California Verbal Learning Test (CVLT). Latent growth (LG) models were developed from the slopes of the subjects' performance over the first five CVLT learning trials at each of three serial administrations (e.g., cohort inception [i.e., baseline] [CVLT1], 18 months [CVLT2] and 36 months [CVLT3]). The resulting growth curves were incorporated into a higher order LG model representing the dynamic change in learning efficiency over time (DeltaCVLT). DeltaCVLT was used to predict each subject's "dementia type" (i.e., clinical state) at 36 months (e.g., no dementia, Type 1 [Alzheimer type] dementia or Type 2 [non-Alzheimer type] dementia), after adjusting for CVLT1, baseline age, and baseline dementia type. Nonlinear (logarithmic) LG models of CVLT1-CVLT3 and DeltaCVLT best fit the data. There was significant variability about both CVLT1 and DeltaCVLT, suggesting subgroups in the sample with significantly different baseline memory function, and different rates of deterioration in learning efficiency. Age, baseline dementia type, and DeltaCVLT made significant independent contributions to final dementia type. CVLT1 did not predict final dementia type independently of the other covariates. These data suggest that baseline memory performance in noninstitutionalized elderly retirees does not predict future dementia type independently of the dynamic rate of change in memory measures. Serial administrations of memory tests may help identify nondemented persons at greater or lesser risk for conversion to frank dementia in the near-term.

Aged↗
PubMed2003

Natural history of lower urinary tract symptoms in men--result of a longitudinal community-based study in Japan.

OBJECTIVES: To investigate the longitudinal changes in the International Prostate Symptom Score (IPSS), bother score, and quality-of-life index in a community-based study in Japan. Of 289 men between 40 and 79 years of age who were analyzed in the first community-based study, 223 (77.2%) participated in a follow-up study conducted 3 years later. The IPSS, bother score, and quality-of-life index, as well as medical histories and current medication use, were evaluated. RESULTS: Neither the average IPSS, bother score, nor quality-of-life index significantly changed after 3 years in any age decade. However, changes in the IPSS varied among individuals, because 32%, 35%, and 33% of the men reported improved, stable, and worsened IPSS, respectively. Transurethral resection of the prostate was performed on 0%, 4%, and 21% of the men in the mild (0 to 7), moderate (8 to 19), and severe (20 to 35) IPSS categories, respectively. Neither prostate volume nor peak urinary flow rate significantly predicted progression of the IPSS after 3 years. CONCLUSIONS: Although no definite general symptomatic progression was observed in the participants during 3 years, changes in subjective urinary symptoms varied among individuals ranging from improvement to worsening. The men with a more severe IPSS had a greater chance of transurethral resection of the prostate within 3 years.

Adult↗
PubMed1988

Hemodynamic and neurohormonal changes in the development of DOC hypertension in the dog.

In this article we summarize studies of the hemodynamic and endocrine effects of desoxycorticosterone (DOC)-induced hypertension in dogs and also review new data of the action of this steroid on baroreceptors. The hemodynamic effect of subcutaneous injections of DOC to dogs, without supplementation of salt in their diet, consisted of increases in arterial pressure that were sustained for a 28-day observation period and associated with augmented cardiac output. At the early stage of the hypertensive response there was a rise in plasma Na+ concentration accompanied by increases in the plasma and cerebrospinal fluid (CSF) levels of vasopressin. The activity of the peripheral renin angiotensin system, as evaluated by the longitudinal changes in plasma renin activity and plasma immunoreactive angiotensin II (irAng-II), was markedly depressed in the hypertensive dogs. In contrast, the concentration of irAngII in the CSF did not change. Additional studies of the carotid occlusion reflex in anesthetized dogs revealed an enhanced buffering baroreceptor capacity in the early (less than day 10), but not the late (greater than day 28), stages of the hypertension. The abnormality in baroreflex function may be mediated by an effect of the steroid on an activity of brain angiotensin II that influences the inhibitory interaction between high and low pressure baroreceptors. The data acquired in these studies agree with the notion that excess mineralocorticoid production causes hypertension by mechanisms that influence the neurohormonal control of blood pressure by the central nervous system.

Angiotensin II↗
PubMed2001

Serum and urine markers of bone metabolism during the year after hip fracture.

OBJECTIVE: As part of a larger study to describe indices of recovery during the year after hip fracture, the current prospective study investigated longitudinal changes in serum and urine markers of bone metabolism for the year after hip fracture and related them to bone mineral density (BMD). DESIGN: A representative subset of participants provided serum and urine samples and had bone density measured at 3, 10, 60, 180, and 365 days postfracture. SETTING: Two Baltimore hospitals. PARTICIPANTS: The subjects were 205 community-dwelling, white women age 65 and older with fresh proximal femur fractures. MEASUREMENTS: Samples were assayed for specific bone-related proteins and bone turnover markers, including serum osteocalcin (OC), procollagen type 1 carboxy-terminal extension peptide (PICP), bone-specific alkaline phosphatase (BAP), and urinary deoxypyridinoline (DPD) cross-links. Selected hormonal regulators of bone metabolism, including parathyroid hormone (PTH), calcitonin (CT), 1,25-dihydroxy vitamin D(3) (1,25 (OH)(2)D), and estrone (E(1)) were measured from serum samples. Repeated measures analyses were used to evaluate postfracture changes in each of the markers. RESULTS: BAP, OC, and PICP were most active during the early postfracture period (3-60 days). BAP and OC remained elevated at 365 days compared with 3 days. DPD rose 48% from 3 days to 60 days, but this difference was not statistically significant. PTH and 1,25 (OH)(2)D increased steadily and significantly from 3 to 365 days. E(1) was highest at baseline and decreased at each time point, whereas CT showed no significant changes. When subjects were stratified into high-, medium-, and low-BMD groups based on their measurement at 3 days, both osteoclastic and osteoblastic markers in the low-BMD group displayed exaggerated and different patterns over time compared with the other groups. CONCLUSION: Currently, the standard treatment of care for hip fractures still results in high morbidity and mortality and failure to regain prefracture quality of life. Gaining an understanding of bone cell activity in these patients after hip fracture, derived by measuring markers longitudinally during recovery, provides a baseline by which to measure the effectiveness of new interventions to improve recovery from hip fracture.

Absorptiometry, Photon↗
PubMedDate not supplied

A study of the relationship between IgG subclass/IgM and idiopathic nephrotic syndrome.

In an attempt to elucidate the relationship between serum IgG subclass/IgM ratio and prognosis in different types of idiopathic nephrotic syndrome (INS), 46 cases of treatment responders and 23 cases of either frequent relapse or non-responders were studied. All patients had received renal biopsy. Serum IgG subclass/IgM ratios were compared between the acute nephrotic phase and remission. The association between therapeutic effect and the parameters of INS were also investigated. There were 24 cases of minimal change nephrotic syndrome (MCNS), 32 cases of IgM nephropathy (IgMN) and 13 cases of focal segmental glomerular sclerosis (FSGS). All cases of MCNS were steroid-responders. Seventeen cases of IgMN experienced frequent relapses. The other 15 cases were responsive to the treatment. 6 cases of FSGS had poor response to any therapy; 7 cases were responsive to either triple therapy or cyclosporine A plus prednisolone. Both IgGI/IgM and IgG2/IgM were correlated with serum albumin and cholesterol levels at the acute nephrotic phase (p < 0.05). Longitudinal change of the immunologic parameters in patients with INS revealed significantly elevated serum IgM level decreased serum IgG level, IgG/IgM, IgG1/IgM, IgG2/IgM, IgG3/IgM, IgG4/IgM and IgG/IgE ratio during acute nephrotic phase. Correlation between therapy responses showed that, for serum IgG1/IgM ratio > 3.0, most of the cases were treatment-responders. For IgG1/IgM ratio > 1.0, all the cases were frequent relapsers or non-responders. These results suggest the immunologic changes in patients of INS may be caused by immune regulatory abnormality. Serum IgG1/IgM ratio may serve as one of the therapeutic and prognostic guides, especially if the patient refuses renal biopsy.

Child↗
PubMed1986

Changes in lung function determined longitudinally compared with decline assessed cross-sectionally. The Cracow Study.

Longitudinal annual changes in lung function (FEV1) with cross-sectional estimates have been compared in the sample of Cracow inhabitants who underwent epidemiological follow-up on chronic nonspecific chest diseases. The annual rate of FEV1 decline was faster in men than in women. Among male smokers the FEV1 decline rate was 30% greater, while in women smokers 9% faster than in non-smokers. The cross-sectional estimates for annual changes differed in both surveys carried out in the interval of 13 years and were not very much consistent with the average longitudinal annual decline observed in the sample. However, the prediction of annual decline across the age groups showed large inconsistencies. They resulted from the curvilinear pattern in lung function decline over the age groups. It was found that the lung function in the elderly appeared to be more homogeneous and the acceleration of decline rates slowed down. There is some evidence that the flattening of the decline curve among elderly might have been influenced by the selection bias.

Adult↗
PubMed1998

Comparison of GAD and ICA512/IA-2 antibodies at and after the onset of IDDM.

OBJECTIVE: Longitudinal changes in GAD antibody (Ab) and ICA512/IA-2 (ICA512) Ab were examined in relation to age at the onset of diabetes and autoimmunity against the thyroid gland. RESEARCH DESIGN AND METHODS: GADAb, ICA512Ab, and antithyroid autoantibody were examined at onset in 40 juvenile-onset IDDM patients (17 males, 23 females, age at onset 9.4 +/- 4.1 years, range 1.7-20). To assess the changes in antibody levels, 29 patients were followed up with sequential serum samples for up to 5 years. RESULTS: At onset, GADAb, ICA512Ab, and antithyroid autoantibody (thyroglobulinAb or thyroid peroxidaseAb) were found in 70, 58, and 25% of the 40 patients, respectively. Prepubertal patients (n = 21) had a significantly higher prevalence and index of ICA512Ab compared with pubertal patients (n = 19) (76 vs. 37%, P = 0.012, and 2.43 +/- 2.36 vs. 0.66 +/- 1.23, P = 0.011), while GADAb was more prevalent in pubertal patients (57 vs. 84%, P = 0.09). A longitudinal analysis of GADAb and ICA512Ab showed that GADAb levels declined more slowly than those of ICA512Ab (P = 0.008). Patients with continuous extremely high levels of GADAb also had high levels of antithyroid autoantibody. CONCLUSIONS: The measurement of ICA512Ab is useful in prepubertal patients, who often show rapid progression of the disease. The presence of autoimmunity against thyroid gland seems to influence the GADAb level but not the ICA512Ab level.

Adolescent↗
PubMed2004

Cross-sectional and longitudinal comparisons of health-related quality of life between patients with prostate carcinoma and matched controls.

BACKGROUND: Prostate carcinoma and treatments affect health-related quality of life (HRQOL). The authors prospectively compared prostate and general HRQOL between prostate carcinoma cases and an age-matched and ethnicity-matched control group. METHODS: The case cohort consisted of 293 men with localized prostate carcinoma who were selected randomly from the population-based New Mexico Tumor Registry, and the control cohort consisted of 618 men who were selected randomly from administrative databases and matched for age and ethnicity. Subjects completed a baseline survey of demographics, socioeconomic status, comorbidity, and prostate and general HRQOL. Also, 210 cases (71.7%) and 421 controls (67.8%) completed a follow-up survey 5 years later. Multinomial logistic regression models compared baseline characteristics as well as 5-year general HRQOL outcomes measured by selected domains of the Medical Outcomes Study SF-36. The authors used a mixed-model repeated-measures analysis of variance and multinomial regression analyses to compare longitudinal changes in urinary, bowel, and sexual function between groups. RESULTS: At baseline, patients with prostate carcinoma had better urinary control and sexual function than controls. Over 5 years, sexual function declined significantly among controls, although urinary function remained stable. However, patients with cancer subsequently reported significant declines in both domains and were left with much worse function and more bother than controls. Bowel function and general HRQOL were similar for both groups at follow-up. CONCLUSIONS: Prostate carcinoma treatment led to significant 5-year declines in urinary and sexual function that far exceeded age-related changes in controls. Patients with cancer had significantly worse function and more bother than controls for these disease-specific domains of HRQOL. Bowel function and general HRQOL were not affected by cancer status.

Cross-Sectional Studies↗
PubMed2000

Correction of odontoid dysplasia following bone-marrow transplantation and engraftment (in Hurler syndrome MPS 1H).

BACKGROUND: Odontoid dysplasia is recognized as a major component of the constellation of dysostosis multiplex lesions associated with Hurler's syndrome (MPS 1H). Because of this abnormality, there is an increased risk of atlantoaxial subluxation with potential cervical spinal cord injury. A significant alteration of the natural history of the disease with respect to the visceral, cardiac, and skeletal systems has resulted in an increased life span for MPS 1H patients associated with engraftment from normal donors. OBJECTIVE: The purpose of this study was to evaluate the longitudinal changes of odontoid dysplasia in MPS 1H following engraftment from bone-marrow transplantation (BMT). MATERIALS AND METHODS: A retrospective review of sequential plain film or cervical spine MR was performed in patients with MPS 1H. Odontoid morphology was graded as aplasia, severe dysplasia, moderate dysplasia, mild dysplasia, or normal. Odontoid morphology was plotted against the time interval. Fully engrafted, nontransplanted, and partially engrafted patients had careful imaging evaluation of the odontoid process. RESULTS: Ten patients were studied with a mean interval follow-up of 8.7 years post-BMT. Seven patients were totally engrafted. Two patients were nontransplanted, and one patient had only partial engraftment (20% enzyme activity). All totally engrafted patients had a progressive improvement in the grade of odontoid dysplasia following BMT. Patients with partial engraftment or without transplantation demonstrated static or increasing odontoid dysplasia. MR imaging showed abnormal dural soft-tissue masses at the level of C2 in all patients. Reduction in the grade of odontoid dysplasia was not associated with significant change in the appearance of the upper cervical soft-tissue masses. CONCLUSION: For the first time, this report documents that patients with MPS 1H show a decrease in the degree of odontoid dysplasia on imaging after successful engraftment following BMT.

Bone Diseases, Developmental↗
PubMed2002

Patterns of outcome of caregiving for the impaired elderly: a longitudinal study in rural Japan.

This longitudinal study investigates the experiences among Japanese caregivers who provide informal care at home to the impaired elderly over one year. Little is known about longitudinal changes in caregivers' burden in Japan. Between 1998-1999, 47 pairs of impaired elderly and their caregivers were followed in Matsuyama Town in a rural area of northern Japan. Caregivers were interviewed initially and then again 12 months later. Findings indicated that the mean score of the Zarit Burden Interview at Time 2 was significantly lower than that of Time 1, suggesting that caregivers adapted to their role over time. Outcomes were further categorized as successful and unsuccessful, depending on the pattern of change over one year. Two factors were related to the outcome in univariate analyses: caring for someone with dementia, and caregiver being a spouse. Logistic regression demonstrated that caring for someone with dementia was five times more likely to be associated with an unsuccessful outcome. The caregiver spouse was five times more likely to be associated with a successful outcome, while daughters-in-law were more likely to have an unsuccessful outcome. The present study suggests that (1) changes in well-being among caregivers in Japan are similar to those observed in most studies in the West, and (2) there was evidence of both the adaptation and wear-and-tear models among caregivers over time.

Aged↗
PubMed1995

Prognostic value of serum hyaluronic acid and type I and III procollagen propeptides in extrahepatic biliary atresia.

Although portoenterostomy has greatly improved the prognosis of extrahepatic biliary atresia (EHBA), 10-20% of patients still die before 5 y of age, and the only treatment option is liver transplantation (LT). To investigate whether these patients may be identified at an early stage, when the changes of successful LT are optimal, we have measured serum concentrations of hyaluronic acid (HA), the amino-terminal propeptide of type III procollagen (PIIINP) and the carboxy-terminal and amino-terminal propeptides of type I procollagen (PICP, PINP) in 24 selected patients with EHBA, both before portoenterostomy and then every 6 mo until death (n = 10, age at death = 7-20 mo), LT (n = 6, age at LT = 1.1-4.8 y) or 5 y of age (n = 8). Raised serum HA above 200 micrograms/L before portoenterostomy identified those patients who would die or require LT in the first 5 y of life with a positive predictive value of 88%; after portoenterostomy, longitudinal changes in HA reflected clinical status in each patient. None of the other three markers was of prognostic value, and only PIIINP showed any relationship with clinical status, and then only up to 1.5 y. Interestingly, PINP (but not PICP) tended to be low in all patients before portoenterostomy and may reflect impaired bone collagen metabolism during early skeletal changes in EHBA. This study therefore suggests that measurement of serum HA may be a useful complementary test in EHBA, particularly in identifying, at an early stage, those patients who should be considered for LT.

Age Factors↗
PubMed1994

A cross-sectional and short-term longitudinal characterisation of NIDDM in Psammomys obesus.

The present study was undertaken to examine the cross-sectional and short-term longitudinal changes in glucose and insulin concentrations as well as measure the enzymatic activity of PEPCK and glycogen synthase in our Psammomys obesus colony. In the cross-sectional study, blood samples were taken from one group of animals at 19 weeks of age (n = 37) in the fed state and following a 4-h fast. In a separate group of 19-week-old animals (n = 69), samples were taken 1 h following an OGTT (1 g/kg body weight) in Psammomys subjected to a 16-h fast. In the longitudinal study, blood samples were taken from one group of animals in the fed state at 7, 11, 15 and 19 weeks of age. All of the cross-sectional data have described the classic inverted U-shaped curve (Starling's curve of the pancreas) in the relationship between glucose and insulin levels. This trend was also reflected by Psammomys subjected to the OGTT; a mild impairment in glucose tolerance was associated with an increase in the insulin response and a further impairment in glucose tolerance was associated with a reduction in the insulin response. Similar results were obtained following a 4-h fast. The short-term longitudinal glucose and insulin data revealed that of the 37 animals examined over the 12-week period, 16 progressed along the inverted U-shaped curve described by the cross-sectional data. Of the other animals, 8 remained unchanged, 7 were unclassifiable and 6 hyperglycaemic Psammomys developed normoglycaemia at the expense of elevated insulin levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Functional and morphologic changes after combined maxillary intrusion and mandibular advancement surgery.

PURPOSE: The purposes of this investigation were 1) to compare the morphology and function of patients with combined vertical maxillary excess (VME) and mandibular retrognathia with that of controls, and 2) to examine how these parameters change after combined maxillary intrusion and mandibular advancement surgery. PATIENTS AND METHODS: Fifteen female VME/retrognathic patients were compared with 26 female controls before and for up to 3 years after orthognathic surgery. Facial skeletal morphology, mandibular range of motion, maximum isometric bite force, and levels of electromyographic activity (EMG) in selected muscles of mastication were measured on all subjects. Where appropriate, one-way analysis of variance (ANOVA) or t-tests were used to compare the patients with controls. Univariate repeated-measures ANOVA was used to study longitudinal changes. RESULTS: Preoperatively, patients' morphologic measurements were characteristic of VME compounded by mandibular retrognathia. At surgery, the maxilla was elevated an average of 2.8 mm, and the mandible was lengthened by an average of 7.1 mm. All of the postoperative morphologic measurements were closer to normal values. The patients' masseter mechanical advantage was significantly lower than that of controls both before and after surgery. Surgically induced changes in mechanical advantage were very small. The patients' maximum range of motion and excursion during mastication were all lower than those of controls before surgery. All measurements of mobility decreased immediately after surgery, with a gradual return to preoperative values. However, even 3 years after surgery, all of the motion measurements remained smaller than those of the controls. Before surgery, the patients had maximum isometric bite forces significantly lower than those of controls. Bite forces increased significantly after surgery, approaching normal values within 2 years. The activity levels in the muscles of mastication during isometric bites were not significantly altered by surgery. CONCLUSIONS: This study confirms that VME/retrognathia patients suffer from substantial deficiencies in their oromotor function. Surgical correction of this particular type of dentofacial deformity improves both the morphologic and functional deficits. Although some changes were not statistically significant, all were toward normalization of the presurgical values.

Adolescent↗
PubMed1999

The use of observational methods for monitoring sun-protection activities in schools.

Evaluation of health promotion interventions aimed at behavioural or environmental change involves assessing change that occurs as a result of the program. Direct observational methods can be used for this purpose and this paper describes three such methods that we pilot tested for use in a 5-year intervention study aimed at reducing sun exposure in primary school children. (1) Monitoring 'No hat, no play' policies. This method involved video taping children in selected school play areas during lunch time and analysing the content of the videos to assess the proportion of children wearing various types of hats. (2) Assessing shade provision in the playground. This method involved taking aerial photographs of each school and using them to estimate the proportion of shade in play areas available to children at lunchtime. (3) Shade use. This involved children wearing polysulphone film badges to measure the amount of UV-B exposure they received during one lunch period, relative to the total possible dose registered on index badges. Each method was implemented successfully, and we demonstrated that the video and aerial photography methods produced highly reproducible results and that all three methods were feasible. These three methods will be used in our intervention study to assess longitudinal change in schools' sun-protection policy and practice.

Child↗
PubMed2005

Progressive gray matter damage in patients with relapsing-remitting multiple sclerosis: a longitudinal diffusion tensor magnetic resonance imaging study.

BACKGROUND: Diffusion tensor magnetic resonance imaging (DT MRI) has the potential to provide in vivo information about tissue microstructure. In multiple sclerosis (MS), DT MRI has disclosed the presence of occult structural damage in the normal-appearing brain tissues. OBJECTIVE: To investigate whether DT MRI is sensitive to longitudinal changes of brain damage that may occur beyond the resolution of T2-weighted images in patients with relapsing-remitting MS. DESIGN: Twenty-six untreated patients with relapsing-remitting MS were followed up for 18 months. Dual-echo, DT and postcontrast T1-weighted MRIs of the brain were obtained at baseline and then every 3 months. Mean diffusivity (D) histograms of normal-appearing gray (GM) and white matter were produced. Total T2-hyperintense and T1-hypointense lesion volumes; normalized whole brain tissue, GM, and white matter volumes; percentage brain volume change between the study entry and exit images; average lesion D; and fractional anisotropy were also calculated. RESULTS: During the study period, a significant decrease of normalized whole brain tissue, average lesion fractional anisotropy and normal-appearing GM D histogram peak height, and a significant increase of average normal-appearing GM D and T2-hyperintense lesion volumes were observed. Changes of normal-appearing GM diffusivity were independent of the concomitant changes of normalized whole brain tissue and GM volumes. CONCLUSIONS: The DT MRI findings show progressive microstructural changes in the normal-appearing GM of patients with untreated relapsing-remitting MS. Such changes do not reflect a concomitant development of brain atrophy and confirm the importance of GM pathology in MS.

Adult↗
PubMed2007

Aging and the prevalence of cardiovascular disease risk factors in older American Indians: the Strong Heart Study.

OBJECTIVES: To describe longitudinal changes in the prevalence of major cardiovascular disease (CVD) risk factors in aging American Indians. DESIGN: Population-based ongoing epidemiological study. SETTING: The Strong Heart Study is a study of CVD and its risk factors. Standardized examinations were repeated in 1993 to 1995 and again in 1997 to 1999. PARTICIPANTS: A diverse cohort of 4,549 American Indians aged 45 to 74 at the initial examinations in 1989 to 1991. MEASUREMENTS: Changes in the prevalence of hypertension, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), current smoking, and type 2 diabetes mellitus. RESULTS: The prevalence of hypertension rose rapidly and steadily with aging. A nonsignificant decrease in LDL-C was seen in men, and men and women initially had rapid increases in the prevalence of low HDL-C. The prevalence of smoking decreased, but the prevalence of diabetes mellitus continued to rise for men and women. CONCLUSION: Overall, unfavorable changes in CVD risk factors were seen in the aging participants and will likely be reflected in worsening morbidity and mortality.

Aged↗