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EURALIM (EURope ALIMentation), a European collaborative study, aimed to determine and describe the extent to which European data on risk factor distributions from different populations could be pooled and harmonised in a common database for international comparisons. Seven independent population-based surveys from six European countries (France, Italy, Northern Ireland/United Kingdom, Spain, Switzerland, the Netherlands). Data for 18 381 women and 12 908 men aged 40-59 were pooled in a common database. Central statistical analyses on major cardiovascular risk factors were conducted with careful consideration of methodological issues, including differences in study designs, data assessment tools, and analytic techniques used. Because of the detected variability among methods used, direct comparisons of risk factor distributions and prevalences between studies were problematic. None the less, comparisons of within population contrasts by sex, age group, and other health determinants were considered to be meaningful and apt, as illustrated here for obesity. Results were targeted and disseminated to both the general public and public health professionals and framed in the context of a European information campaign. International and national comparisons between existing locally run studies are feasible and useful, but harmonisation methods need improvement. Development of an international risk factor surveillance programme based on decentralised data collection is warranted. In the meantime, risk factor contrasts across populations can be used as a basis for targeting needed public health intervention programmes. [ABSTRACT FROM AUTHOR]

Type A behaviour was assessed by modified Framingham scale in a total sample of 1956 employed men in the Caerphilly study. Prevalent heart disease was measured by cardiovascular questionnaire to obtain evidence of myocardial infarction and angina, and by electrocardiogram (ECG) for evidence of ischaemia. Type A was inversely related to age and systolic blood pressure and was positively related to social class and height. It was not related to serum cholesterol or alcohol consumption. After control for age, systolic blood pressure, height, smoking and social class, type A was found to be independent of angina but positively associated with an increased risk of possible myocardial infarction (MI). Type A was also associated with increased risk of confirmed MI. An inverse association was found between type A and asymptomatic ischaemic heart disease (IHD). The association between type A and symptomatic IHD could be due to symptom reporting. [ABSTRACT FROM AUTHOR]

In surveys of 4860 middle-aged men in Caerphilly (South Wales) and Speedwell (Bristol) alcohol consumption has been related to high density lipoprotein (HDL) cholesterol and its major subfractions, HDL2 and HDL3, measured in a single fasting blood sample. The results confirm that high density lipoprotein cholesterol concentration increases as the amount of alcohol regularly consumed increases. The relationship appears to be linear and is independent of age, smoking habit, body mass index, low density lipoprotein cholesterol and plasma total triglyceride. This rise in HDL cholesterol is not mediated through either HDL2 cholesterol or HDL3 cholesterol alone. Both subclasses increase significantly and by similar amounts with increasing alcohol intake. [ABSTRACT FROM AUTHOR]

In epidemiological studies the diagnosis of a past history of myocardial infarction is made from the answer to a single question: 'Have you ever had a severe pain across the front of your chest lasting for half an hour or more?' Two additional questions, which form an optional part of the London School of Hygiene and Tropical Medicine chest pain questionnaire, were used in two large community studies, with other information to determine the likely accuracy of the diagnosis ('Did you see a doctor about this pain?' If so, 'What did he say it was?') The prevalence of possible myocardial infarction from the use of the single question was significantly higher among men from South Wales than among men from Speedwell, Bristol (10.1% and 6.9% respectively); in contrast, positive responses to the additional questions reduced the prevalence in the two populations to 5.8% and 4.9% respectively. These latter figures are very similar to those of self-reported coronary thrombosis in the two populations. Among subjects with positive responses to the additional questions the prevalence of ECG ischaemia was about 50%; in contrast, the prevalence of ECG ischaemia among those positive only to the severe chest pain question was very similar to that among those with no history of chest pain (12%). Preliminary mortality data show a similar classification of level of risk. These findings indicate that the false positive error rate for possible myocardial infarction could be significantly reduced by the use of two additional questions which form an optional part of the London School of Hygiene chest pain questionnaire but are rarely used. However, the present findings relate to populations with uniform levels of adequately accessible medical care; comparisons between populations with different levels of medical care will require cautious interpretation. [ABSTRACT FROM AUTHOR]

Data for 387 men who had completed seven-day weighed dietary records as part of the Caerphilly Heart Study were examined for relations of alcohol, diet, body mass index (BMI), and other variables to blood pressure. These included age, smoking, exercise, and social class. For men not on antihypertensive treatment (n = 356) regression analysis showed that age (p less than 0.001), BMI (p less than 0.05), and alcohol intake (p less than 0.01) were significantly related to systolic blood pressure, and BMI (p less than 0.001) and alcohol intake (p less than 0.01) to diastolic blood pressure. In addition, protein intake (p less than 0.05) was significantly and inversely related to the risk of being hypertensive, but other dietary variables were not related to blood pressure. For men on antihypertensive treatment (n = 31) significant inverse correlations were observed between diastolic blood pressure and the intakes of potassium (p less than 0.01), fibre (p less than 0.001), polyunsaturated fat (p less than 0.01), and a number of other dietary variables. Reasons for these differences are discussed. [ABSTRACT FROM PUBLISHER]

Cross sectional data from a survey of 2512 men aged 45-49 years were used to examine the confounding effects of heart rate, employment, and ischaemic heart disease (IHD) on the relation between cereal fibre intake and blood pressure. Daily cereal fibre intake (g/day) was associated with systolic pressure (r = -0.053, p less than 0.01), diastolic pressure (r = -0.057, p less than 0.01), and heart rate (r = -0.071, p less than 0.01). The associations were strengthened in employed men and inapparent in unemployed men. Unemployed men had more IHD than employed men. Persons with any manifestation of IHD had significantly higher blood pressure and heart rates but ate less cereal fibre (7.0 v 7.9 g/day, p less than 0.001) than those without IHD, regardless of employment status. In employed men, after adjustment for age, body mass index, prevalent IHD, and heart rate, systolic pressure changed -0.186 mmHg (95% CI = -0.362, -0.009) and diastolic pressure changed -0.111 mmHg (95% CI = 0.228, 0.005) for each gram of cereal fibre eaten daily. The association between cereal fibre and blood pressure was inapparent in unemployed men. Heart rate, employment, and prevalent IHD confound the association between cereal fibre intake and blood pressure. Future work concerning this relationship will have to account for the effects of these variables. [ABSTRACT FROM AUTHOR]

The suitability of an automatic sphygmomanometer for epidemiological work was evaluated in two studies. In the first, blood pressure measurements were made alternately on the automatic machine and on a Hawksley random zero instrument on 14 volunteers on each of four consecutive days by a single medical observer. No significant difference was found between the mean diastolic pressure obtained by each instrument but the mean systolic pressure was 5 mm higher on average on the automatic machine. In the second study, the effect of cuff position for the automatic instrument was examined. Differences between recommended and errant cuff positions of up to 4.5 mmHg were recorded but these did not reach statistical significance. These studies indicate that if used carefully this automatic instrument is suitable for survey and experimental use. [ABSTRACT FROM AUTHOR]

Dietary, social, and constitutional determinants of plasma concentrations of some major risk factors for ischaemic heart disease were investigated in a cross sectional study among 711 men from the general population aged 30-69. For high density lipoprotein cholesterol (HDL-C) six variables were significantly associated with plasma concentrations, and these variables explained 12.6% of the variance. For low density lipoprotein cholesterol (LDL-C), total cholesterol (T-C), and triglyceride 8.4%, 7.5%, and 18.5% of the variance was explained by significantly associated variables. Fibrinogen concentrations determined chemically were significantly associated with age, smoking habit, body mass index, alcohol consumption, and intake of cereal fibre (24.2% variance). These data provide some encouragement for the possibility of dietary intervention to influence plasma concentrations of major risk factors for ischaemic heart disease in men. [ABSTRACT FROM PUBLISHER]

An epidemiological study was carried out among a random sample of women aged 18 to 69 years to examine possible determinants of plasma high density lipoprotein and total cholesterol (HDL-C and T-C). In a multiple regression analysis consumption of alcohol, fatty fish, and parental longevity showed positive associations with HDL-C, which were statistically significant. Smoking habit, sucrose consumption, and a family history of ischaemic heart disease showed significantly negative associations. In contrast, T-C was associated significantly only with age and Quetelet's index of body mass. Five variables having significant associations with HDL-C explained only 8% of the total variance; in the case of T-C 17% of the variance was explained by age and body mass. [ABSTRACT FROM AUTHOR]

Possible aetiological factors for urinary incontinence were examined in a prevalence study among a random sample of 1000 women aged 18 and over. Infective factors were not markedly associated with incontinence but mechanical factors such as parity and obesity were. No association was found, however, between a history of perineal damage at childbirth and incontinence. Women with incontinence had on average a higher score for a 'neuroticism' trait elicited by questionnaire than women without the disorder. [ABSTRACT FROM AUTHOR]

One thousand and sixty women aged 18 or over, randomly selected from a defined geographical area in South Wales, were interviewed at home about their urinary symptoms. Ninety-five per cent co-operated, of whom 45% admitted to some degree of incontinence. "Stress' incontinence was reported by 22% of women, "urge' incontinence by 10%, and both types combined--"complex'--by 14%. In most women urinary loss was both small and infrequent but 5% of all women experienced a loss sufficient to necessitate a change of clothes; in 2.6% such loss occurred daily. Over 3% of all women reported that incontinence interfered with their social or domestic life but only half of these had sought medical advice. [ABSTRACT FROM PUBLISHER]