Search

The relationship of oats and buckwheat intake to cardiovascular disease risk factors was studied in 850 Yi people, an ethnic minority in southwest China. Blood pressure was measured on 3 consecutive days. Serum total cholesterol, high-density-lipoprotein (HDL) cholesterol, and triglycerides were measured after a 14-h fast. Oats and buckwheat intakes were assessed by questionnaire. In multiple-regression analysis, oats intake (100 g/d) was associated with lower body mass index (-0.25, in kg/[m.sup.2]; P < 0.05), systolic (-3.1 mm Hg, P < 0.001) and diastolic (-1.3 mm Hg, P < 0.01) blood pressure, and HDL cholesterol (-0.13 mmol/L, P < 0.001). Buckwheat intake (100 g/d) was associated with lower serum total cholesterol (-0.07 mmol/L, P < 0.01) and low-density-lipoprotein cholesterol (-0.06 mmol/L, P < 0.05) and a higher ratio of RDL to total cholesterol (0.01, P < 0.05). These findings suggest a role for oats and buckwheat consumption in the prevention and treatment of both hypertension and hypercholesterolemia.

Backgraound: The association of lipoprotein levels with cardiovascular disease (CVD) is less well understood in women than in men. To better characterize any relationships, associations between CVD death and total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol and triglyceride levels in women were explored using data from female participants in the Lipid Research Clinics' Follow-up Study. Methods: Using a sample of 1405 women aged 50 to 69 years from the Lipid Research Clinics' Follow-up Study, age-adjusted CVD death rates and summary relative risk (RR) estimates by categories of lipid and lipoprotein levels were calculated. Multivariate analysis was performed to provide RR estimates adjusted for other CVD risk factors. Results: Average follow-up was 14 years. High-density lipoprotein and triglyceride levels were strong predictors of CVD death in age-adjusted and multivariate analyses. Low-density lipoprotein and total cholesterol levels were poorer predictors of CVD mortality. After adjustment for other CVD risk factors, HDL levels less than 1.30 mmol/L (50 mg/dL) were strongly associated with cardiovascular mortality (RR=1.74; 95% confidence interval [CI], 1.10 to 2.75). Triglyceride levels were associated with increased CVD mortality at levels of 2.25 to 4.49 mmol/L (200 to 399mg/dL)(RR=1.65;95% CI,0.99to2.77)and4.50mmol/L (400 mg/dL) or greater (RR=3.44; 95% CI, 1.65 to 7.20). At total cholesterol levels of 5.20 mmol/L (200 mg/dL) or greater and at all levels of LDL and triglycerides, women with HDL levels of less than 1.30 mmol/L (

Objective: To examine associations between demographic characteristics and use of interventional procedures in patients with peripheral arterial disease. Design: Case series drawn from a statewide hospital discharge database. Setting: Nonfederal acute-care hospitals in Maryland. Patients and Interventions: A total of 7080 cases of angioplasty, bypass surgery, or amputation for lower-extremity peripheral arterial disease in 1988 through 1989. Main Outcome Measure: Use of angioplasty, bypass surgery, and lower-extremity amputation. Results: A total of 1185 angioplasties, 4005 bypass operations, and 1890 amputations were identified. Population-based annual rates showed that angioplasty use peaked at about 70 per 100 000 at the age of 65 to 74 years, bypass surgery use peaked at more than 250 per 100 000 at 75 to 84 years of age, and amputation use peaked at about 225 per 100 000 at 85 years of age and older. The age-adjusted likelihood of having a procedure for peripheral arterial disease was 1.7 times higher in men than in women and 1.6 times higher in blacks than in whites. Compared with patients who had angioplasty or bypass surgery, patients who had amputations were more likely to be more than 65 years old, to be black (odds ratio, 2.5), to have Medicaid or no insurance (odds ratio, 1.7), to have diabetes mellitus (odds ratio, 3.0), and not to have hypertension (odds ratio, 3.1). Compared with patients who had bypass surgery, patients who had angioplasty were more likely to be under 65 years old, to be white (odds ratio, 1.7), and not to have diabetes mellitus (odds ratio, 1.3). Conclusion: Patient race is associated with differences in the frequency with which angioplasty, bypass surgery, and amputation are performed for peripheral arterial disease, and insurance status is associated with the likelihood of having amputation.

Blacks in the US have a rate of treated end-stage renal disease (ESRD; irreversible kidney failure) that is almost four times as high as the rate for whites; the racial difference is most striking for kidney failure associated with high blood pressure, or hypertension (HT-ESRD). To evaluate to what extent the association between race and HT-ESRD is independent of other risk factors for ESRD that may be more prevalent among blacks, a prospective analysis was carried out of newly identified HT-ESRD cases listed in a regional registry (in Maryland). Risk factors for the patients were calculated from population-based surveys. During the six-year study period, 534 patients with HT-ESRD were entered into the registry. In all age- and sex-specific subgroups, the incidence of the disease was higher among blacks than among whites (from 4 to 14 times higher). Overall, blacks had a sevenfold higher incidence than whites. Blacks in all subgroups also had higher incidences of hypertension than whites. Although blacks had a higher prevalence of other risk factors for HT-ESRD (hypertension, severe hypertension, diabetes, low socioeconomic level, smoking), there was considerable overlap between white and black subgroups. When the contribution of all other risk factors besides race (including hypertension) was controlled in the statistical analysis, blacks still had a risk of HT-ESRD that was four and one half times that of whites. It is possible that blacks are more susceptible to the development of kidney disease; other risk factors, including socioeconomic status, cannot account for the increased rate of disease among this group. (Consumer Summary produced by Reliance Medical Information, Inc.)

The effect of screening for elevated cholesterol levels and compliance with or adherence to follow-up recommendations were assessed in 375 subjects who attended a free screening program at a shopping mall walk-in clinic. Cholesterol levels were normal in 139 subjects, borderline in 135 subjects, and high in 101 subjects. Subjects with borderline and high cholesterol levels were instructed to consult with their physicians within two months to confirm their cholesterol measurements. Of 338 subjects responding to a questionnaire at three months follow-up, eight subjects with normal levels, 23 subjects with borderline levels, and 44 subjects with high levels had visited a physician for assessment of their cholesterol levels since the screening. The factors associated with visiting a physician were: category of cholesterol level at the time of screening; use of medication to lower blood pressure; history of disease of the coronary arteries, the major blood vessels supplying the heart; and history of high cholesterol levels. These findings suggest that labeling or classification of a person as being at high rather than borderline risk leads to a greater likelihood that the person will follow-up with a physician. (Consumer Summary produced by Reliance Medical Information, Inc.)

Background: Little is known about the regular source of care (RSOC) among physicians, a group whose self-care may reflect the attitudes and recommendations they convey to their patients. Methods: We performed a cohort study of physicians who graduated from the Johns Hopkins School of Medicine from 1948 through 1964 to identify predictors of not having an RSOC, and to determine whether not having an RSOC was associated with subsequent receipt of preventive services. The RSOC was assessed in a 1991 survey; use of cancer screening tests and the influenza vaccine was assessed in 1997. Results: The response rate in 1991 was 77% (915 respondents); 35% (312) had no RSOC. Internists (odds ratio [OR], 3.26; 95% confidence interval [CI], 1.58-6.74), surgeons (OR, 2.42; 95% CI, 1.17-5.02), and pathologists (OR, 5.46; 95% CI, 2.09-14.29) were significantly more likely to not have an RSOC than pediatricians. Not having an RSOC was inversely related to the belief that health is determined by health professionals (OR, 0.45; 95% CI, 0.29-0.68) and directly related to the belief that chance (OR, 1.90; 95% CI, 1.28-2.82) determines health. Not having an RSOC in 1991 predicted not being screened for breast, colon, and prostate cancer, as well as not receiving an influenza vaccine at 6 years of follow-up. Conclusions: A large percentage of physicians in our sample had no RSOC, and this was associated with both medical specialty and beliefs about control of health outcomes. Not having an RSOC was significantly associated with failure to use preventive services several years later.