Dan Garside

Alcohol consumption, cardiovascular risk factors, and mortality in two Chicago epidemiologic studies.

Multivariate analysis of the association at baseline between problem drinking and cardiovascular risk factors among 1,233 white male employees of the Chicago Peoples Gas Company age 40-59 showed the 38 problem drinkers with significantly higher blood pressures and cigarette consumption and significantly lower relative weights than the others. Similar analyses among 1,899 white male employees of the Hawthorne Works of the Western Electric Company in Chicago age 40-55 showed the 117 men consuming 5 or more drinks per day with significantly higher blood pressures and cigarette use than the others. No significant differences were recorded between heavy drinkers and the others in serum cholesterol level. The gas company problem drinkers had significantly higher 15- year mortality rates from all causes, cardiovascular diseases, coronary heart disease, and sudden death. These differences could not be entirely explained by their blood pressure, smoking, and relative weight status. The Western Electric heavy drinkers had increased 10-year mortality rates both for all causes and noncardiovascular causes.

Relationship of education to major risk factors and death from coronary heart disease, cardiovascular diseases and all causes, Findings of three Chicago epidemiologic studies.

The relationship of education to risk factors at baseline and to long‐term mortality from coronary heart disease (CHD), cardiovascular diseases (CVD), and all causes was analyzed for three cohorts of middle‐aged employed white men in Chicago: 8047 from the Chicago Heart Association Detection Project in Industry (CHA) (entry 1967‐1973), 1250 from the Peoples Gas Company Study (PG) (entry 1958-1959) and 1730 from the Western Electric Study (WE) (entry 1957-1958). Each man was classified into one of four groups: not a high school graduate, high school graduate, some college but not a graduate, or college graduate. For all three cohorts, a graded, inverse association was observed at baseline between education and blood pressure, which was statistically significant for CHA and WE men and independent of age and relative weight. For all three cohorts, a significant, graded, inverse association was also recorded between education and cigarette use at entry. For serum cholesterol, no clear pattern was observed for the education groups in any of the three cohorts. CHA men showed a graded, inverse relationship between education and relative weight. This cohort was the only one of three showing a significant, graded inverse association between education and prevalence of ECG abnormalities at entry. For this CHA cohort, 5-year follow-up data showed a statistically significant, graded, inverse relationship between education and ageadjusted mortality rates from CHD, CVD and all causes. With adjustment for entry age, diastolic pressure, cigarettes, serum cholesterol, relative weight and ECG abnormalities, this inverse relationship remainedreduced in degree, but still statistically significant for CVD mortality. Similarly, for the pooled PG-WE cohort of 2980 with 20-21 years of follow-up, education and the three mortality end points were inversely related but not graded, with statistical significance for all three end points in the univariate analyses. The results of these studies indicate inverse relationships between education and lifestyle-related risk factors at baseline and between education and long-term risk of CHD, CVD and all-causes mortality. The inverse relationship between education and mortality is accounted for in part by the established major biomedical risk factors.

Alcohol consumption and 17-year mortality in the Chicago Western Electric Company study

Abstract The association between baseline alcohol intake and mortality from all causes and specific causes based on 17 years of follow-up experience was analyzed for 1,832 white males originally age 40–55 from the Chicago Western Electric Company study. Alcohol consumption was expressed as number of drinks per day for all intake combined, including hard liquor, beer, and wine, based on the maximum intake reported on three questionnaires. With mortality rates adjusted only for age, total intake was associated with increased risk of death from all causes, the cardiovascular diseases, coronary heart disease, cancer, and other causes at the level of six or more drinks per day. There was no increase in mortality with increasing alcohol consumption below this level. Only the associations between alcohol intake and death from the cardiovascular diseases and coronary heart disease failed to persist after adjustment for other risk factors, such as smoking and blood pressure. When the deaths were divided into those occurring within the first 10 years of follow-up and those occurring more than 10 years after entry, the association between baseline alcohol intake and mortality was generally stronger for those deaths occurring more than 10 years after entry.

DIETARY CHOLESTEROL, FAT, AND FIBRE, AND COLON-CANCER MORTALITY: An Analysis of International Data

It has been suggested that high fat, high cholesterol, and low fibre intakes play a role in the causation of colon cancer, but since they are highly intercorrelated, it is difficult to determine which (if any) variable is truly related to colon cancer. Food disappearance data for 1954--65 and mortality data for 1967--73 from 20 industrialised countries were used to assess which variables are independently related to colon cancer. Simple correlation analysis indicated that intake of total fat, saturated fat, monounsaturated fat, cholesterol, and fibres are each highly correlated with mortality-rate for colon cancer. The partial correlation of dietary cholesterol with colon cancer remains highly significant when fat or fibre is controlled. However, the partial correlations of fat or of fibre iwth colon cancer are no longer significant when cholesterol is controlled. Cross-classification showed a highly signficant main effect for cholesterol, but nor for fat or fibre. The findings support the possibility of a causal relationship between cholesterol intake and colon cancer.

Trends in mortality from cerebrovascular diseases in the United States, 1960 to 1975.

A long-term decline in death rates from cerebrovascular diseases in the United States accelerated in 1969, with a further increase in the rate of decline after 1972. This break in the pattern of the mortality curve for stroke was observed in all 4 major sex-color groups, and affected all age groups in which a significant number of stroke deaths occur. The decline for non-whites was relatively and absolutely greater than for the comparable white sex. If the 1960 rates had persisted in 1975, 87,600 more lives would have been lost to cerebrovascular diseases. Although there are no data documenting a declining prevalence of hypertension in the population, detection, treatment and control of hypertension have improved markedly over recent years. A concomitant decrease in the severity of epidemic respiratory infection may have contributed to the improvement in recorded death rates from stroke. Mortality from all major cardiovascular diseases has demonstrated a parallel downward trend. Continued emphasis on public health efforts to detect and treat hypertension and other known cardiovascular risk factors can be expected to result in further improvement in cardiovascular mortality.

The decline in mortality from Coronary Heart Disease, U.S.A., 1968–1975

Abstract Mortality rates from Coronary Heart Disease (CHD) in the U.S. declined significantly during the period 1968–1975. An improvement in mortality from this cause was recorded for each of the four sex-color groups, the trend being relatively more favorable for nonwhites. Age-adjusted rates for the population as a whole fell 19%, with even greater declines recorded for persons 35–74 yr of age. Total cardiovascular and All Causes death rates also improved markedly. The observed downturn in CHD beginning in 1968 represents a clear departure from the pattern of that disease since 1940.

Independent contribution of electrocardiographic abnormalities to risk of death from coronary heart disease, cardiovascular diseases and all causes. Findings of three Chicago epidemiologic studies.

The importance of major and minor ECG abnormalities at baseline for subsequent risk of death from coronary heart disease, cardiovascular diseases and all causes was analyzed for middle-aged white men from the Chicago Peoples Gas Company, Chicago Western Electric Company and Chicago Heart Association Detection Project in Industry studies. Univariate analysis showed that in all three studies, men with major ECG abnormalities had death rates considerably higher than those with normal ECGs. When baseline age, diastolic pressure, serum cholesterol, relative weight and number of cigarettes per day were taken into consideration in multivariate analysis, ECG abnormalities retained significant relationship to the three death end points. Findings from the Chicago Western Electric Company and Chicago Heart Association studies showed independent relationship between minor ECG abnormalities and the three death end points. In the Chicago Peoples Gas Company (20-year follow-up) and in the Chicago Western Electric Company (17-year follow-up), when the deaths were divided into those that occurred within the first 10 years of follow-up and those that occurred more than 10 years after entry, the association between ECG abnormalities and mortality held for both the first and second decades of follow-up. Overall, findings from this study demonstrate an independent relationship between ECG abnormalities and death from coronary heart disease, cardiovascular disease and all causes.

Measures of Adiposity and Coronary Heart Disease Mortality in the Chicago Western Electric Company Study

Associations of body mass index (BMI), two measures of percent body fat derived from skinfolds, body weight adjusted for height, triceps and subscapular skinfolds, and their sum, with 22-year coronary heart disease (CHD) mortality were compared in 1707 white men ages 40-55 years at baseline (1958) and free of CHD and cancer in 1961 in the Western Electric Study. Because associations of adiposity measures with CHD mortality differed by length of follow-up, analyses were conducted separately for the first 14 years of follow-up and years 15 through 22. In Cox regression analyses, none of the adiposity measures was significantly related to CHD mortality for the first 14 years of follow-up. For years 15-22, all adiposity measures, except triceps skinfold, were significantly related with adjustment for age, as well as eight other covariates. These results indicate that a positive relation of adiposity to CHD risk may not become apparent until several years after the assessment of adiposity.

Relationship of glucose tolerance to prevalence of ECG abnormalities and to 5-year mortality from cardiovascular disease: Findings of the Chicago Heart Association Detection Project in Industry

Abstract Among the 40,000 employed men and women screened in Chicago industry, 7841 white men age 40–59 formed the cohort studied to determine significance of asymptomatic hyperglycemia for coronary disease. In cross-sectional analysis of frequency of ECG abnormalities, those in the upper 2 1 2 % of the glucose distribution had higher rates of such abnormalities than the rest of the group, and men in the highest quintile likewise had higher rates of ECG abnormalities than were seen in the lowest quintile. Analysis of these data using the multiple logistic showed inconsistent positive association of glucose with prevalence of ECG abnormalities defined by the Whitehall and Pooling Project criteria, but no association with definite MI, on ECG. In 5-yr mortality follow-up, while men with overt diabetes experienced coronary death rates 2–3 times higher than those without such a diagnosis, similar univariate analysis that excluded diagnosed diabetics showed no association between glucose level and coronary mortality. In multivariate analysis as well, no association between initial glucose and subsequent coronary or cardiovascular mortality was seen, although all causes mortality rates were significantly related to glucose levels. The inconsistent results between univariate and multivariate analyses, as well as between cross-sectional and prospective findings, do not support a conclusion that asymptomatic hyperglycemia is a major coronary risk factor.

Demographic Adjustments for the Spanish Version of the WAIS-III

The Spanish version of the third edition of the Wechsler Adult Intelligence Scale (WAIS-III) by TEA Ediciones is an excellent addition to available instruments for Spanish speakers. The Spanish norms function similarly to US norms for individuals aged 16-35. The norms become increasingly different for individuals 35 and older, seemingly because of the lower levels of formal education of the older Spanish cohorts. Using data from a random half of the Spanish sample, the authors developed regression equations to adjust the scaled scores for individuals with a low level of education. The adjustment is made to the level that would have been expected if the individual had 12 years of education, the median level of education of the US norms. The article includes the methodology and values necessary to make the adjustments. The scaled scores were then adjusted for individuals on the second random half of the Spanish sample and compared to the United States norms. The results showed the adjustments succeed in bringing the Spanish norms closer to the US norms.