Egon Riss

The incidence of hypertension and associated factors: The Israel ischemic heart disease study☆

Abstract In a study of male Israeli civil service workers, five-year incidence rates of hypertension (using the WHO definition) were found to increase with age and were higher for European-born subjects. Data are presented in support of a hypothesis that the size of the family group living together is inversely related to the risk of developing hypertension. Other factors found associated (at p

Blood Groups, Myocardial Infarction and Angina Pectoris among 10,000 Adult Males

Abstract A five-year prospective investigation of 10,000 Israeli male government employees 40 years of age and over was conducted as part of the Israeli Ischemic Heart Disease Project. The six areas of birth represented were Eastern Europe, Central Europe, Southeastern Europe, Israel, Asia, and North Africa. Subjects with blood Groups A1, B, and A1B tended to have higher incidence rates of myocardial infarction than those with other blood groups. High rates were also noted in A1 and B subjects for angina pectoris. Subjects in blood Group O tended to have lower rates of infarction and angina pectoris than those of other groups, but the differences were not significant. Among the Rhesus, MN, Kell, Duffy and Kidd blood groups, subjects with Kidd negative (JKa-) had the highest rates for both myocardial infarction and angina pectoris. When this group was added to the ABO system, the combinations of A1Jka-, BJka- and, particularly, A1BJka-, had very high incidence rates.

Myocardial infarction over a five-year period—I. Prevalence, incidence and mortality experience☆

Abstract A 5-yr (1963–1968) follow-up of 10,059 male government and municipal employees of Israel aged 40 and over, divided into six regions of birth—Central Europe, Eastern Europe, Southeastern Europe, North Africa, Middle East and Israel—was completed. In the first survey (1963), 86.2 per cent of the invited sample participated in the examination. They were re-examined in 1965 and 1968, with 98 per cent of the original respondents participating in the final examination. There was complete coverage in respect of knowing whether the subjects were alive or dead. The results revealed a significant variation between the birth-areas in respect of age-adjusted prevalence and incidence rates of myocardial infarction as well as total mortality for all causes. The infarct incidence rates were higher in the first generation Israelis than in immigrants from the same areas of origin, but were substantially lower for second generation subjects. The age-adjusted annual myocardial infarction rate of 8.7 1000 at risk, places this study population among the highest in the world. In contrast to this, the case-fatality rate of 15.9 per cent after an average period of 2.5 yr of observation is one of the lowest in the world and contrasts markedly with many international studies which report higher figures for deaths within 1 hr after onset of symptoms. One of the possible reasons for this apparent anomaly might be the fact that 39.8 per cent of the 427 first myocardial infarcts were of the ‘silent’ type. The latter seem to have a lower mortality experience than the clinically recognized infarcts.

Factors related to diabetes incidence: a multivariate analysis of two years observation on 10,000 men. The Israel Ischemic Heart Disease study.

Abstract The 2-yr incidence of diabetes (131 cases) among 8369 Israeli men is related to area of birth and 15 other variables using a multiple logistic risk function. The variables found to be most strongly related to diabetes incidence are age, wt ht ratio and the presence of peripheral vascular disease or intermittent claudication. Also related to diabetes incidence were: cholesterol, education (negative relationship), being born in Eastern Europe (negative relationship) and being born in Africa. The model predicts markedly increased risk of diabetes incidence for persons with increased wt ht ratio and presence of peripheral vascular disease or intermittent claudication. The failure to find a relationship between the presence of ischemic heart disease and diabetes incidence suggests that the well known association between these two diseases lie only in the direction of increased risk of IHD for diabetics. None of the food variables studied was related to diabetes incidence. Other variables found unrelated to diabetes incidence in our study were diastolic blood pressure, uric acid, non-specific T-wave and an anxiety index.

Diabetes Prevalence and Serum Uric Acid: Observations among 10,000 Men in a Survey of Ischemic Heart Disease in Israel

In 1963 a long-term incidence study of ischemic heart disease and hypertension was initiated in Israel. A total of 10,059 Jewish men over forty years of age in government service were surveyed. The initial examination included a medical history and determinations of blood sugar, cholesterol,and uric acid. There were 682 men designated as diabetic suspects, because of either a history of diabetes or a casual blood sugar value of at least 130 mg. or both. Results of previous glucose tolerance tests, fasting blood sugar estimates, and information about treatment were obtained from physicians and clinics, or a glucose tolerance test was done at the survey laboratory. For forty-three men not enough information was obtained to decide whether they actually had diabetes. Seventy-nine men were not diabetic, and sixty-two others were not diabetic but had abnormal glucose tolerance tests. The remaining 498 men were classified as diabetic, and of these 296 had a history of the disease and 202 were newly discovered in the survey. The prevalence of diabetes was directly related to age. When rates were standardized for age, however, men born in the Middle East, North Africa and Israel had 50 per cent more diabetes than the men born in Europe. Also, there was an association between the prevalence of newly discovereddiabetes and body mass. But this was observed in only one group with respect to prevalence of previously diagnosed diabetics (Middle East-North Africa). Similarly, serum cholesterol was found to have a direct relation to prevalence of newly discovered diabetes, but this association was not established with certainty in respect to the prevalence of previously diagnosed diabetes. A highly significant inverse relation was observed between diabetes and serum uric acid. Serum uric acid values were lower among men with a history of diabetes than those with newly discovered disease. Both groups had values significantly lower than those of the rest of the survey population, however. Men without diabetes but with slightly abnormal glucose tolerance tests had values similar to those of the nondiabetic subjects. It seemed probable that the lower values accompanied rather than preceded the disease. Possible mechanisms causing increased uric acid excretion in diabetes are discucoed.

ASSOCIATION BETWEEN BLOOD-PRESSURE AND PEPTIC-ULCER INCIDENCE

Abstract A strong inverse highly significant association between peptic ulcer and blood-pressure has been demonstrated in an adult male population aged 40-49. This association holds with both the prevalence and incidence of peptic ulcer and was observed in each of the six areas of birth-groups into which the study population is divided. The association is stronger for diastolic than for systolic blood-pressure and is not removed by adjustment for the weight/height ratio. A weaker negative association was found at older ages, but this could easily have been due to chance.

Diabetes Incidence: A Two-year Follow-up of 10,000 Men in a Survey of Ischemic Heart Disease in Israel

In 1963, 10,059 men aged forty years and over were examined in an I.H.D. survey and 9,711 of them were re-examined two years later. At both these examinations suspect diabetics werescreened out by a casual blood glucose value and/or a positive history of diabetes. Further information was collected on all these suspect diabetics to enable their classification into diabetic categories using similar criteria on both occasions. Among 9,079 persons judged at risk of developing diabetes, 144 new cases of diabetes were discovered two years after the 1963 examination. The over-all two-year incidence rate for men over forty was 15.5 per thousand. Four regions of origin, Central Europe, Southeastern Europe, Israel and North Africa had incidence rates approximately equal to the over-all rate. The age adjusted incidence rate for men from Eastern Europe was lower (8.5 per 1,000) and from the Middle East higher (20.3 per 1,000) than the average.