Lucile L. Adams-Campbell

A comparison between BMI and Conicity index on predicting coronary heart disease: the Framingham Heart Study.

PURPOSE This study examined the relationship of mortality and morbidity of coronary heart disease with body mass index (BMI) and Conicity index (CI). METHODS Among 5209 Framingham Heart Study participants, 1882 men and 2373 women had waist and weight measurement at the 4th examination period and height measured on the 5th visit. These were used for BMI and CI. RESULTS During a 24-year follow-up, 597 men and 468 women developed CHD and 248 men and 150 women died from CHD associated causes. In men the relative risks (RR) (95% confidence interval) adjusted for age, hypertension, diabetes, smoking status, and total cholesterol for CHD incidence in 2nd, 3rd, and 4th quartiles of BMI were 1.28 (1.0, 1.65), 1.45 (1.13, 1.86), and 1.53 (1.19, 1.96). The RR for CHD incidence in the 4th quartile of BMI in women was 1.56 (1.16, 2.08). No CI quartiles were risk factors for CHD incidence. There was 86% higher risk of CHD related death in the 4th quartile of BMI than the 1st quartile of BMI in women. In men no significantly higher risks of death were found across the quartiles of BMI. No associations were found between CI quartiles and CHD mortality. CONCLUSIONS Obesity as measured by BMI is an important risk factor for CHD incidence in men and women and for CHD mortality in women. CI was not associated with an increase in CHD incidence or mortality. Thus, BMI is a better marker than CI for predicting CHD incidence and mortality.

Addictive behaviors and depression among african americans residing in a public housing community

Numerous studies have indicated that there is an association between cigarette smoking, alcohol use, and depression. However, little attention has been devoted to understanding how demographic factors, such as socioeconomic status and ethnicity, influence these relationships. To address this gap in the literature, cigarette and alcohol use were examined in a sample of African Americans from an urban area. A single public-housing community in Washington, DC was selected for complete ascertainment of the adult population. A total of 126 African American subjects were recruited. Semi-structured interviews were conducted to assess depressive symptoms and to characterize cigarette and alcohol use patterns. Cigarette smoking was not related to the severity of depressive symptoms. By contrast, increased symptoms of depression were related to alcohol use patterns. Light drinkers had a mean score of 5.77 on the Centers for Epidemiologic Studies Depression Scale, compared to a mean of 8.30 for abstainers and 10.07 for heavy drinkers (F = 4.968, p < .003). An analysis of patterns of substance use revealed that subjects were more likely to either abstain from both substances (30.2%) or to use both substances (32.5%) (chi2 = 8.516, df = 1. p < .004). It is unclear which specific processes work to link alcohol use and depressive symptoms in this group of urban African Americans from a low-income community. What is clear is that alcohol use is clearly related to depressive symptoms in the sample. It is hypothesized that both self-medicating processes and substance-induced depressive symptoms may be responsible for these findings. Important factors to consider in developing effective intervention programs that target this specific population are discussed.

Environmental influences, employment status, and religious activity predict current cigarette smoking in the elderly

The objective of this study was to describe the smoking histories, patterns of cigarette use, and quitting behaviors in a predominantly African American sample of older adults. Study participants were a convenience sample of senior center attendees in the Washington, DC metropolitan area. Self-report questionnaires were used to measure depression, nicotine dependence, smoking motives, and readiness to quit. Results showed that living with another smoker increased the likelihood of current smoking (odds ratio = 2.07, 95% CI = 1.72-36.73). Being employed or seeking work was also associated with a higher likelihood of current smoking (odds ratio = 2.73, 95% CI = 2.00-118.76). Subjects who reported less frequent participation in organized religious activities were also more likely to smoke (odds ratio = 2.04, 95% CI = 1.17-50.38). Both former and current smokers identified personal will power and physician advice as the two most influential factors in successful smoking cessation. However, current smokers believed that nicotine replacement would aid in a successful cessation attempt, while former smokers did not endorse the efficacy of these products. The findings are discussed in terms of implications for intervention.

Plasma lipid alterations in African-American women with breast cancer

Abstract The purpose of this study was to examine the relationship between plasma lipid and lipoprotein levels, stage of disease and breast cancer risk in African-American women. The study population comprised 163 African-American women: patients (n= 58) and controls (n= 105), with mean ages of 57.2 years and 47.7 years respectively. Approximately 71% and 56% of the women with breast cancer and the control population, respectively, were postmenopausal. Those with cancer had significantly higher education levels, P≤ 0.01, and higher triglyceride levels compared to the controls, P≤ 0.001, but lower body mass index (BMI) levels, P≤ 0.01. There were no statistically significant differences observed in total cholesterol, high-density-lipoprotein-containing cholesterol and low-density-lipoprotein-containing cholesterol between the patients and controls. After adjustments for age, education, BMI, and menopausal status, triglycerides remained significantly and positively associated with breast cancer risk. The significant correlation between the high levels of triglycerides and breast cancer risk (odds ratio = 5.12) may be attributed to differences in lipid metabolism between the women with breast cancer and controls, or to the consequences of breast cancer.

Obesity and hypertension among college-educated black women in the United States

It is established that obesity is an important risk factor for hypertension, but there is little information on this relationship among highly educated black women. We assessed the relationship of body mass index (weight (kg)/height2 (m)) to prevalent hypertension among US black women who had completed college, and among less educated women as well. The data were collected in 1995 in the Black Women’s Health Study: 64530 African–American women aged 21 to 69 years enrolled by completing mailed health questionnaires; 44% of the participants had completed college. We compared the 9394 participants who reported a diagnosis of hypertension treated with a diuretic or antihypertensive drug (cases) with 9259 participants of similar ages who did not have hypertension (controls). Multivariate odds ratios were estimated by logistic regression. The odds ratio for treated hypertension increased with increasing body mass index at every educational level. Among college-educated women, the odds ratio for hypertension was 2.7 for overweight women (index 27.3–32.3) and 4.9 for severely overweight women (index ⩾32.3), relative to women with a body mass index <22.8. the prevalences of obesity and hypertension were high among the college-educated women, although not as high as among women with fewer years of education. about a quarter of the difference in the prevalence of hypertension across educational levels was explained by the difference in the proportions who were overweight or severely overweight. these results document a high prevalence of obesity and hypertension, and a strong association of obesity with hypertension, among highly educated us black women.

Anthropometric determinants of risk factors in an African American population

This study assessed the association of biological markers, including cholesterol, HDL, LDL, triglycerides, ApoA‐1, and ApoB, with estimates of the body composition, including the conicity index (CI), BMI, bioelectrical impedance analysis, and the waist‐to‐hip ratio (WHR). One hundred‐twenty‐six African American adults (43‐males, 83‐females) from a public housing community in the District of Columbia were recruited. Females were four times more likely to be obese than were males. Among the four anthropometric indicators, the WHR was the best method to explain the variances in biological markers, including cholesterol and ApoB levels in females. The CI showed relationships with log triglyceride levels in females, while percentage body fat (%BF) explained the variances of log HDL and log ApoA‐1 in males. For cholesterol, log triglycerides and ApoB, mean values were positively associated with tertiles of the WHR, whereas mean values of log HDL and log ApoA‐1 were negatively associated with tertiles of %BF. The WHR and CI, indicators of relative body fat distribution, are more related to risk factors for CVD and diabetes among females than is the BMI. Am. J. Hum. Biol. 10:249–258, 1998.

Factors Influencing Patient Survival in a Group of Men with Prostate Cancer in Yaoundé, Cameroon

Purpose: We evaluated the survival time of patients with stage D cancer of the prostate (CaP) in Yaounde, Cameroon, so as to lay the groundwork for evaluating patient management and outcomes in such communities in sub-Saharan Africa. Patients and Materials: A cohort of 200 patients was recruited at diagnosis and followed over a 171 month period. They had a standard work-up and staging protocol except for the absence of bone scan. Treatment was offered after they were staged following the Whitemore ABCD-system. Standard statistical analysis was performed for quantitative variables and graphs developed for continuous variables. Pearson correlation and Chi-square tests were used to evaluate associations between variables. The Kaplan-Meier product-limit method was used to estimate survival functions and log-rank test to compare data from complete survival curves. The statistical significance level was fixed at p values less than or equal to 0.05. Results: The mean age of our patients was 67 years and 41.5% of...