Ethnicity and other characteristics predictive of coronary heart disease in a developing community: principal results of the St James Survey, Trinidad

A ten-year community survey was undertaken to investigate the high coronary heart disease (CHD) incidence among people of Indian (South Asian) descent in Trinidad, West Indies. Of 2491 individuals aged 35-69 years, 2215 (89%) were examined and 2069 (83%) found to be clinically free of CHD at baseline. After exclusion of 71 of minority ethnic groups, 786 African, 598 Indian, 147 European and 467 adults of Mixed descent were followed for CHD morbidity and mortality. In both sexes, adults of Indian origin had higher prevalence rates of diabetes mellitus, a low concentration of high-density lipoprotein (HDL) cholesterol, and recent abstinence from alcohol than other ethnic groups. Indian men also had larger skinfold thicknesses than other men. In participants free of CHD at entry, the age-adjusted relative risk of a cardiac event believed due to CHD was at least twice as high in Indian men and women as in other ethnic groups. In men, blood pressure, diabetes mellitus and low-density lipoprotein (LDL) cholesterol concentration were positively and independently related to risk of CHD, whereas alcohol consumption and HDL cholesterol concentration were inversely associated with risk after allowing for age and ethnic group. The ethnic contrasts in CHD persisted when these characteristics were taken into account. In the smaller sample of women, only ethnic group was predictive of CHD as defined. The failure of point estimates of risk to explain the high CHD incidence in Indians calls for focus on age of onset of risk and examination of other potential risk factors such as insulin concentration.     

Variation in coronary risk factor levels of men and women between the German-speaking MONICA centres

The aim of this analysis was to compare levels of risk factors for coronary heart disease (CHD) in men and women aged 25-64 years between German-speaking MONICA collaborating centres, the German Democratic Republic (GDR), Augsburg - the Federal Republic of Germany (FRG)(Au), Bremen - FRG (Br), Heidelberg - FRG (He), and Vaud/Fribourg - Switzerland (CH, with a German-speaking minority). Prevalence of cigarette smoking in men showed little variation in four centres (34 to 40%) and was higher in BR men (49%), while it varied from 17% (GDR) to 33% (BR) in women. Mean total serum cholesterol values (mmol/L) were highest in GDR and CH men (both 6.2) and GDR women (6.1), and lowest in both He men (5.7) and He women (5.6). The proportion with cholesterol values greater than or equal to 6.7 mmol/L was largest in CH men (34%) and smallest in FRG (He) women (17%), while lowering the cut-off point from 6.7 to 6.5 mmol/L raised the prevalence of hypercholesterolaemia in all centres by 5 to 10%. Mean values (mmHg) of blood pressure (BP) were highest in both GDR men (140/88) and women (138/86), as was the prevalence of hypertensive BP values. In all centres, women aged 25-34 had BP values approximately 12/5 mmHg lower than age-matched men, but BP values similar to men at age 55-64, which indicates that age-parallel increase in BP was steeper in women than men.(ABSTRACT TRUNCATED AT 250 WORDS)     

Coronary heart disease risk factors in dutch schoolchildren—results of a pilot-study

This paper summarizes reasons for primary prevention of CHD in childhood. The results of a pilot study, concerning the feasibility of studying CHD risk factors in a large number of schoolchildren and the prevalence of obesity and hypercholesterolemia in these children, are reported. Of the original population, aged 4–13 years, 1003 children, or 88%, participated in the study. The prevalence of frank obesity, based on the measurement of three skinfold thicknesses, was 5% in boys and 7% in girls. The mean serum cholesterol concentration, which was determined by the Abell-Kendall method, was slightly, but statistically significantly, higher in girls (180 ± 30 mg/100 ml) than in boys (176 ± 30 mg/100 ml). The serum cholesterol level was positively related to age in both sexes. Serum cholesterol levels exceeding 200 mg/100 ml were present in 24% of all examined schoolchildren. A significant relationship between serum cholesterol and skinfold thicknesses was not observed. The high prevalence of obesity and hypercholesterolemia in these Dutch schoolchildren warrants the need for future studies, designed to elucidate the relationship between these risk factors and their determinants.     

北京市城区人群血脂异常的分布和相关因素分析

目的 分析血脂异常在北京市人群中的分布情况，方法 横断面调查法调查北京市城区12391例成人血脂水平，分析低HDLC，高LDLC，高TC，高TG的年龄性别分布，与糖尿病，高血压，肥胖的关系，并用非条件多元Logistic回归分析与其相关的危险因素。结果 血脂异常在人群中有相当高的发生率，并呈低龄化的趋势，男性发生率增高的年龄段在30-40岁，女性在40-50岁之间，50岁以前，男性发生率高于女性；50岁后，女性的发生率显高于累性，血脂异常也常常与其他心血管危险因素合并存在，以与肥胖，高血压的聚集尤为突出，分析与血脂异常相关的因素发现，除高LDLC和高TC外，低HDLC和高TG均与肥胖，吸烟量呈正相关，而与体育运动呈负相关，结论 血脂异常的防治十分紧迫，人群防治措施可根据分布特点而实施，增加体育运动，减轻体重对降低血脂异常有十分重要的意义。     

2002年上海市部分居民血脂现况分析

[目的]通过了解居民血脂异常、胆固醇边缘升高、高胆固醇血症、高三酰甘油血症、低密度脂蛋白血症和混合型高脂血症的现患率,为进一步研究和制订预防控制血脂异常发生的策略提供科学依据。[方法]采用分层多阶段整群随机的方法调查上海地区居民血脂现况,并根据卫生部血脂异常标准进行判断和评价。[结果]①上海居民血脂异常率为11.96%,其中男性为12.85%,女性为11.12%,市区为11.79%,郊区为12.29%,血脂异常患病率随年龄的上升而增高,除市区女性最高在60岁~年龄组外,市区男性和郊区男女组最高均在40岁~年龄组;②胆固醇边缘增高现患率2.88%,女性高于男性,市区高于郊区,市区男性30岁~和60岁~年龄组无差异;③不同类型血脂异常现患率分别为:高胆固醇血症2.47%(女性高于男性、市区高于郊区,以60岁~年龄组占比例大),高三酰甘油血症5.74%(市区高于郊区,以40岁~、60岁~年龄组占比例大),低密度脂蛋白血症5.35%(郊区高于市区),混合型高脂血症1.32%(以60岁~年龄组占比例大)。[结论]上海居民血脂异常率为11.96%,男女性别和市、郊两地间差别不大,现患率随年龄的上升而增高,主要以40岁~年龄组发病居多;市区男性中青年胆固醇边缘增高现患率呈现明显上升趋势;不同类型的血脂异常现患率以中、老年为主。     

Income,education, and blood pressure in adults in Jamaica,a middle-income developing country

BACKGROUND: At present, little is known about how socioeconomic status (SES) is related to blood pressure (BP) and hypertension in developing countries. This cross-sectional study examined associations between SES and BP in 2082 adults from a peri-urban area of Jamaica, a middle-income developing country. METHODS: Hypertension (systolic BP >/=140 mmHg, diastolic BP >/=90 mmHg or current hypertensive medication use) was estimated based on self-reported medication use and the mean of the second and third of three manual BP measurements. Income and education were self-reported. Linear or logistic regressions were used to estimate multivariate associations between BP or hypertension and SES. RESULTS: Hypertension prevalence was 20% in men and 28% in women. In both men and women, the income distributions of BP and hypertension were non-linear, indicating elevated levels in low as well as in high-income groups. In contrast to the negative relationships typical for industrialized countries, multivariate-adjusted BP and hypertension were highest in the wealthiest women. In men with some high school education, income was positively associated with BP, while there were negative associations in men with lesser education. Unlike women, mean BP were highest in poor men with limited education. Low SES men were also least likely to receive diagnosis and treatment. CONCLUSIONS: Socioeconomic status is related to BP and hypertension in Jamaica, although relationships are non-linear. Behavioural and environmental factors that explain elevated BP among both low and high SES adults in developing countries must be identified to develop effective prevention strategies.     

High density lipoprotein cholesterol: prognosis after myocardial infarction. The Israeli Ischemic Heart Disease Study

In people without overt clinical coronary heart disease (CHD), reduced levels of high density lipoprotein cholesterol (HDLC) are a known predictor of a first myocardial infarction (MI), and of death from CHD. Less is known about the role of HDLC in the prognosis of patients with coronary heart disease. In 130 men with electrocardiographic evidence of myocardial infarction examined in the Israeli Ischemic Heart Disease Study in 1963, the relationship of HDLC to prognosis was examined. Approximately 60% (77 men) died between 1963 and 1978. Analysis of mortality by HDLC quartiles revealed the highest rate, 74%, in the bottom HDLC quartile (less than 30 mg/dl). Quartile analysis was also performed for HDLC as a per cent of total cholesterol (PHDL), known as a better predictor of CHD incidence. Mortality was as high as 81% in the bottom quartile (PHDL less than 13%), with a relative mortality risk of 1.71 for subjects in the bottom quartile compared to those in the top quartile (PHDL greater than or equal to 19%). Initial mean PHDL in patients surviving 15 years was significantly higher than in those dying during that time (17.8% versus 16.2%, p less than 0.05). Multivariate analysis, using the Cox proportional hazards model, indicated an association close to conventional statistical significance between HDLC and long-term mortality (p = 0.069). The results are comparable with those reported by the Coronary Drug Project Study. Further investigations of larger cohorts of CHD survivors are needed before firm conclusions about the role of HDLC and the potential for the use of HDLC affecting drugs or lifestyle changes can be drawn.     

延边地区汉族和朝鲜族农村居民代谢综合征的调查

目的了解延边农村社区汉族和朝鲜族居民代谢综合征的患病状况。方法于2004年8月～9月期间,随机选择447名50～60岁汉族和朝鲜族居民,测量其血压、血糖、血脂及体格指标。结果(1)无论男女朝鲜族的高血压、高血糖及血脂异常患病率均明显高于汉族(P<0.01)。(2)汉族女性的中心肥胖率(腰围>0.80)高于朝鲜族(P<0.05)。(3)朝鲜族男女代谢综合征的患病率分别是36.2%和44.8%,汉族分别是7.3%和12.2%,且朝鲜族均显著高于汉族(P<0.01)。结论延边农村社区汉族和朝鲜族居民代谢综合征的患病水平存在明显差异。     

Prävalenz von depressiver Symptomatik und diagnostizierter Depression bei Erwachsenen in Deutschland

In the German Health Interview and Examination Survey (DEGS1), current depressive symptoms were assessed with the “Patient Health Questionnaire” (PHQ-9) in a representative population-based sample of 7,988 adults 18–79 years old. In addition, previously diagnosed depression was assessed by physician interview. The prevalence of current depressive symptoms (PHQ-9 ≥?10 points) is 8.1?% (women: 10.2?%; men: 6.1?%). For both sexes, the prevalence is highest among 18- to 29-year-olds and decreases with age. Persons with higher socioeconomic status (SES) are less likely to have current depressive symptoms. The lifetime prevalence of diagnosed depression is 11.6?% (women: 15.4?%; men: 7.8?%) and is highest among persons 60–69 years old. The 12 month prevalence is 6.0?% (women: 8.1?%; men: 3.8?%) and is highest among 50- to 59-year-olds. In women, but not in men, prevalences decrease with increasing SES. The results describe the distribution of two important aspects of depression among the adult population in Germany and confirm previously observed associations with age, gender and SES. An English full-text version of this article is available at SpringerLink as supplemental.     

Metabolic and anthropometric profile of Aruák Indians: Mehináku, Waurá and Yawalapití in the Upper Xingu, Central Brazil, 2000-2002

The objective of this study was to describe the anthropometric and metabolic profile of Aruák Indians (Mehináku, Waurá, and Yawalapití) in the Upper Xingu, Central Brazil. In July 2000 and October 2002, 201 subjects of both genders and aged >or= 20 years were submitted to physical (anthropometric and blood pressure measures) and laboratory (fasting blood glucose, serum lipids, and uric acid) examination. As compared to females, males had lower mean skinfold thickness measurements and serum HDL cholesterol, and higher body mass index, arm circumference, systolic and diastolic blood pressure, serum triglycerides, VLDL cholesterol, and uric acid. The prevalence rates for overweight (51.8%), obesity (15%), dyslipidemia (77.1%), and hypertension (37.7%) were higher among men than women, but prevalence of abdominal obesity (52.1%) was higher among women than men, independently of age and origin. These results corroborate the need to implement measures to control and prevent obesity and other cardiovascular risk factors among these indigenous peoples.     

Triglyceride and coronary heart disease mortality in a 24-year follow-up study in Xi'an, China

PURPOSE: To study whether serum triglyceride (TG) was associated with coronary heart disease (CHD) mortality. METHODS: A cohort analytic study carried out in a machinery factory in Xi'an, China on 1696 subjects aged 35 years or above (1124 men and 572 women) examined in 1976 and followed up till 2000. RESULTS: At baseline, the mean serum total cholesterol (TC) and triglyceride (TG) was 4.64 and 1.16 mmol/L in men, 4.62 and 1.10 mmol/L in women, respectively. Three hundred six (239 men, 67 women) had died within 37,781 person-years of follow-up, with 49 CHD deaths (36 male, 13 female). The relative risk (95% confidence interval) of CHD mortality per mmol/L increase in TG was 2.13 (1.46-3.17) after adjusting for age, marital status, occupation, education, systolic blood pressure and TC. Dose-response relationship between TG levels by tertiles and CHD risk was found. Stratified analyses showed TG was an independent predictor for CHD mortality in subjects with lower or higher TC. CONCLUSIONS: Chinese had lower levels of TC and TG than Western populations. This study provides new evidence that TG is an independent risk factor of CHD in subjects with lower or higher TC levels, and supports the lowering of cut-off value for elevated triglyceride.     

Nutrition and aging: nutritional status of “apparently healthy” elderly (Dutch nutrition surveillance system).

In a nationwide survey the nutritional status was assessed of 539 apparently healthy, independently living elderly aged 65-79 years. Anthropometric data showed no energy deficits. The prevalence of anemia was 4 and 1% among men and women, respectively. Many elderly showed a low level of 25-hydroxyvitamin D in plasma (less than 31 nmol/L: men 35%; women 43%), indicating a marginal status. Although the prevalence of low blood levels of folate, pyridoxal-5′-phosphate, and total carotenoids was higher among the elderly than among younger adults, clear (clinical) signs of nutritional deficiencies were not observed. Prevalence of obesity (13%), hypercholesterolemia (38%), and hypertension (63%) was found to be high, the percentages being higher for women than for men. Several indicators of the nutritional status appeared to differ among age groups. It is concluded that few differences can be considered as being due to physiological aging, which finding should be reflected in reference values for elderly people.     

Non-obese (body mass index < 25 kg/m2) Asian Indians with normal waist circumference have high cardiovascular risk

OBJECTIVE: Although the prevalence of obesity is not high in Asian Indians, increased prevalence rates of metabolic perturbations and cardiovascular risk factors have been reported. In this study, we evaluated body mass index (BMI), anthropometric measurements, and body fat profiles of obese and non-obese subjects and correlated those values with cardiovascular risk factors. METHODS: This cross-sectional study involved 639 subjects (170 men and 469 women) from low socioeconomic stratum residing in urban slums of New Delhi. Non-obese subjects were categorized into quartiles of percentage of body fat (%BF) and waist circumference (WC). Using logistic regression analysis, the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of cardiovascular risk factors (diabetes mellitus [DM], hypertension, hypercholesterolemia, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, and high levels of low-density lipoprotein cholesterol) were computed with first quartile in the non-obese group as the reference category for the following five categories: %BF and WC quartiles in the non-obese group and obese group (BMI > or = 25 kg/m(2)). RESULTS: In the non-obese group, approximately 66% of men and 88% of women had at least one risk factor. In non-obese women, significantly high ORs and 95% CIs were found for hypertension (3.2, 1.4-7.2), DM (2.8, 1.2-6.3), and hypertriglyceridemia (3.9, 1.9-8.3) in the upper quartiles of %BF, and significantly high OR (95% CIs) was observed for hypertriglyceridemia (3.9, 1.4-10.8) in non-obese men. Among non-obese men, significantly high OR (95% CIs) was found for hypertriglyceridemia (3.2, 1.0-10.3); among non-obese women, significantly high ORs (95% CIs) were observed for hypertension (2.5, 1.1-5.8) and hypertriglyceridemia (2.5, 1.2-5.2) in the normal range of WC (70-80 cm). CONCLUSION: The study showed that Asian Indians have excess cardiovascular risk at BMI and WC values considered "normal." These data suggested that definitions of "normal" ranges of BMI and WC need to be revised for Asian Indians.     

Coronary heart disease and cardiovascular risk factors among people aged 25–65 years,as seen in Romanian primary healthcare

Background: In Romania data on cardiovascular risk factors are sparse. Objective: To describe the prevalence and distribution of cardiovascular risk factors in a primary care setting in Romania. Methods: In a cross-sectional study, patients aged 25–65 years on the lists of four general practitioners in Iasi (Romania), selected by 1/5 systematic sampling, were invited for a cardiovascular risk evaluation (interview, physical examination, blood tests for cholesterol and glucose). Prevalence rates for coronary heart disease (CHD), diabetes (DM) and other risk factors were estimated, SCORE risk was determined, and treatment targets were evaluated. Results: The response rate was 79% (325 men, 476 women). Prevalence rates were: CHD 7.4%, DM 3.2%, hypercholesterolemia (>190 mg%) 47.2%, hypertension 23.7%, obesity 21.2%, and smoking 33.8%. In women, obesity and lack of physical exercise were more prevalent, whereas in men, higher rates were found for smoking and an unhealthy diet. The proportion of patients considered to be at high risk (CHD, DM or SCORE ≥ 5%) was 39.2%. Female patients failed to meet targets for systolic blood pressure, total cholesterol and glucose, whereas smoking cessation will be the greatest challenge for men. Conclusion: There were relevant gender differences in modifiable cardiovascular risk factors. Many patients failed to meet treatment targets.     

Current Zinc Intake and Risk of Diabetes and Coronary Artery Disease and Factors Associated with Insulin Resistance in Rural and Urban Populations of North India

Objective: To determine the association between current zinc intake and prevalence of coronary artery disease (CAD) and diabetes as well as factors associated with insulin resistance.

Design, Subjects and Methods: In this cross sectional survey, 3575 subjects, aged 25 to 64 years, including 1769 rural (894 men, 875 women) and 1806 urban (904 men, 902 women) subjects were studied. The survey methods included questionnaires for 7-day food intake record, physical examination, and electrocardiography using World Health Organization criteria.

Results: The prevalence of CAD, diabetes and glucose intolerance was significantly higher among subjects consuming lower intakes of dietary zinc. There was a higher prevalence of hypertension, hypertriglyceridemia and low high-density lipoprotein cholesterol levels which showed significant upward trend with lower zinc intakes. Serum lipoprotein (a) and 2-hour plasma insulin levels also were associated with low zinc intake. Multivariate logistic regression analysis after adjustment for age showed that zinc intake and CAD were inversely associated. Serum zinc (odds ratio:men 0.77, women 0.57), serum triglycerides (men 0.86, women 0.81), blood pressure (0.83 men, women 0.76), diabetes mellitus (men 0.90, women 0.85), central obesity (men 0.88, women 0.87), glucose intolerance (men 0.66, women 0.57) and low high-density lipoprotein cholesterol (men 0.72, women 0.70) were significant risk factors for CAD (explained by tertiles of zinc status) in urban subjects. These associations were not observed in rural subjects.

Conclusion: Lower consumption of dietary zinc and low serum zinc levels were associated with an increased prevalence of CAD and diabetes and several of their associated risk factors including hypertension, hypertriglyceridemia and other factors suggestive of mild insulin resistance in urban subjects.     

Milk and milk products consumption in relationship to serum lipid levels: a community-based study of middle-aged and older population in Japan

The authors examined the association of milk and milk products consumption (MMPC) with serum lipid profiles including total cholesterol (TC), triacylglycerols (TG), HDL cholesterol (HDLC), LDL cholesterol (LDLC), and TC/HDLC ratio in a community-based sample. The study population comprised 461 men and 834 women aged 40-79 years who, in 2001, participated in an annual healthy examination and a lifestyle related survey Consumption frequency of 17 foods, including milk and milk products, was determined by a self-administered questionnaire. The participants were asked by "Do you drink cow's milk or eat milk products such as yoghurt and cheese everyday?", and two groups ("Yes" and "No") of MMPC were classified. Multiple linear regression analyses were conducted to examine the relationships between MMPC and 5 serum lipid profile levels adjusted for sex, age, body mass index (BMI), alcohol consumption, smoking, physical activity, and fat intake. Univariate and multivariate analyses indicated inverse associations of MMPC with TC, HDLC, and LDLC, and that the "Yes" group had higher adjusted means of serum TC by 7.133 mg/100 ml (p < 0.001), HDLC by 1.844 mg/100 ml (p < 0.05), LDLC by 5.459 mg/100 ml (p < 0.001). We suggested that MMPC has an association with serum lipid and lipoprotein levels and that MMPC may have an unfavorable effect on hypercholesterolaemia in the Japanese population.     

Distribution of blood pressure, body mass index and smoking habits in the urban population of Dar es Salaam, Tanzania, and associations with socioeconomic status

OBJECTIVE: To estimate the distribution of blood pressure (BP), body mass index (BMI), smoking habits and their associations with socioeconomic status (SES) in an urban population in early epidemiological transition. METHODS: Cross-sectional survey of the entire population aged 25-64 years in five branches of Dar es Salaam (Tanzania) through visits to all homes in the study area. Blood pressure was based on the mean of the second and third readings with an automated device. Socioeconomic status was estimated with indicators of education, occupation and wealth. RESULTS: In all 9254 people were examined. Age-adjusted prevalence (%) among men/ women aged 35-64 years was 27.1/30.2 for BP > or = 140/90 mmHg or antihypertensive medication, 13.1/17.7 for BP > or = 160/95 mmHg or antihypertensive medication, 28.0/27.4 for BMI of 25.0-29.9 kg/m(2), 6.9/17.4 for BMI > or = 30 kg/m(2), and 22.0/2.6 for smoking (> or = 1 cigarette per day). Prevalence of categories of drinking frequency and history of diabetes are also reported. After adjustment for covariates, SES was associated inversely with BP and smoking and directly with BMI. Body mass index was associated positively with BP (1.01 and 0.91 mmHg systolic BP per 1 kg/m(2) BMI in men and women, respectively) and inversely with smoking (-1.14 kg/m(2) in male smokers versus non-smokers). Hypertension treatment rates were low, particularly in people of low SES. CONCLUSIONS: High prevalence of several cardiovascular risk factors in the urban population of a low-income country stresses the need for early public health interventions and adaptation of the health care infrastructure to meet the emerging challenge of cardiovascular disease. The direct SES-BMI association may drive increasing BMI and BP while the population becomes more affluent.     

牛奶饮用频率与小学生肥胖及代谢异常的关系

目的了解牛奶饮用频率与儿童肥胖及代谢异常的关系,为制定干预措施提供基础数据。方法从哈尔滨、北京、济南、上海、重庆、广州6个大城市随机整群抽取6～13岁小学生7 082名,问卷调查他们的年龄、性别、家庭经济情况及牛奶饮用频率等信息。按照标准程序测量身高、体重、腰围、血压,采集晨起空腹血测定血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和三酰甘油等指标。结果饮用牛奶频率为每周7次以上、7次、1～6次和基本不喝奶的4组儿童中,肥胖率依次为8.6%,10.1%,11.0%和12.1%;腹型肥胖率在4组中依次为12.9%,13.7%,15.7%和15.6%;高三酰甘油血症率在各组中依次为2.6%,4.0%,4.2%和4.6%。调整混杂因素后,各组间肥胖、腹型肥胖、高三酰甘油血症检出率差异有统计学意义,其他肥胖相关代谢异常检出率差异无统计学意义。结论饮用牛奶频率与儿童肥胖及代谢异常有关,应大力提倡儿童饮用牛奶以利于他们的健康成长。     

The Emergence of Clinically Abnormal Levels of Cardiovascular Disease Risk Factor Variables Among Young Adults: The Bogalusa Heart-Study

Background. The Bogalusa Heart Study, a long-term epidemiologic investigation of the early natural history of atherosclerosis, was conducted for the first time in 1973-1974 on children from birth through the age of 14 in a biracial (black-white) population. Methods. The emergence of clinically recognizable abnormalities (obesity, hypertension, and hyperlipidemia) was studied in 1,928 young adults, ages 19-32 years, examined in the 1988-1991 survey. Results. The occurrence of morbid levels of cardiovascular disease risk factors varied by race and gender. The prevalence of severe overweight, body mass index ≥ 31.1 kg/m² for males and ≥ 32.3 kg/m² for females, was much higher for black women (20.1%) than for white women (8.7%), black men (14.0%), or white men (11.7%). The frequency of hypertension [systolic blood pressure (BP) ≥ 140 mm Hg, diastolic BP ≥ 90 mm Hg, or treatment for high BP] was greatest for black women (13.9%) versus black men (10.1%), white men (6.2%), or white women (5.0%). Approximately 9.5% of the men and 6% of the women had elevated LDL cholesterol (≥160 mg/dl), while elevated triglycerides (≥250 mg/dl) ranged from 0% in black females to 7.4% in white males. Dyslipoproteinemia related to HDL cholesterol (≤35 mg/dl) was more marked among white men (16%) compared with the other groups (approximately 4%). Correlations for risk factors in a subgroup of 1,587 individuals initially surveyed as children in 1973-1974 were examined as an indication of tracking over a 15-year period. Highly significant correlations were seen for obesity, blood pressure, and LDL cholesterol. Conclusion. Early identification of adverse levels of cardiovascular disease risk factors defined by clinical experience should help to predict and prevent future cardiovascular disease morbidity and mortality.     

Coronary heart disease risk factors in a random sample of Athenian adults. The Athens Study

Risk factors for cardiovascular diseases not previously investigated in Greece were studied in a random sample of 4,097 Athenian adults. Mean systolic and diastolic blood pressures increased with age in both sexes. Similar findings were observed for mean serum total cholesterol up to age 50 years, but no significant changes were observed in older persons. Smoking was more common for men than for women and less common in those aged more than 50 years. Mean values of body mass index were higher for men than for women in those less than 45 years, but the opposite was observed for the older age groups. The age-adjusted prevalence rate of borderline hypertension was 10.1% for men and 9.1% for women and of stable hypertension (greater than 160/95 mmHg), 8.1% and 8.6%, respectively; the age-adjusted prevalence rate of obesity was 23.5% for men and 23.2% for women and of hypercholesterolemia (total cholesterol greater than or equal to 260 mg/100 ml), 20.1% for men and 17.3% for women. The associations of age and systolic blood pressure and of age and diastolic blood pressure persisted even after controlling for body mass index, total cholesterol, and smoking. In the examined representative sample, the prevalence rates of risk factors for cardiovascular diseases are the same or greater than those in industrialized countries.