The control of cardiovascular risk factors in the elderly

Although measures to prevent cardiovascular diseases should preferably be started early in the life span, epidemiological evidence and the limited available results of trials suggest that the control of cardiovascular risk factors is of value even in later adult life. Such intervention may be expected to have a greater absolute short-term effect on the burden of these diseases than similar intervention among younger people, in spite of its smaller impact on the individual's risk. The specific measures which are probably of value among the elderly include blood pressure and weight control, the stopping of cigarette smoking, and (with less certainty) the control of blood lipids and the encouragement of physical activity. The practical implementation of these measures at individual, family, and local community levels is probably best achieved within the ordinary primary health care system. An illustrative community program in Jerusalem is described, in which the control of multiple risk factors is undertaken as an integral and central function of a family practice.     

老年肥胖与心血管病主要危险因素聚集的关系

目的 探讨老年人肥胖与发生心血管疾病主要危险因素聚集之间的相关关系.方法 采用横断面调查546名60～90岁的老年人,用描述性统计方法、logistic回归和ROC工作曲线法进行相关分析. 结果 (1)四种危险因素及危险因素聚集的检出率随着BMI、腰围(WC)水平的上升而增加,危险因素聚集检出率为59.5%,其中男性组为52.5%,女性组为65.7%.(2)随着BMI和(或)WC水平的上升,老年男性发生危险因素聚集风险的增长速度要高于女性,其中男性最高水平组OR值为13.579,女性组为2.876.(3)男性BMI和WC均与危险因素聚集存在独立的相关性(P<0.05),logistic回归系数分别为bBMI=0.196,bWC=0.074;女性只有WC与危险因素聚集存在独立的相关性(P<0.05),logistic回归系数为bWC=0.060,而BMI与危险因素聚集不存在独立的相关性(P=0.537).(4)男性的BMI和WC组合公式(CE)为CEBMI+WC=0.726×BMI+0.274×WC,最佳截断值为41.59,其灵敏度和特异度分别为0.785和0.598. 结论 四种主要的心血管病危险因素经常伴随着肥胖出现,BMI和WC对于心血管疾病的一级预防具有重要意义,两者的组合公式可用于预测个体的心血管疾病危险因素聚集风险.     

Obesity and undernutrition and cardiovascular risk factors in rural and urban Gambian communities

OBJECTIVES: This study documented the prevalence of and cardiovascular risk factors associated with obesity and undernutrition in the Gambia. METHODS: Adults (> or =15 years; N = 5373) from rural and urban areas completed a questionnaire; their height, weight, and waist and hip circumferences were measured, and their cardiovascular risk factors were assessed. RESULTS: Prevalence of undernutrition (body mass index < 18 kg/m(2)) was 18.0%; all strata of society were affected. Prevalence of obesity (body mass index > or =30 kg/m(2)) was 4.0% but was higher (32.6%) among urban women 35 years or older. Cardiovascular risk factors were more prevalent among obese participants. CONCLUSIONS: Undernutrition coexists with obesity, demonstrating a "double burden of disease." Differential interventions should focus on high-risk groups; prevention needs a multisectorial approach.     

幽门螺杆菌感染与心血管疾病及其危险因素关系研究进展

近年来,幽门螺杆菌的高感染率及其对心血管疾病的影响引发了人们的关注,其可能通过炎症反应、免疫反应和损伤内皮细胞等多种机制直接参与冠心病、脑卒中等心血管疾病的发生发展,同时也可在动脉粥样硬化、高血压、高同型半胱氨酸血症和血脂异常等心血管疾病危险因素的形成中发挥重要作用。但目前国内外研究结果尚不一致,仍需要通过大量实验进一步确证,以采取有效措施控制心血管疾病的发生率。本文现就幽门螺杆菌与心血管疾病的流行情况、国内外研究现状及其相互作用机制进行综述。     

Obesity and cardiovascular disease risk factors in firefighters: a prospective cohort study

OBJECTIVE: Obesity, despite being a significant determinant of fitness for duty, is reaching epidemic levels in the workplace. Firefighters' fitness is important to their health and to public safety. RESEARCH METHODS AND PROCEDURES: We examined the distribution of BMI and its association with major cardiovascular disease (CVD) risk factors in Massachusetts firefighters who underwent baseline (1996) and annual medical examinations through a statewide medical surveillance program over 5 years of follow-up. We also evaluated firefighters' weight change over time. RESULTS: The mean BMI among 332 firefighters increased from 29 at baseline to 30 at the follow-up examination (2001), and the prevalence of obesity increased from 35% to 40%, respectively (p < 0.0001). In addition, the proportion of firefighters with extreme obesity increased 4-fold at follow-up (from 0.6% to 2.4%, p < 0.0001). Obese firefighters were more likely to have hypertension (p = 0.03) and low high-density lipoprotein-cholesterol (p = 0.01) at follow-up. Firefighters with extreme obesity had an average of 2.1 CVD risk factors (excluding obesity) in contrast to 1.5 CVD risk factors for normal-weight firefighters (p = 0.02). Finally, on average, normal-weight firefighters gained 1.1 pounds, whereas firefighters with BMI > or = 35 gained 1.9 pounds per year of active duty over 5 years of follow-up. DISCUSSION: Obesity is a major concern among firefighters and shows worsening trends over time. Periodic medical evaluations coupled with exercise and dietary guidelines are needed to address this problem, which threatens firefighters' health and may jeopardize public safety.     

Major risk factors for cardiovascular disease in elderly migrants in Sweden

Objective. The knowledge of elderly migrants' health, particularly those who are retired or in transition to retirement is limited. The purpose of this study was to analyse the association between migration, socio-economic status (SES), and risk factors for cardiovascular disease (CVD). Design. A simple random sample of 253 foreign-born persons and 2847 Swedish-born persons aged 55-74 were drawn from the Swedish Population Registry. They were interviewed by Statistics Sweden in 1988-89. Outcome variables were leisure-time physical inactivity, smoker/non-smoker status, body mass index (BMI), hypertension, and diabetes mellitus. Explanatory variables were sex, age, marital status, migration status (country of birth), and SES (income). Logistic and linear regression were used. Results. Elderly foreign-born people ran an increased risk of engaging in no physical activity (men only), being a current smoker, and having an increased BMI after adjustment for background factors. In addition, a low income (first tertile) was an independent risk factor for physical inactivity (men only), as was being a current smoker (men only), BMI, hypertension, and diabetes mellitus. Thus, the burden of being an elderly migrant increases the risk of a disadvantaged lifestyle between 50 and 80% compared with Swedes. Conclusions. This study shows that migrants who are retired or in transition to retirement have a disadvantaged risk profile for cardiovascular disease. It might be possible to improve this situation by intervention, as for example by increasing a person's interest in walking.     

职业紧张与心血管疾病危险因素的关系

目的探讨职业紧张因素、个性特征和心理性紧张反应与心血管疾病危险因素的关系.方法采用横断面研究方法对93名铁路货运调度员进行研究,使用问卷法测试职业紧张因素、个性特征和紧张反应评分,分析血清中胆固醇、甘油三酯和糖化血红蛋白浓度,测定血压和心率.结果相关分析结果表明,社会支持评分与收缩压(r=0.22)和舒张压(r=0.30)呈正相关(P＜0.05),工作满意感评分与收缩压(r=-0.37)、舒张压(r=-0.47)与血清甘油三酯浓度(r=-0.28)呈负相关(P＜0.05),自尊感评分与收缩压呈负相关(r=-0.21,P＜0.05).方差分析显示,不同社会支持因素评分组间舒张压[(78.5±13.1)、(83.6±8.2)、(88.1±12.3)、(85.8±9.8)mmHg]差异有显著性(P＜0.05),工作难度评分组间身体肥胖指数差异有显著性(P＜0.01),工作负荷评分组间收缩压[(110.1±20.5)、(112.4±12.9)、(129.1±19.7)、(125.2±15.1)mmHg]差异有显著性(P＜0.05),各紧张易感性评分组间血清中胆固醇浓度[(4.96±1.18)、(5.39±0.85)、(5.00±1.15)、(4.374±0.91)mmol/L]、收缩压[(124.9±14.4)、(129.7±13.1)、(118.4±16.4)、(133.5±23.1)mm Hg]和舒张压[(85.5±11.3)、(87.0±9.8)、(80.1±10.1)、(88.9±12.0)mmHg]差异有显著性(P＜0.05),竞争性评分组间收缩压和血清中糖化血红蛋白浓度差异有显著性(P＜0.05).逐步回归分析结果表明,工作时间需求和消极应付策略对胆固醇有较大影响(R2＞0.05),工作关系、工作难度、决定自由度、自尊感、焦虑特质和消极应付策略对吸烟预测方程的贡献较大(R2＞0.05),A型行为的竞争性因子是心率的预测因子(R2=0.06).结论工作中的社会心理紧张因素可能与某些心血管危险因素有关.     

Obesity, abdominal obesity, and clustering of cardiovascular risk factors in South Korea

The aim of this study was first, to investigate the prevalence of obesity, abdominal obesity, and clustering of cardiovascular (CVD) risk factors, and secondly, to identify the BMI or waist circumference (WC) level at which clustering increases in South Koreans. A population-based, cross-sectional National Health Examination Survey was carried out in 1998. A total of 8,816 subjects (4,029 men and 4,787 women) aged 15-79 y were selected by stratified multistage probability sampling design. The measurements taken of the subjects included: height, weight, waist and hip circumference, blood pressure, fasting glucose, and lipids. The prevalence of BMI > or = 25 kg/m2 was 25.3% for men and 28.3% for women. The prevalence of WC >90 cm in men, and >80 cm in women was 18.5%, and 38.5%, respectively. Clustering of 3 or more CVD risk factors was 22.7% in men ad 21.7% in women. Using <21 kg/m2; as a referent, subjects with BMI of 23 kg/m2; and 27 kg/m2; had an odds ratio of 3.5 and 10.2 in men, and 3.1 and 6.7 in women, respectively for clustering of CVD risk factors. Using <65 cm as a referent, subjects with a WC of > or = 90 cm in men and > or = 85 cm in women had an odds ratio of 13.4, and 13.6, respectively for clustering of CVD risk factors. Considering the significant associations between clustering of CVD risk factors and BMI or WC, the present study suggests that high prevalence of overweight may have important implications for the health care system, even at a lower level of BMI or WC.     

Obesity,diabetes and associated cardiovascular risk factors among Torres Strait Islander people

OBJECTIVE: To describe the lifestyle-related chronic disease and risk factor prevalence among Torres Strait Islander people of the Torres Strait and Northern Peninsula Area Health Service District and to compare this information with that available for the general Australian population. METHODS: Voluntary community-based screening for persons aged 15 years and older, including oral glucose tolerance test, anthropometry, health questionnaire, measurement of lipids and lipoprotein levels, blood pressure and urinary albumin to creatinine ratio. RESULTS: Nine communities participated in screening between 1993 and 1997. Five hundred and ninety-two participants (286 male and 306 female) identified as Torres Strait Islander. There were high prevalences of overweight (30%), obesity (51%), abdominal obesity (70%), diabetes (26%), hypercholesterolaemia (33%), albuminuria (28%), hypertension (32%) and tobacco smoking (45%). Only 8.5% of men and 6.5% of women were free of any cardiovascular risk factors (abdominal obesity, hypercholesterolaemia, hypertension, dyslipidaemia, smoking, diabetes, albuminuria). Comparisons of this information for Torres Strait Islander people with results from the AusDiab survey show rates of obesity three times higher and diabetes six times higher than for other Australians. CONCLUSIONS: There is a very high prevalence of preventable chronic disease and associated risk factors among Torres Strait Islander people of the Torres Strait and Northern Peninsula Area. Implications: Effective interventions to prevent and manage obesity, diabetes and associated cardiovascular risk factors are essential if the health of the Torres Strait Islander people is to improve. Such interventions could inform initiatives to stem the burgeoning epidemic of obesity and diabetes among all Australians.     

Risk ratios and risk differences in estimating the effect of risk factors for cardiovascular disease in the elderly

This article reviews the nature of the effects of hypertension, smoking and cholesterol on the incidence of cardiovascular disease and emphasizes how these effects vary by age. In the Methods section, we discuss briefly the concepts of additive and multiplicative statistical models as tools for summarizing data. In the results section, we summarize available data on the association between incident stroke and coronary heart disease in the elderly and each of these major risk factors. The traditional multiplicative model parsimoniously characterizes the individual and joint effects of age and high blood pressure in terms of risk ratios; but, for smoking and cholesterol, an additive model appears to be the most parsimonious. We discuss the consequences of these observations for the study and prevention of cardiovascular disease in the elderly.     

Sarcopenic-obesity and cardiovascular disease risk in the elderly

Objectives  To determine: 1) whether sarcopenic-obesity is a stronger predictor of cardiovascular disease (CVD) than either sarcopenia or obesity alone in the elderly, and 2) whether muscle mass or muscular strength is a stronger marker of CVD risk. Design  Prospective cohort study. Participants  Participants included 3366 community-dwelling older (65 years) men and women who were free of CVD at baseline. Measurements  Waist circumference (WC), bioimpedance analysis, and grip strength were used to measure abdominal obesity, whole-body muscle mass, and muscular strength, respectively. Subjects were classified as normal, sarcopenic, obese, or sarcopenic-obese based on measures of WC and either muscle mass or strength. Participants were followed for 8 years for CVD development and proportional hazard regression models were used to compare risk estimates for CVD in the four groups after adjusting for age, sex, race, income, smoking, alcohol, and cognitive status. Results  Compared with the normal group, CVD risk was not significantly elevated within the obese, sarcopenic, or sarcopenic-obese groups as determined by WC and muscle mass. When determined by WC and muscle strength, CVD risk was not significantly increased in the sarcopenic or obese groups, but was increased by 23% (95% confidence interval: 0.99–1.54, P=0.06) within the sarcopenic-obese group. Conclusion  Sarcopenia and obesity alone were not sufficient to increase CVD risk. Sarcopenic-obesity, based on muscle strength but not muscle mass, was modestly associated with increased CVD risk. These findings imply that strength may be more important than muscle mass for CVD protection in old age.     

中老年人心脑血管危险因素相关物质浓度及与高密度脂蛋白胆固醇的关系

目的 研究中老年人心脑血管危险因素相关物质:血清瘦素、脂联素、白细胞介素-6(IL-6)及纤溶酶原激活物抑制物-1(PAI-1)与高密度脂蛋白胆固醇(HDL-C)的关系,探讨其在传统心脑血管危险因索中的作用.方法 在广州市生物库第3期注册登记的10027名中老年人中随机抽取1 996名中老年人进行问卷调查和健康体检.以酶联免疫吸附双抗夹心法(ELISA)测定瘦素、脂联素、IL-6、PAI-1,以直接法测定血清脂类.其中共1 520名受检者参与血瘦素、脂联素和PAI-1的测定,1 293名参与IL-6的测定.结果 广州市中老年人脂联素随年龄增加而升高,差异有统计学意义(男:P=0.044,女:P＜0.01),随着年龄的增加,瘦素水平在男性中升高(P=0.036).校正年龄和性别因素后,瘦素、脂联素、IL-6、PAI-1和HDL-C之间均呈明显的相关(P＜0.01).结论 瘦素、脂联素、IL-6、PAI-1与HDL-C密切相关.     

Assessment of cardiovascular risk factors in the elderly: The Framingham heart study

In elderly Framingham men and women, systolic blood pressure and cigarette smoking status, as well as a subject's age and sex, strongly influenced the risk of developing cardiovascular disease during ten years of follow-up. Multivariable proportional hazards models were used to assess the roles of several primary risk factors and to examine their secondary effects. The first three factors were noted in both sexes, separately and combined, but the risk function for blood pressure was steeper in men than in women (hazard ratio, HR, 1·53 per 20 mmHg, 95 per cent confidence interval, CI, 1·33 to 1·75 in men; HR = 1·19, 95 per cent CI 1·07 to 1·33 in women). Systolic pressure measured ten years earlier also contributed to CVD risk (HR = 1·16 per 20 mmHg, 95 per cent CI 1·04 to 1·30), even after accounting for current level. Smoking was associated with a 64 per cent elevation in risk, male sex with a 51 per cent increase, and each 5 years increment in age with a 22 per cent increase. Body mass index measured 10 years ago had a modest association, but current body mass index did not. Among diabetic subjects, total serum cholesterol had an asymmetrical U-shaped risk function, the risk increasing to either side of sex-specific median values; diabetes per se, however, was not significant in the final model. In non-diabetic subjects, there was little change in CVD risk up to the median cholesterol values and a modest increase thereafter. None of the risk functions was age dependent.     

Relationship between hyperuricemia and other cardiovascular disease risk factors among adult males in Taiwan

Hyperuricemia is associated with cardiovascular disease risk factors such as obesity, impaired glucose tolerance, hypertension, and hyperlipidemia. However, this relationship between serum uric acid (SUA) concentrations and cardiovascular disease (CVD) is a controversial one, especially among males. The purpose of this study is to evaluate the association between SUA concentrations and other CVD risk factors among adult males in Taiwan. After multi-stage sampling procedures, we randomly selected 1743 Taiwanese males with a mean age of 35 years (from 22 to 54) in this study. Anthropometric, blood pressure and biochemical variables, including serum uric acid, glucose, total cholesterol and triglyceride concentrations, were measured. Among the study population, the mean SUA concentration was 6.5 ± 1.5 mg/dl. There were 290 (16.6%) subjects with SUA concentrations 8.0 mg/dl (defined as hyperuricemia). Compared to normouricemic subjects, hyperuricemic subjects had significantly greater age-adjusted body weight (75.3 vs. 69.2 kg, p < 0.001), body mass index (BMI, 25.5 vs. 23.6 kg/m², p < 0.001), higher blood pressure (BP, 120.2 vs. 115.2 mmHg for systolic BP and 78.5 vs. 75.3 mmHg for diastolic BP, both p < 0.001) and blood lipid concentrations (193.8 vs. 182.1 mg/dl for total cholesterol and 123.7 vs. 94.4 mg/dl for triglycerides, both p < 0.001). SUA concentration was positively correlated with body weight, BMI, BP and serum lipid concentrations (all p < 0.001). In multivariate regression analyses, after adjusting for potential confounders, SUA concentration was significantly positively associated with diastolic BP, serum total cholesterol and triglyceride concentrations. An increase of 1 mg/dl of SUA was associated with a 2.1 mg/dl elevation in serum total cholesterol (p < 0.001) and a 5.4 mg/dl increase in triglyceride (p < 0.001). From this study, we found that hyperuricemia in subjects is associated with being overweight, and having high blood pressure and hyperlipidemia. There is a significantly positive association between SUA concentration and other CVD risk factors among adult males in Taiwan.     

鸡蛋摄人与心血管疾病危险因素关系的横断面研究

目的探讨蛋类食物的摄入与心血管疾病危险因素之间的关联。方法采用随机抽样的横断面设计，使用食物频数问卷（FFQ）在广州市越秀区人民街调查了459名居民的膳食摄入情况，检测身高、体重和血压，抽取空腹静脉血检测血脂（TC、LDL—C、HDL—C、TG）、凝血酶原时间（PT）和纤维蛋白原（Fibrinogen），进行心电图检查（心率和QT间期）以及用B超检测颈动脉血管壁内中膜厚度（IMT），分析鸡蛋摄入次数与心血管疾病危险因素之间的关联。根据鸡蛋摄入次数将研究对象分为4组，用方差分析和协方差分析研究组间心血管疾病危险因素的差异和线性趋势。结果459名研究对象中男性174人，女性285人，平均每人每周吃2．5次鸡蛋（中位教）。根据鸡蛋摄入次数分为4组：〈1次／周、≥1且〈3次／周、≥3且〈6次／周、≥6次／周。4组人数分别为：62（13．5％）、187（40．7％）、120（26．1％）和90（19．6％）人。在未校正混杂因素的模型中，蛋类食物的摄入与血浆TC和LDL．C存在负相关关系，蛋类食物摄入量最多组（≥6次／周）相比于最低组（〈1次／周），血浆TC和LDL—C分别低8．8％（P〈0．01）和11．7％（P〈0．05）；校正了多种因素后，蛋类食物的摄入与血浆TC（P〈0．05）和LDL—C（P〈0．01）存在负相关关系。未发现蛋类摄入量与血压、HDL、PT、纤维蛋白原、心率及QTc之间存在关联（均P〉0．05）。结论该研究提示蛋类摄入可能与血浆TC和LDL—C存在负相关。     

中老年人群高尿酸血症与心血管危险因素关系

目的探讨中老年人群高尿酸血症与心血管危险因素及聚集性之间的关系,为高尿酸血症的防治提供有效的策略和依据。方法采用随机整群抽样方法抽取在广州军区广州总医院健康管理体检中心接受长期定期体检的14个体检单位1 176名45~75岁人群进行问卷调查、体格检查和实验室检测。结果中老年人群男性高尿酸血症患病率为55.7%,标化患病率为37.7%,女性高尿酸血症患病率为46.5%,标化患病率为40.7%;男女性高尿酸血症组年龄、甘油三酯、血肌酐、体质指数、腰臀比及高血压患病率均高于非高尿酸血症组,高密度脂蛋白胆固醇低于非高尿酸血症组,女性高尿酸血症组糖尿病患病率高于非高尿酸血症组,差异均有统计学意义（P<0.05）;多因素logistic回归分析显示,调整年龄和饮酒后,甘油三酯含量较高（OR=1.923,95%CI=1.304~2.834）、腹型肥胖（OR=1.482,95%CI=1.001~2.194）是中老年男性高尿酸血症患病的危险因素;血肌酐含量较高（OR=1.061,95%CI=1.037~1.086）、肥胖（OR=6.345,95%CI=2.524~15.952）是中老年女性高尿酸血症患病的危险因素,高密度脂蛋白胆固醇含量较高（OR=0.387,95%CI=0.222~0.676）是中老年女性高尿酸血症患病的保护因素;随着心血管危险因素的增多,高尿酸血症患者所占比例也随之增多（P<0.05）;校正年龄、饮酒、性别等混杂因素后,随着个体存在心血管危险因素的增多,高尿酸血症的患病风险也随之升高,具有1、2、≥3个心血管危险因素的个体患高尿酸血症的危险性分别是无危险因素个体的1.557、1.688、2.666倍。结论中老年男性高尿酸血症的影响因素为甘油三酯、腰臀比,中老年女性高尿酸血症的影响因素为血肌酐、体质指数、高密度脂蛋白胆固醇;高尿酸血症患者具有心血管危险因素聚集性。     

Obesity indices in relation to cardiovascular disease risk factors among young adult female students

The objective of the present study was to compare the percentage of body fat (%BF), BMI, and central fat distribution anthropometric measures as indices of obesity and to assess the respective associations with cardiovascular risk factors in young female students. Subjects were 220 healthy Greek female students. Dual-energy X-ray absorptiometry was used to estimate %BF, anthropometric measurements were obtained and blood samples were analysed for CVD risk factors. Results showed that 48.6 % of students had increased adiposity, while a considerable proportion was characterised by central fat distribution irrespective of the anthropometric index used. The proportion of subjects with at least one metabolic risk factor present was 60.4 %. Although %BF was not associated with any of the CVD risk factors, waist circumference, waist:hip ratio and waist:height ratio were all associated with CVD risk factors. Higher levels of these anthropometric variables demonstrated higher prevalence of CVD risk factors. The lack of association between %BF and CVD risk factors could be attributed to the fact that females with undesirable adiposity had a tendency for the gynaecoid type of obesity. In contrast, the present results suggest that central body fat distribution in young women may reflect increased risk due to high visceral and particularly intra-abdominal fat levels. Recent epidemiological data from Greece show a high prevalence of overweight and obesity in young adults. Therefore, assessing the risk for the presence of CVD risk factors is of particular importance. Central obesity anthropometric indices seem to be valuable screening tools for young women.     

Family study of the relationship between height and cardiovascular risk factors in the STANISLAS cohort

BACKGROUND: Short stature is a risk factor for coronary heart disease and is associated with an adverse cardiovascular profile. Mechanisms responsible for this association remain unknown. A genetic contribution to this association would imply a familial clustering between height and cardiovascular risk factors. METHODS: This study investigated whether lipids and blood pressure (BP) levels shared a common familial component with height. The sample included 865 nuclear families from the French STANISLAS cohort volunteering for a free health examination between 1993 and 1994. Within-individual correlations and familial intra-trait and cross-trait correlations were estimated using the Estimating Equation technique extended to a bivariate phenotype. RESULTS: Height negatively correlated to total and low density lipoprotein cholesterol (LDL-C) and triglycerides in both parents and offspring, and positively correlated to high density lipoprotein cholesterol (HDL-C) in parents only. In offspring, the correlation between height and HDL-C markedly increased with sexual maturation to reach after puberty the same value as in parents. The correlation of height with systolic BP was negative in fathers and positive in sons, whereas it was non-significant in mothers and daughters. The pattern of cross-trait familial correlations between height and LDL-C was compatible with the existence of a weak transmissible component explaining the relationship between these two traits. By contrast, the pattern observed for HDL-C and triglycerides was rather compatible with the influence of shared environmental factors. No familial clustering between height and BP levels was detected. CONCLUSIONS: The association between short stature and increased LDL-C might be partly of familial origin.     

Alcohol consumption and its relation to cardiovascular risk factors in Germany

OBJECTIVE: To analyse the association of alcohol consumption and blood lipids, haemostatic factors, and homocysteine in German adults by gender and age groups. DESIGN: Cross-sectional population-based survey. SETTING: Data from the German National Health Interview and Examination Survey 1998, representative for age, gender, community size, and federal state. SUBJECTS: From a sample of 7124 Germans between 18 and 79 y old, 2420 women and 2365 men were selected. Only individuals who were not currently receiving medical treatment or did not have disorders related to cardiovascular disease were selected for this study. RESULTS: Using analyses of variance, mean blood levels of total cholesterol, HDL cholesterol, HDL/total cholesterol ratio, total glycerides, fibrinogen, antithrombin III, and homocysteine adjusted for age, socioeconomic status, East/West Germany residence, body mass index, tobacco use, sports activity, and coffee consumption, if appropriate are presented by alcohol consumption groups (0, >0-10, >10-20, >20-30 and >30 g/day). The HDL/total cholesterol ratio increased with higher alcohol groups up to 10-20 g/day (+15%) for women and >30 g/day (+18%) for men, showing the strongest rise among men aged 55-79 y. Fibrinogen decreased with higher alcohol groups up to 10-20 g/day for women and 20-30 g/day for men. Among women, homocysteine levels showed a U-shaped curve with a minimum of 8.49 mmol/l at 10-20 g alcohol/day (-8%, reference: nondrinking), whereas an inverse association was observed for men. CONCLUSIONS: Moderate alcohol consumption is associated with favourable levels of several cardiovascular risk factors. The most favourable cardiovascular risk factor profile among women was observed among those drinking 10-20 g alcohol/day. Beneficial effects seem to be more pronounced among older men.     

Impact of acculturation on cardiovascular risk factors among elderly Mexican Americans

PurposeHigher levels of acculturation among Latinos have been shown to be associated with a higher prevalence of cardiovascular (CV) risk factors in some studies of middle-age persons. The association of acculturation and prevalence of CV risk factors in elderly Latinos is less well established.MethodsAcculturation was measured using the validated bidimensional Acculturation Rating Scale for Mexican Americans-II. We conducted a cross-sectional analysis of the association of acculturation with prevalence of CV risk factors among 1789 elderly men and women from the Sacramento Area Latino Study on Aging using multivariate linear and logistic regression. We tested for the interaction of acculturation with risk factors by nativity status.ResultsMedian age was 69.8 years. Higher acculturation was associated with lower systolic blood pressure, lower low-density lipoprotein, higher high-density lipoprotein, and lower prevalence of CV disease after age and sex adjustment. Higher acculturation remained associated with lower level of low-density lipoprotein and higher level of high-density lipoprotein after full adjustment. Nativity status did not affect these results.ConclusionsContrary to other reports in middle-aged persons, higher levels of acculturation were associated with better lipid profiles and no significant differences in other CV risk factors by acculturation level in elderly Latinos.