Average Volume of Alcohol Consumed,Drinking Patterns,and Metabolic Syndrome in Older Korean Adults

Background

Controversial results have been reported on the relationship between alcohol intake and metabolic syndrome (MetS). We examined the association of average volume of alcohol consumed and drinking patterns with MetS and its components.

Methods

This study was conducted as a baseline survey for the Dong-gu Study of adults aged 50 years or older. Drinking patterns were assessed using a structured interview, and average volume of alcohol consumed was calculated. MetS was defined according to the updated version of the National Cholesterol Education Program.

Results

Compared with individuals who never drank, the adjusted odds ratio (OR) for the prevalence of MetS was significantly higher in men who consumed 2.1 to 4.0 drinks/day (OR, 1.53; 95% CI, 1.17–2.00) and greater than 4.0 drinks/day (OR, 1.63; 95% CI, 1.23–2.14), whereas no significant association was observed in women. Significant dose-response relationships between average volume of alcohol consumed and all metabolic components were observed in men. A usual quantity of 5 to 6 drinks/drinking day (OR, 1.57; 95% CI, 1.19–2.09), 7 or more drinks/drinking day (OR, 1.88; 95% CI, 1.45–2.44), and binge drinking on at least 1 occasion/week (OR, 1.33; 95% CI, 1.01–1.76) were associated with a significantly higher OR for prevalence of MetS in men; however, none of these drinking patterns were associated with MetS in women.

Conclusions

Unhealthy drinking patterns such as high usual quantity and binge drinking were significantly associated with MetS, suggesting that the effect of alcohol consumption on MetS should be considered in the context of drinking pattern, particularly in men.Key words: metabolic syndrome, alcohol consumption, cross-sectional study     

Vital Signs: Binge Drinking Among Women and High School Girls — United States, 2011

Background

Excessive alcohol use accounted for an estimated average of 23,000 deaths and 633,000 years of potential life lost (YPLL) among women and girls in the United States each year during 2001–2005. Binge drinking accounted for more than half of those deaths and YPLL. Binge drinking also is a risk factor for many health and social problems among women and girls, including unintended and alcohol-exposed pregnancy, sexually transmitted diseases, and breast cancer.

Methods

To describe the prevalence, frequency, and intensity of binge drinking (four or more drinks on an occasion in the last 30 days) among U.S. women aged ≥18 years, CDC analyzed data from the 2011 Behavioral Risk Factor Surveillance System. Data were also analyzed from the 2011 national Youth Risk Behavior Survey on the prevalence of current alcohol use (one or more drinks during the past 30 days) and binge drinking (five or more drinks in a row during the past 30 days) among U.S. high school girls in grades 9–12.

Results

Among adult women, the prevalence of binge drinking was 12.5%, and among those who binge drank, the frequency of binge drinking was 3.2 episodes per month and the intensity was 5.7 drinks on occasion. Binge drinking was most prevalent among women aged 18–24 years (24.2%) and 25–34 years (19.9%), and among those from households with annual incomes of ≥$75,000 (16.0%). Among those who binge drank, women aged 18–24 years had the highest frequency (3.6 episodes) and intensity (6.4 drinks) of binge drinking. Among high school girls, the prevalence of current alcohol use was 37.9%, the prevalence of binge drinking was 19.8%, and the prevalence of binge drinking among girls who reported current alcohol use was 54.6%.

Conclusions

Binge drinking is reported by one in eight U.S. adult women and one in five high school girls. Women who binge drink tend to do so frequently and with high intensity. Most high school girls who reported current alcohol use also reported binge drinking.

Implications for Public Health Practice

More widespread implementation of evidence-based interventions, such as those recommended by the Guide to Community Preventive Services and the U.S. Preventive Services Task Force, would be expected to reduce the frequency and intensity, and ultimately the prevalence of binge drinking among women and girls, and the harms related to it.     

Peer Reviewed: Acculturation and Dental Visits Among Hispanic Adults

Introduction

Acculturation may strongly influence use of or access to health services among Hispanics in the United States. We assessed the relationships between acculturation and use of oral health services among Hispanic adults in the United States.

Methods

Data were analyzed from Hispanic adults aged 18 years or older who participated in the 2006 Behavioral Risk Factor Surveillance System. Hispanics were defined by self-report of Spanish or Hispanic heritage. Preference to be interviewed in English or Spanish was used as a proxy for acculturation. Having had a dental visit in the previous 12 months was used as a proxy for use of oral health services.

Results

English-speaking Hispanics were more likely to have had a dental visit in the previous 12 months compared with Spanish-speaking Hispanics (crude odds ratio [OR], 1.52; 95% confidence interval [CI], 1.36-1.71). After controlling for potential confounders, language was not significantly associated with having had a dental visit (OR, 1.05; 95% CI, 0.87-1.26; P = .61,). The most significant predictors for having had a dental visit in the previous 12 months were sex, education, income, and having health insurance.

Conclusion

Acculturation assessed by language spoken was not significantly associated with having had a dental visit in the previous 12 months among adult Hispanics in the United States. The common determinants of health care use, such as sex, income, level of education, and health insurance status, were the most significant predictors of use of oral health services among adult Hispanics.     

Modifying Effects of Resting Heart Rate on the Association of Binge Drinking With All-cause and Cardiovascular Mortality in Older Korean Men: the Kangwha Cohort Study

Background

Although binge drinking and high resting heart rate independently affect cardiovascular and all-cause mortality risk, the combined effect of these two risk factors and their interaction has rarely been studied. This study examined the association between binge drinking and cardiovascular and all-cause mortality and evaluated the potential modifying effect on this association of resting heart rate in Korean men.

Methods

Men aged 55 years or older in 1985 (n = 2600) were followed for cardiovascular and all-cause mortality for 20.8 years, until 2005. We estimated hazard ratios (HRs) for cardiovascular and all-cause mortality by binge drinking and resting heart rate using the Cox proportional hazard model.

Results

Heavy binge drinkers (≥12 drinks on one occasion) with elevated resting heart rate (≥80 bpm) had a HR of 2.25 (95% confidence interval [CI], 1.47–3.45) for death from cardiovascular disease and 1.37 (95% CI, 0.87–2.14) for all-cause mortality compared to the reference group (non-drinking and resting heart rate 61–79 bpm). The HRs of dying from cardiovascular disease increased linearly from 1.36 to 1.52, 1.71, and 2.25 among individuals with resting heart rate greater than or equal to 80 bpm within the four alcohol consumption categories (non-drinking, non-binge, moderate binge, and heavy binge), respectively.

Conclusions

Our findings suggest that, among older Korean men, heavy binge drinkers with an elevated resting heart rate are at high risk for cardiovascular and all-cause mortality.Key words: alcohol drinking, binge drinking, cardiovascular disease, mortality, resting heart rate     

Peer Reviewed: Survey Language Preference as a Predictor of Meeting Fruit and Vegetable Objectives Among Hispanic Adults in the United States, Behavioral Risk Factor Surveillance System, 2009

Introduction

Although Hispanics are a rapidly growing ethnic minority in the United States, the effect of acculturation on the proportion of Hispanics who meet national objectives for fruit and vegetable consumption has not been fully investigated. Our objective was to determine the extent to which ethnicity and acculturation (indicated by survey language preference) are associated with fruit and vegetable consumption among Hispanics in the United States.

Methods

Fruit and vegetable consumption among adult respondents to the 2009 Behavioral Risk Factor Surveillance System was determined from data collected from the 31 states and 2 territories that offered the fruit and vegetable screener in Spanish and English (n = 287,997). Logistic regression analyses were used to determine whether ethnicity (Hispanic vs non-Hispanic white) and survey language preference (English vs Spanish) were related to meeting objectives of consuming fruit 2 or more times per day and vegetables 3 or more times per day.

Results

More Hispanics (37.6%) than non-Hispanic whites (32.0%) and more Spanish-speaking Hispanics (41.0%) than English-speaking Hispanics (34.7%) ate fruit 2 or more times per day. Conversely, more non-Hispanic whites (28.5%) than Hispanics (18.9%) and more English-speaking Hispanics (21.8%) than Spanish-speaking Hispanics (15.8%) ate vegetables 3 or more times per day. All associations remained significant after controlling for covariates.

Conclusion

Our findings have implications regarding how brief screeners can be used to determine possible dietary disparities among the Hispanic population in the United States and to monitor population goals to eliminate racial and ethnic health disparities.     

Vital Signs: Alcohol Poisoning Deaths — United States, 2010–2012

Background

Alcohol poisoning is typically caused by binge drinking at high intensity (i.e., consuming a very large amount of alcohol during an episode of binge drinking). Approximately 38 million U.S. adults report binge drinking an average of four times per month and consuming an average of eight drinks per episode.

Methods

CDC analyzed data for 2010–2012 from the National Vital Statistics System to assess average annual alcohol poisoning deaths and death rates (ICD-10 codes X45 and Y15; underlying cause of death) in the United States among persons aged ≥15 years, by sex, age group, race/ethnicity, and state.

Results

During 2010–2012, an annual average of 2,221 alcohol poisoning deaths (8.8 deaths per 1 million population) occurred among persons aged ≥15 years in the United States. Of those deaths, 1,681 (75.7%) involved adults aged 35–64 years, and 1,696 (76.4%) involved men. Although non-Hispanic whites accounted for the majority of alcohol poisoning deaths (67.5%; 1,500 deaths), the highest age-adjusted death rate was among American Indians/Alaska Natives (49.1 per 1 million). The age-adjusted rate of alcohol poisoning deaths in states ranged from 5.3 per 1 million in Alabama to 46.5 per 1 million in Alaska.

Conclusions

On average, six persons, mostly adult men, die from alcohol poisoning each day in the United States. Alcohol poisoning death rates vary substantially by state.

Implications for Public Health Practice

Evidence-based strategies for preventing excessive drinking (e.g., regulating alcohol outlet density and preventing illegal alcohol sales in retail settings) could reduce alcohol poisoning deaths by reducing the prevalence, frequency, and intensity of binge drinking.     

Results of a community-based survey of construction safety climate for Hispanic workers

Background:

Hispanic construction workers experience high rates of occupational injury, likely influenced by individual, organizational, and social factors.

Objectives:

To characterize the safety climate of Hispanic construction workers using worker, contractor, and supervisor perceptions of the workplace.

Methods:

We developed a 40-item interviewer-assisted survey with six safety climate dimensions and administered it in Spanish and English to construction workers, contractors, and supervisors. A safety climate model, comparing responses and assessing contributing factors was created based on survey responses.

Results:

While contractors and construction supervisors’ (n = 128) scores were higher, all respondents shared a negative perception of safety climate. Construction workers had statistically significantly lower safety climate scores compared to supervisors and contractors (30.6 vs 46.5%, P<0.05). Safety climate scores were not associated with English language ability or years lived in the United States.

Conclusions:

We found that Hispanic construction workers in this study experienced a poor safety climate. The Hispanic construction safety climate model we propose can serve as a framework to guide organizational safety interventions and evaluate safety climate improvements.     

Drinking Patterns and Behavioral Consequences: A Cross-Sectional Study among Romanian University Students

Background

Alcohol/binge drinking among university students has become a major public health problem. Many of young students will be exposed to substantial changes in living arrangements, socialization groups and social activities during the transitional period.

Aim

The aim of this study was to analyse the alcohol consumption in Romanian university students, and to describe the behaviours occurring after drinking.

Methods

A cross-sectional study was conducted on 468 undergraduate students, from a university for medicine and law. Of these students, 35.5% were males and 64.5% were females. The mean age of students was 21.9 ± 3.22 years. Validated anonymous paper questionnaires were completed voluntary by the students. Questionnaires contained demographic items, six questions for determining the level of alcohol consumed in terms of quantity and frequency, and 19 statements or problems resulting from drinking.

Results

The findings of the study showed that males drunk more units of alcohol/week than females (p<0.001). The prevalence of abstainers was 10.8% in males and 17.6% in women. Heavy drinkers (drinking 5 or more drinks more than once a week) were more common among male (19.3%) than among female students (16.2%). Most frequently, drinking behaviours are related to academic performance, and the possible link between poor academic performance and alcohol consumption appears tenuous and merits further investigation.

Conclusion

Effective intervention strategies should be implemented to prevent students’ alcohol consumption and adverse health and social consequences resulting from this behaviour.     

Peer Reviewed: Depression, Diabetes, and Chronic Disease Risk Factors Among US Women of Reproductive Age

Introduction

Depression and chronic disease have implications for women''s overall health and future pregnancies. The objective of this study was to estimate the prevalence and predictors of diabetes and chronic disease risk factors among reproductive-age women with depression.

Methods

We used population-based data from the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System to examine prevalence of diabetes and prediabetes, binge and heavy drinking, smoking, overweight and obesity, and physical inactivity among 69,043 women aged 18 to 44 years with current major or minor depression, a past depression diagnosis, or no depression. In a multivariable logistic regression model, we calculated adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of 1, 2, and 3 or more chronic disease risk factors by depression status.

Results

We found that 12.8% of reproductive-aged women experienced both current depression and 1 or more chronic disease risk factors. Compared to women with no depression, currently depressed women and those with a past diagnosis had higher prevalence of diabetes, smoking, binge or heavy drinking, obesity, and physical inactivity (P < .001 for all). Odds of 3 or more chronic conditions and risk factors were elevated among women with major (AOR, 5.7; 95% CI, 4.3-7.7), minor (AOR, 4.7; 95% CI, 3.7-6.1), and past diagnosis of depression (AOR, 2.8; 95% CI, 2.4-3.4).

Conclusion

Depressed women of reproductive age have high rates of chronic disease risk factors, which may affect their overall health and future pregnancies.     

A Study of High-Risk Drinking Patterns Among Generations Based on the 2009 Korea National Health and Nutrition Examination Survey

Objectives

The aim of this study was to identify how the drinking patterns of a generation on the paternal side affect those of the next generations by estimating the number of high-risk drinkers by generation according to the Alcohol Use Disorder Identification Test.

Methods

Data were selected from the 2009 Korea National Health and Nutrition Examination Survey conducted by the Korea Centers for Disease Control and Prevention and were analyzed using SPSS 18.0.

Results

Later generations started drinking earlier (62.4%, 71.8% and 91.1%, respectively). The majority of the second generation consumed more than 2–4 drinks a month (83.7%), but only a small proportion experienced difficulty in everyday life (9.6%), felt repentance (9.6%), or experienced memory loss (17.9%) after drinking. Unmarried third-generation adults with high-risk-drinking fathers reported more frequent alcohol consumption [odds ratio (OR) 1.441), greater amounts on one occasion (>7 cups for men, OR 1.661; > 5 cups for women, OR 2.078), temperance failure (OR 2.377), and repentance after drinking (OR 1.577). Unmarried third-generation adults with high-risk-drinking grandfathers consumed greater amounts of alcohol on one occasion (OR 3.642), and unmarried third-generation women more frequently consumed large amounts of alcohol (>5 cups, OR 4.091). Unmarried third-generation adults with high-risk-drinking fathers were more likely to exhibit high-risk drinking patterns (OR 1.608). Second-generation individuals from a high-risk-drinking first generation were more likely to engage in high-risk drinking (OR 3.705).

Conclusion

High-risk drinking by a generation significantly affects the high-risk drinking patterns of subsequent generations.     

Alcohol Consumption and Mortality: The Khon Kaen Cohort Study,Thailand

Background

The prevalence of alcohol consumption among Thais is high, around 30%. We quantified the relationship between alcohol drinking and mortality in a rural population in the most populous region of Thailand.

Methods

The data were from the Khon Kaen Cohort Study. About 24 000 Thai adults were enrolled between 1990 and 2001, and follow-up for vital status continued until March 16, 2012. Mortality data were obtained from the Bureau of Policy and Strategy, Ministry of the Interior, Thailand. A Cox proportional hazards model was used to analyze the association between alcohol drinking and death, controlling for age, education level, and smoking, and floating absolute risk was used to estimate the 95% confidence intervals of hazard ratios.

Results

In total, 18 457 participants (5829 men and 12 628 women) were recruited, of whom 3155 died (1375 men and 1780 women) during a median follow-up period of 13.6 years. Although alcohol drinking was common (64% of men and 25% of women), the amounts consumed were very low (average, 4.3 g/day in men and 0.8 g/day in women). As compared with never drinkers, mortality risk was lower among current drinkers and higher among ex-drinkers. Current drinking was not associated with mortality from cancer or diseases of the circulatory system, although ex-drinkers appeared to have a higher risk of death from the latter.

Conclusions

The leading causes of mortality were not associated with current alcohol drinking at the low consumption levels observed in this population.Key words: alcohol consumption, mortality, health behaviour, rural population     

The Drinking Habits of Users of an Alcohol Drinking Screening Website in Slovenia

Background

Alcohol consumption in Slovenia is one of the highest in Europe. In Slovenia there were a few epidemiological studies on drinking habits among adult population, but none of them has used the AUDIT questionnaire or the Internet for research.

Objective

The aim of this study was to analyse the drinking habits of the visitors of our website www.nalijem.si, which included an anonymous questionnaire for self-assessment of alcohol drinking.

Methods

A cross sectional survey was conducted between January 2010 and December 2013. The front page of our website included an invitation to fill in the anonymous web-based questionnaire; a part of it was the AUDIT 10 questionnaire. Everyone who filled in the questionnaire completely received an individualized feedback on his drinking.

Results

54.020 persons visited our website, 15.817 (29.3%) of them started to fill in the questionnaire, 12.800 (80.9%) filled it in completely. In the analysis, 9.087 (71.0%) persons were included who completed the questionnaire for themselves. There were 37.1% (N=3.373) women and 62.9% (N=5.714) men. The average age was 33 years, the majority was employed (59.7%, N=5.222). The minority drank alcohol 2–4 times per month (32.8%, N=2.977) and most of them (64.5%, N=5.869) drank more than 3 units of alcohol per one occasion on a typical day. The average AUDIT 10 score was 11.7 for men, 8.1 for women.

Conclusions

A large percentage of participants were identified as hazardous and harmful drinkers, which should be a matter of serious concern.     

Peer Reviewed: Alcohol Use and Selected Health Conditions of 1991 Gulf War Veterans: Survey Results, 2003-2005

Introduction

A sizable literature has analyzed the frequency of alcohol consumption and patterns of drinking among veterans. However, few studies have examined patterns of alcohol use in veterans of the first Gulf War or factors associated with problem drinking in this population. We examined the frequency and patterns of alcohol use in male and female veterans who served in the 1991 Gulf War or during the same era and the relationships between alcohol use and selected health conditions.

Methods

We analyzed data from a follow-up survey of health information among population-based samples of 15,000 Gulf War and 15,000 Gulf Era veterans. Data had been collected from 9,970 respondents during 2003 through 2005 via a structured questionnaire or telephone survey.

Results

Posttraumatic stress disorder (PTSD), major depressive disorder (MDD), unexplained multisymptom illness (MSI), and chronic fatigue syndrome (CFS)–like illness were more frequent among veterans with problem drinking than those without problem drinking. Approximately 28% of Gulf War veterans with problem drinking had PTSD compared with 13% of Gulf War veterans without problem drinking. In multivariate analysis, problem drinking was positively associated with PTSD, MDD, unexplained MSI, and CFS–like illness after adjustment for age, sex, race/ethnicity, branch of service, rank, and Gulf status. Veterans who were problem drinkers were 2.7 times as likely to have PTSD as veterans who were not problem drinkers.

Conclusion

These findings indicate that access to evidence-based treatment programs and systems of care should be provided for veterans who abuse alcohol and who have PTSD and other war-related health conditions and illnesses.     

Racial/Ethnic Differences in Receipt of Timely Adjuvant Therapy for Older Women with Breast Cancer: Are Delays Influenced by the Hospitals Where Patients Obtain Surgical Care?

Objective

To examine whether hospitals where patients obtain care explain racial/ethnic differences in treatment delay.

Data Source

Surveillance, Epidemiology, and End Results data linked with Medicare claims.

Study Design

We examined delays in adjuvant chemotherapy or radiation for women diagnosed with stage I–III breast cancer during 1992–2007. We used multivariable logistic regression to assess the probability of delay by race/ethnicity and included hospital fixed effects to assess whether hospitals explained disparities.

Principal Findings

Among 54,592 women, black (11.9 percent) and Hispanic (9.9 percent) women had more delays than whites (7.8 percent, p < .0001). After adjustment, black (vs. white) women had higher odds of delay (odds ratio = 1.25, 95 percent confidence interval = 1.10–1.42), attenuated somewhat by including hospital fixed effects (OR = 1.17, 95 percent CI = 1.02–1.33).

Conclusions

Hospitals are the important contributors to racial disparities in treatment delay.     

Association between occupational heat stress and kidney disease among 37,816 workers in the Thai Cohort Study (TCS)

Background

We examined the relationship between self-reported occupational heat stress and incidence of self-reported doctor-diagnosed kidney disease in Thai workers.

Methods

Data were derived from baseline (2005) and follow-up (2009) self-report questionnaires from a large national Thai Cohort Study (TCS). Analysis was restricted to full-time workers (n = 17 402 men and 20 414 women) without known kidney disease at baseline. We used logistic regression models to examine the association of incident kidney disease with heat stress at work, after adjustment for smoking, alcohol drinking, body mass index, and a large number of socioeconomic and demographic characteristics.

Results

Exposure to heat stress was more common in men than in women (22% vs 15%). A significant association between heat stress and incident kidney disease was observed in men (adjusted odds ratio [OR] = 1.48, 95% CI: 1.01–2.16). The risk of kidney disease was higher among workers reporting workplace heat stress in both 2005 and 2009. Among men exposed to prolonged heat stress, the odds of developing kidney disease was 2.22 times that of men without such exposure (95% CI 1.48–3.35, P-trend <0.001). The incidence of kidney disease was even higher among men aged 35 years or older in a physical job: 2.2% exposed to prolonged heat stress developed kidney disease compared with 0.4% with no heat exposure (adjusted OR = 5.30, 95% CI 1.17–24.13).

Conclusions

There is an association between self-reported occupational heat stress and self-reported doctor-diagnosed kidney disease in Thailand. The results indicate a need for occupational health interventions for heat stress among workers in tropical climates.Key words: occupational heat stress, kidney disease, Thai Cohort Study, Thailand     

Peer Reviewed: Binge Drinking and Occupation,North Dakota, 2004–2005

Introduction

Binge drinking is a leading cause of preventable death and results in employee absenteeism and lost productivity. Knowledge about the prevalence of binge drinking among employees of different occupations is limited.

Methods

We assessed the prevalence of binge drinking (i.e., consuming five or more drinks per occasion during the previous 30 days) by primary occupation using data from the 2004–2005 North Dakota Behavioral Risk Factor Surveillance System. We used logistic regression to assess the association between binge drinking and primary occupation.

Results

Overall, 24.1% (95% confidence interval [CI], 22.5–25.7) of North Dakota workers reported binge drinking. The prevalence was highest among farm or ranch employees (45.3%; 95% CI, 28.3–63.4), food or drink servers (33.4%; 95% CI, 23.9–44.4), and farm or ranch owners (32.5%; 95% CI, 26.3–39.4). The prevalence was lowest among health care workers (13.2%; 95% CI, 10.3–16.8). Compared with health care workers, the adjusted odds of binge drinking were highest among farm or ranch employees (adjusted odds ratio [AOR], 2.2; 95% CI, 0.9–5.5), food or drink servers (AOR, 2.1; 95% CI, 1.1–4.0), and farm or ranch owners (AOR, 1.7; 95% CI, 1.1–2.6). Health insurance coverage was lowest among employees in occupations with the highest prevalence of binge drinking.

Conclusion

We found occupational differences in the prevalence of binge drinking among employees in North Dakota. Many occupational categories had a high prevalence of binge drinking. We recommend the implementation of both employer-sponsored and population-based interventions to reduce binge drinking among North Dakota workers, particularly because employees in occupations with the highest rates of binge drinking had the lowest rates of health insurance coverage.     

Gender Differences in Hypertension Control Among Older Korean Adults: Korean Social Life,Health, and Aging Project

Objectives:

Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients’ attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults.

Methods:

This cross-sectional study analyzed data from 653 Koreans aged ≥60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension.

Results:

Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one’s blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013).

Conclusions:

This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.     

Peer Reviewed: An Observational Study of the Secondary Effects of a Local Smoke-Free Ordinance

Introduction

The secondary, sometimes unintended effects of smoke-free ordinances have not been thoroughly evaluated. In this observational study, we evaluated the association of a local ordinance implemented in Madison, Wisconsin, with changes in public disturbances; smoking, drinking, and bar-going behaviors in the general population; and smoking and drinking behaviors among university students.

Methods

We obtained data from 4 sources: police records, key informant interviews, a community survey, and an undergraduate survey. Except for interviews, which we conducted postenactment only, we compared measures before and after the ordinance was put into effect.

Results

We found no evidence of association of the ordinance with public disturbances. We found that the ordinance was not associated with changes in smoking rates, drinking rates, or bar-going in the general population, although bar-going decreased among the 16% of the general adult population who smokes (from 84% in 2005 to 70% in 2007, P < .001). Student smoking rates also decreased (from 23% in 2005 to 16% in 2007, P < .001), but student binge drinking did not change.

Conclusion

The study adds unique information to the evidence base on the effect of smoke-free policies, finding little evidence of their secondary, unintended effects. With the addition of these results to existing evidence, we conclude that the potential health benefits of smoke-free ordinances outweigh the potential harms from unintended effects.     

Amount and Frequency of Alcohol Consumption and All-Cause Mortality in a Japanese Population: The JMS Cohort Study

Background

Lower mortality has been reported in light-to-moderate alcohol drinkers. We examined the association between the amount and frequency of alcohol consumption and all-cause mortality in a Japanese population.

Methods

We conducted a prospective cohort study among 8934 Japanese people (3444 men and 5490 women) who completed a baseline survey between 1992 and 1995. We confirmed the date and cause of death by referring to death certificates. The Cox proportional hazards model was used to evaluate the effect of alcohol consumption on risk for all-cause mortality, after adjustment for potential confounding factors.

Results

We identified 637 (397 men and 240 women) deaths during the 12.0 years of mean follow-up. Among men, as compared with non-drinkers, the relative risk was higher in ex-drinkers (hazard ratio [HR], 1.18), lower in light drinkers (HR, 0.95) and moderate drinkers (HR, 0.91), and significantly higher in heavy drinkers (HR, 1.67; 95% confidence interval, 1.10–2.55). Among women, light, moderate, and heavy drinkers were grouped into current drinkers. The relative risk was slightly higher in current drinkers (HR, 1.23), and that in ex-drinkers was near 1.0 (HR, 0.97). In stratified analysis, the harmful effects of heavy drinking were more severe among male smokers and younger men. In terms of frequency, men who drank only on special occasions had the highest mortality (HR, 1.28), regardless of alcohol intake per drinking session.

Conclusions

In men, a near J-shaped association was identified between alcohol consumption and all-cause mortality. Both the amount and frequency of alcohol consumption were related to mortality.Key words: cohort studies, alcohol drinking, mortality, Japan