V. Medical effects of aircraft noise: Community cardiovascular survey

Summary Data of a community cardiovascular survey in the area around Schiphol airport (Amsterdam) were related to existing aircraft noise levels.About 6,000 people (men and women, aged 35–64 years) were screened. Afterwards the participants were divided into two groups: those living in areas with more (NNI > 37) and those living in areas with less (NNI = 20–37) aircraft noise.It appeared that in areas with more aircraft noise, more people were under medical treatment for heart trouble and hypertension and — especially more women — took cardiovascular drugs. Moreover, in areas with more aircraft noise in more people high blood pressure and pathological heart shape were observed. The discrepancies that were found could not be explained by age, sex, smoking habits, height/weight, and — as far as this could be checked — by socio-economic differences. In areas with more aircraft noise roughly 50% more people had cardiovascular impairment.     

Residual agglutinins against rickettsial agents in human sera from central and eastern Turkey and their relation to cardiovascular diseases

Many workers have shown that the recrudescence of rickettsial infections may cause cardiovascular diseases of all kinds. As Turkey is a region where rickettsial infections in man are endemic, the relation between such infections and cardiovascular disease has been further studied there. Sera were collected from patients with cardiovascular diseases and also from healthy people and patients with diseases not affecting the heart, who served as a control group. A considerably higher percentage of positive sera was obtained from the patients with cardiovascular diseases, particularly for R. prowazekii, R. conorii and C. burnetii. It was also found that the highest percentage of positive sera was obtained from people in the 20-40 years age-group. Antistreptolysin-O (ASO) determinations were also made and it was found that, on average, agglutinin-negative sera had the higher ASO titres.     

It’s The “Why”: Links between (Non)autonomous Sexual Motives,Sexual Assertiveness,and Women’s Orgasm in Casual Sex

Existing literature shows conflicting and inconclusive evidence regarding women’s sexual experiences in casual sex. Some studies have found negative sexual outcomes (e.g., fewer orgasms), while others have found positive sexual outcomes (e.g., more orgasms, higher sexual satisfaction) when women had casual sex. According to self-determination theory (Deci & Ryan, 1985), people’s needs are fulfilled when their choice and behavior are self-motivated and reflect their intrinsic values. We hypothesized that women’s autonomous motivation to have casual sex would be associated with higher orgasmic function, whereas nonautonomous motivation would be associated with lower orgasmic function in casual sex. We also hypothesized that sexual assertiveness would mediate the relationship between sexual motives and orgasmic function in casual sex. Participants in this study were women (N?=?401) aged 18–59 years who reported having had casual sex in the past 12 months. Participants completed an online survey reporting their motives to have casual sex, sexual assertiveness, and orgasmic function (e.g., orgasm frequency, satisfaction with orgasm) in casual sex. We focused on two motives: (a) pleasure motive and (b) insecurity (i.e., self-esteem boost and pressure) motive. Results showed that greater pleasure (autonomous) motives related to higher sexual assertiveness, which in turn related to higher orgasmic function in casual sex. In contrast, greater insecurity (nonautonomous) motives related to lower sexual assertiveness, which in turn related to lower orgasmic function in casual sex. The findings support self-determination theory, suggesting that autonomous motives are important for women’s sexual experience in casual sex.

     

Prevention and follow-up of cardiovascular disease among patients without a personal GP

OBJECTIVE: This paper describes the characteristics of Belgian people who declare that they have a personal GP (PGP) compared with those who do not. Furthermore, patterns of cardiovascular prevention and care are described for these two groups. METHODS: The data are derived from the 1997 Belgian Health Interview Survey (HIS) in which a representative sample (n = 10 221) of the Belgian population was questioned. The HIS data about physical activity, food, blood pressure, cholesterol, cardiovascular diseases, diabetes and stroke are analysed. RESULTS: After standardization for age and gender, 7.0% of the subjects declared that they did not have a PGP. The mean age of patients without a PGP (33.2 +/- 20.4 years) is significantly lower than for those with a PGP (40.4 +/- 22.7 years) (P < 0.001). More smokers (38.5% compared with 28.5%) were reported among the subjects without a PGP (P < 0.001). For 14.8% of the subjects without a PGP, their blood pressure had never been measured, and for 51.1% their cholesterol had never been measured (6.7% and 35.7%, respectively in subjects with a PGP). Among the subjects without a PGP, 3.8% had high blood pressure and 1.5% had a coronary heart disease. Among the hypertensive patients without a PGP, 43.6% are not treated by any physician. CONCLUSION: Subjects without a PGP were less likely to have a healthy way of life. Having a PGP seemed to have a beneficial influence on the screening for and the follow-up of cardiovascular risk factors. However, it has never been confirmed that providing people who do not have a PGP with one would result in health improvements. In particular, cardiac patients without a PGP sought their medical treatment directly from specialists.     

江汉区65岁及以上老年人慢性病患病状况调查

摘要:目的　了解江汉区65岁及以上老年人的慢性病患病状况,为制定有效防治措施提供依据。方法　对2014年5月-12月在江汉区13所社区卫生服务机构参加免费体检的15113名老年人进行问卷调查和体检。结果　江汉区65岁及以上老年人慢性病总患病率为75.63%,患病率排在前三位的依次是高血压（66.98%）、糖尿病（18.40%）和冠心病（8.31%）;女性的糖尿病、高脂血症患病率高于男性,而慢性支气管炎患病率低于男性。体重超重/肥胖者高血压（P＜0.01）、糖尿病（P＜0.01）、冠心病（P＜0.05） 的患病率明显高于体重正常者。高血压患者患糖尿病、冠心病、高脂血症和脑中风的风险增加（P＜0.01）。结论　江汉区老年人慢性病患病率较高,采取有效措施控制老年人体重和血压,对降低老年人心脑血管疾病患病率,提高生命质量具有重要的意义。     

江苏省心血管病高危人群中高血压患者血压控制的随访研究

目的 探讨心血管病高危人群中高血压患者血压随访控制情况,为高血压及心血管病防治提供理论依据和参考。方法 选取2016―2019年参与项目的心血管病高危人群中20 091名高血压患者作为研究对象,对研究对象进行两次随访。采用广义估计方程对血压控制情况进行分析。结果 在心血管病高危人群中,第1次随访血压控制率为37.8%,第2次随访血压控制率为32.8%。吸烟者、城市居民以及受教育程度越高和家庭年收入越高的人群血压越易控制,而高血压知晓者、饮酒者和BMI高者血压均不易得到控制(均有P<0.05)。结论 江苏省心血管病高危人群中高血压患者的血压控制水平还有待于提高,应加强重点人群的血压防控工作,且需进行规范化的血压管理和有效的干预措施来提高控制效果。     

广西壮族自治区40岁以上人群冠心病事件发病影响因素的队列研究

目的探讨影响广西壮族自治区40岁以上人群冠心病事件发病的影响因素。方法在1991年全国高血压调查的基础上，对广西壮族自治区〉40岁以上11818人进行了随访调查，取得其冠心病发病资料。结果冠心病事件的发生与收缩压（SBP）、舒张压（DBP）、脉压、吸烟、体重指数（BMI）和有无心肌梗死（心梗）史有关。Cox回归分析表明，有心梗史者较无心梗史者发生冠心病事件的相对危险度（RR）大21倍（95％CI：9．06～48．44）；脉压每增高10mmHg（1mmHg=0．133kPa），冠心病事件发生的RR为1．29倍（95％CI：1．11～1．49），大于DBP的118倍（95％CI：1．02～1．22）、SBP的1．13倍（95％CI：105～1．28）；吸烟者比不吸烟者的冠心病事件的RR增加1．23倍（95％CI：1．05～1．45）；每增加1的BMI，冠心病事件的RR增加1．03倍（95％CI：1．01～1．05）。结论有心梗史者、高血压、吸烟、高BMI是冠心病发病的危险因素。     

Physical development and the cardiovascular system in young people in relation to the level of motor activity

The age-related changes in anthropometric and cardiovascular parameters have been studied in young persons aged 10-19 years who live in Magadan. The children and adolescents who do not go in for sports show more irregular yearly increments in their height and body weight. Those who go in for sports display lower average heart rate and systolic blood pressure (SBP). Among the young males (aged 16-19 years) who do not go in for sports, 15% had a SBP of 140 mm Hg or higher while only 3% of the athletes had this pressure. It is concluded that going in for sports is an important factor of prevention of early arterial hypertension in young people living in North-Eastern Russia.     

Acute effect of maternal smoking on fetal blood circulation

The authors examined the acute effects of cigarette smoking on maternal and fetal cardiovascular system in 22 healthy voluntary pregnant smoker women. All examined patients were chronic cigarette smokers who smoked more than 5 cigarettes per day before and during pregnancy. All of the pregnancies subsequently had normal outcomes. Maternal heart rate, and blood pressure, fetal heart rate, resistance indices of fetal descending aorta, those of umbilical artery, middle cerebral artery and uterine artery were measured immediately before and after cigarette smoking. It was found that smoking was associated with increase in maternal and fetal heart rate and an increase in umbilical artery resistance indices was also observed. These changes might be considered as a reaction improving fetal oxygen supply.     

Low levels of cardiovascular risk factors and coronary heart disease in a UK Chinese population.

OBJECTIVE: To compare the prevalence of cardiovascular risk factors and coronary heart disease in Chinese and Europid adults. DESIGN: Population based, cross sectional survey. SETTING: Newcastle upon Tyne, UK, 1991-93. SUBJECTS: Altogether 380 Chinese and 625 Europid adults, aged 25-64 years. MAIN OUTCOME MEASURES: Fasting lipid levels, blood pressure, body mass index (BMI), the proportions who smoked, and the prevalence of coronary heart disease based on the Rose angina questionnaire and major electrocardiographic abnormalities on resting 12 lead electrocardiogram (Minnesota codes 1.1-1.2). All figures were age adjusted to the 1991 England and Wales population. RESULTS: Altogether 183 and 197 Chinese, and 310 and 315 Europid men and women respectively were seen. Compared with Europid men, Chinese men had a lower mean total cholesterol concentration (5.1 versus 5.6 mmol/l, p < 0.001) and LDL cholesterol (3.2 versus 3.6 mmol/l, p < 0.001); lower BMI values (23.8 versus 26.1 kg/m-2, p < 0.001); and smoked less (23% versus 35%, p < 0.01)). Compared with Europid women, Chinese women also had lower mean lipid levels (total cholesterol: 4.9 versus 5.4 mmol/l p < 0.001, LDL cholesterol: 2.8 versus 3.1 mmol/l p < 0.001); BMI values (23.5 versus 26.1 kg/m-2, p < 0.001); and far fewer were smokers (1.4% versus 33%, p < 0.001). Chinese women, however, had higher mean systolic (121 versus 117 mmHg, p > 0.05) and diastolic (75 versus 68 mmHg, p < 0.001) blood pressures. The prevalence of coronary heart disease was significantly lower in Chinese than Europid men (4.9% versus 16.6%, p < 0.001) but not significantly different in women (7.3% versus 11.1%, p = 0.16). CONCLUSION: Strategies for UK Chinese are needed to maintain this favourable risk factor profile and prevent any potential increase in the risk of coronary heart disease associated with increasing acculturation.     

Parental history and cardiovascular disease risk factor variables in children

As part of a total community study of cardiovascular disease (CVD) risk factor variables in children (ages 5–17 years), parental histories of heart attacks, hypertension, diabetes, and stroke were obtained for each of 4,074 participating children. Subsequently, each child was examined for serum total cholesterol, triglycerides, lipoproteins (LP) and glucose, measurement of height, weight, triceps skinfold thickness, and blood pressure (BP), and had a physical examination. A family history of high BP was reported by 26.5% of all children, diabetes by 7.1%, heart attacks by 6.8%, and stroke by 2.1%. The children of parents with heart attacks or diabetes were heavier and had different lipid and LP profiles than children without this background. Children of reported hypertensive parents had higher systolic and diastolic BP, were heavier and had thicker skinfolds. The heaviest children were more likely to have a parental history of diabetes, hypertension, and heart attack. Children in the highest decile for systolic or diastolic BP were more likely to come from a family reporting hypertension. Children with the highest cholesterol, triglycerides, β + pre-β-LP and lowest α-LP values tended to have parents with heart attacks or diabetes. These data indicate that familial tendencies in multiple CVD risk factors are observable early in life. Children of parents with CVD or manifested risk factors clearly differ in their own risk factor profiles from children of parents without these conditions.     

Cardiovascular disease in Navajo Indians with type 2 diabetes.

Rates of both type 2 diabetes and cardiovascular disease have risen sharply in recent years among Navajo Indians, the largest reservation-based American Indian tribe, but the association between the two conditions is not entirely clear. Rates of cardiovascular disease and some possible associations in several hundred diabetic and non-diabetic Navajos were estimated. Nearly one-third (30.9 percent) of those with diabetes had formal diagnoses of cardiovascular disease--25.3 percent had heart disease, 4.4 percent had cerebrovascular disease, and 4.1 percent had peripheral vascular disease. (The percentages exceed the total because some people had more than one diagnosis. Age-adjusted rates were 5.2 times those of nondiabetics for heart disease, 10.2 times for cerebrovascular disease, and 6.8 times for peripheral vascular disease. Accentuation of risk was most marked in young diabetics and in female diabetics. Hypertensive diabetics had a twofold increase in heart disease and more than a fivefold increase in cerebral and peripheral vascular disease over nonhypertensive diabetics. Age, blood pressure, cholesterol levels, and albumenuria were independent risk factors for cardiovascular disease. Triglyceride levels or body weight were not. Male sex and diabetes duration were independent risk factors for cerebral and peripheral vascular disease but not for heart disease. In view of the impressive segregation of cardiovascular disease in the diabetic Navajo population, the prevention of diabetes through population-based health promotion seems basic to its containment. Over the short term, vigorous treatment of hypertension in subjects who are already diabetic is mandatory.     

The association between birthplace in different regions of the world and cardiovascular mortality among residents of Spain

The objective of this study is to estimate the association of birthplace with mortality from cardiovascular diseases in residents of Spain by analysing immigrant populations that are unlikely to have adopted health-related attitudes and behaviours of the host country. Data from the population register and cause of death register were used for the period 2001–2005. The study included people aged 20–64 years. Age-adjusted mortality from cardiovascular diseases—and from ischaemic heart disease, cerebrovascular disease and hypertension-related disease—according to birthplace were estimated and compared with those for the native Spanish population by mortality rate ratios. Compared with the native Spanish population, residents who came from Eastern Europe, Sub-Saharan Africa and South Asia had a higher risk of mortality from most of the cardiovascular diseases analysed. Women from North Africa and the Caribbean also had a higher risk of cardiovascular mortality. A higher risk of mortality from ischemic heart disease was observed in persons from the Middle East, and from cerebrovascular disease in those from Eastern Asia. Compared with the native Spanish population, residents from South America and Eastern Asia had a lower risk of mortality from ischemic heart disease. This pattern of mortality from cardiovascular diseases in residents of Spain who have come from different regions of the world is very similar to the findings of studies in other countries, and probably reflects the burden of disease in the countries of origin.     

Dietary Soy Consumption and Cardiovascular Mortality among Chinese People with Type 2 Diabetes

Randomized controlled trials showed that soy intervention significantly improved blood lipids in people with diabetes. We sought to prospectively examine the association of soy consumption with the risk of cardiovascular death among individuals with diabetes. A total of 26,139 participants with a history of diabetes were selected from the Chinese Kadoorie Biobank study. Soy food consumption was assessed by a food frequency questionnaire. Causes of death were coded by the 10th International Classification of Diseases. The Cox proportional hazard regression was used to compute the hazard ratios. During a median follow-up of 7.8 years, a total of 1626 deaths from cardiovascular disease (CVD) were recorded. Compared with individuals who never consumed soy foods, the multivariable-adjusted risks (95% confidence intervals) of CVD mortality were 0.92 (0.78, 1.09), 0.89 (0.75, 1.05), and 0.77 (0.62, 0.96) for those who consumed soy foods monthly, 1–3 days/week, and ≥4 days/week, respectively. For cause-specific cardiovascular mortality, significant inverse associations were observed for coronary heart disease and acute myocardial infarction. Higher soy food consumption was associated with a lower risk of cardiovascular death, especially death from coronary heart disease and acute myocardial infarction, in Chinese adults with diabetes.     

A prospective study of high blood pressure and cardiovascular disease in women

The relation of self-reported high blood pressure to the subsequent development of coronary heart disease and stroke was examined in a cohort of 119,963 women, aged 30-55 years, who were initially free from cardiovascular disease. Participants in the Nurses' Health Study reported high blood pressure and other cardiovascular risk factors on baseline questionnaires mailed in 1976. During six years of follow-up, there were 308 incident cases of coronary heart disease (66 fatal and 242 nonfatal myocardial infarctions) and 175 strokes (50 fatal and 125 nonfatal). Fatal as well as nonfatal coronary heart disease and stroke were all significantly more frequent among the women who had reported high blood pressure. After adjusting simultaneously for age and other risk factors, the relative risks were 3.5 (95% confidence interval (Cl) 2.8-4.5) for total coronary heart disease and 2.6 (95% Cl 1.8-3.5) for total stroke. This association was evident at all levels of relative weight. The results emphasize the importance of high blood pressure as an independent predictor of coronary heart disease and stroke in middle-aged women and suggest that the increased risk occurs in both lean and obese women.     

Changes in physical activity in leisure time and the risk of myocardial infarction, ischemic heart disease, and all-cause mortality

Physical activity is associated to a lower risk of mortality from all-causes and from coronary heart disease. The long-term effects of changes in physical activity on coronary heart disease are, however, less known. We examined the association between changes in leisure time physical activity and the risk of myocardial infarction (MI), ischemic heart disease (IHD), and all-cause mortality as well as changes in blood pressure in 4,487 men and 5,956 women in the Copenhagen City Heart Study. Physical activity was measured in 1976–1978 and 1981–1983 and participants were followed in nation-wide registers until 2009. Men who decreased physical activity by at least two levels and women who decreased by one level had a higher risk of MI relatively to an unchanged physical activity level (hazard ratio [HR] = 1.74, 95% confidence interval [95% CI]: 1.17–2.60 and HR = 1.30, 95% CI: 1.03–1.65). Similar associations were found for IHD although only significant in women. In all-cause mortality, men who increased physical activity had a lower risk and both men and women who reduced physical activity had a higher risk compared to an unchanged physical activity level. No association between changes in physical activity and blood pressure was observed. Findings from this prospective study suggest that changes in physical activity affect the risk of MI, IHD and all-cause mortality. A decrease in physical activity was associated to a higher risk of coronary heart disease.     

Comparison of patterns of smoking behavior change among smokers in the Multiple Risk Factor Intervention Trial (MRFIT)

The Multiple Risk Factor Intervention Trial (MRFIT) is a 6-year clinical trial for the study of the prevention of heart disease. Twelve thousand eight hundred and sixty-six men in the upper 10–15% of heart attack risk were randomly assigned to Special Intervention (SI) or Usual Care (UC). The SI participants received “risk factor” (hypertension, hypercholesterolemia, and cigarette smoking) intervention at the clinical centers; the UC participants were referred to their usual source of medical care for treatment. Forty percent of SI and 21% of UC smokers at entry reported not smoking at year 4, with lighter smokers in both treatment groups reporting significantly more cessation than heavier smokers. The greatest SI-UC difference in cessation rate was achieved during the first year of the program. The use of serum thiocyanate, an objective indicator of cigarette smoking, avoided problems inherent in self-reported data. Misreporting of smoking status was found in both groups with more occurring among the SI smokers. Cohort analysis revealed that of the smokers who stopped during the first year of the trial, 68% of SI and 57% of UC remained abstinent through the 4-year follow-up. Of the smokers who stopped later in the program the UC had better maintenance rates than the SI.     

Factors related to total cholesterol and blood pressure in British 9 year olds.

STUDY OBJECTIVE: To assess which factors are associated with total cholesterol concentration and blood pressure in 9 year olds, and to examine the extent to which a report of a heart attack in a close relative identifies children with a high total cholesterol value or high systolic blood pressure. DESIGN: This was a cross sectional study. SETTING: The analysis was based on 22 study areas from a representative English sample, 14 areas from a representative Scottish sample, and 20 areas from an inner city sample. PARTICIPANTS: There were 1987 children aged 8 or 9 whose blood pressure was measured and 1662 children whose total cholesterol was assessed. MEASUREMENTS AND MAIN RESULTS: Blood pressure was measured using the Dinamap 1846 automated sphygmomanometer and cholesterol using the Lipotrend C. Multiple regression analysis was used to examine the independent associations with each of the outcome variables. Either weight for height or sum of skinfolds measured in four sites was highly associated with the outcome measures in the study (p < 0.001). Fatter or overweight children had higher blood pressure and higher cholesterol concentrations. Child's height was also associated with the outcome measures in most of the analyses, but was positively related to blood pressure and negatively associated with cholesterol value. There was an association between diastolic blood pressure and area of residence as represented by the regional health authority (RHA), but the association was not the same as the association reported between coronary heart disease, standardised mortality ratio, and RHA. Children with low birth weight and those with shorter gestation had higher systolic blood pressure (p < 0.05 and p < 0.01 respectively), but not diastolic blood pressure. A report of a premature heart attack in a parent or a grandparent was not associated with higher cholesterol or blood pressure. CONCLUSIONS: Reducing obesity in children, together with the avoidance of smoking, may be an appropriate action to prevent coronary heart disease in adulthood. A report of heart disease in a close relative is an ineffective means of identifying children at greater risk of high cholesterol or blood pressure without other measurements from relatives.     

Egg Consumption and Human Cardio-Metabolic Health in People with and without Diabetes

The guidelines for dietary cholesterol and/or egg intake for both the general population and those at higher risk of cardiovascular disease (for example, people with type 2 diabetes mellitus (T2DM)) differ between countries, and even for different specialist societies in a country. The disparity between these guidelines is at least in part related to the conflicting evidence as to the effects of eggs in the general population and in those with T2DM. This review addresses the effect of eggs on cardiovascular disease (CVD) risk from both epidemiological research and controlled prospective studies, in people with and without cardio-metabolic disease. It also examines the nutritional qualities of eggs and whether they may offer protection against chronic disease. The evidence suggests that a diet including more eggs than is recommended (at least in some countries) may be used safely as part of a healthy diet in both the general population and for those at high risk of cardiovascular disease, those with established coronary heart disease, and those with T2DM. In conclusion, an approach focused on a person’s entire dietary intake as opposed to specific foods or nutrients should be the heart of population nutrition guidelines.     

Influence of family history and lifestyle on blood pressure and heart rate in young adults in Jordan

BACKGROUND: The most prevalent disease in Jordan is hypertension. Jordan is a small, middle-income developing country in the Middle East. It has a population of 5611202 people. Few studies have examined the associated cardiovascular risk factors in Jordan. DESIGN: The aim of this investigation was to explore specific lifestyles in Jordan, measuring blood pressure and heart rate through a randomized cross-sectional population study. METHODS: A total of 14310 adult males (7400) and females (6910) were selected in various regions of Jordan. Selected participants were interviewed by trained senior pharmacy students. They were asked whether they had hypertension or other cardiovascular disorders and if the answer was negative further questions were asked. This was followed by measurement of blood pressure and heart rate. Demographic data such as age, sex and nationality were also recorded, as was family history of hypertension. For each individual of the sample, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate were measured three times with 10-15min intervals in a sitting position and resting state. The Student's unpaired t-test was used for statistical analysis. Results were considered statistically significant when the P value was less than 0.05. RESULTS: A general trend in all the results tables was a lower blood pressure among those without a family history of cardiovascular disease and higher values among those with a family history of cardiovascular disease. CONCLUSION: This study demonstrates that SBP and DBP increase with all associated risk factors if a family history of hypertension is positive. This cross-sectional study revealed the presence of a consistent and strong relationship between certain lifestyle risk factors with an elevation in blood pressure concurrent with a positive family history of hypertension.