Showing papers by "Diederick E. Grobbee published in 1993"

Polymorphism of the angiotensin I converting enzyme gene is apparently not related to high blood pressure: Dutch Hypertension and Offspring Study.

Abstract: Objective:Studies in genetically hypertensive rats and their normotensive Wistar-Kyoto control rats have revealed a linkage of a chromosomal region containing the angiotensin converting enzyme (ACE) gene with blood pressure. This led to the hypothesis that ACE is a possible candidate gene for primar

Cardiovascular risk and all-cause mortality; a 12 year follow-up study in the netherlands

Abstract: To assess the contribution of cardiovascular risk indicators to all-cause mortality, we used data from a follow-up study conducted in the Netherlands since 1975. Of 6,057 participants aged 20 years or over at the start of the study, 9.5% died during the 9 to 12 year follow-up period. Risk indicators independently related to all-cause mortality were age and diabetes mellitus in both sexes; pulse rate, smoking habits, antihypertensive drug use and a history of myocardial infarction most clearly in men; and body mass index and systolic blood pressure in women. A larger body mass index was associated with a gradual decrease in mortality probability. The risk of death for women in the highest quartile of body mass index (> 26.4 kg/m2) relative to those in the lowest quartile (< 21.9 kg/m2) was 0.56 (95% confidence limits 0.36 and 0.87). Serum cholesterol level showed no association with overall mortality. Risk functions were calculated to predict an individual's probability of dying within 11.5 years as a function of the level of cardiovascular risk indicators. Our findings suggest that the major cardiovascular risk indicators, apart from affecting cardiovascular morbidity and mortality, also influence all-cause mortality. Consequently, favourable changes in these charateristics might lead to an increase in life expectancy. The maximum individual benefit to be expected from these changes may be estimated using the risk functions derived from our data.

High blood-pressure and the incidence of non-insulin-dependent diabetes-mellitus - findings in a 11.5 year follow-up-study in the netherlands

Abstract: To examine the contribution of cardiovascular risk factors to the development of non-insulin dependent diabetes mellitus, a prospective follow-up study was performed of a cohort, initially examined in a population survey on cardiovascular risk factors. The survey was conducted from 1975 to 1978 in the Netherlands among 5700 men and women aged 20 to 65. In 1988 a questionnaire on the prevalence of chronic diseases, including diabetes mellitus, was sent to all living participants of the initial survey. The general practitioners of the persons who indicated to have diabetes mellitus were asked to confirm the diagnosis. Diabetes mellitus was defined as current use of oral hypoglycemic drugs or insulin. After exclusion of the prevalent cases at the initial survey, 65 incident confirmed cases remained. All others responding to the questionnaire served as controls. The incidence of diabetes mellitus was associated with body mass index, use of diuretics, systolic and diastolic blood pressure. After adjustment for age and body mass index systolic and diastolic blood pressure were still associated with the incidence of non-insulin dependent diabetes mellitus in men; relative risks 1.28 (95% confidence interval 1.06-1.54) and 1.40 (95% CI 1.06-1.85) per 10 mmHg respectively. For women, only the relative risk associated with the use of diuretics remained statistically significant (2.26, 95% CI 1.04-4.90). This probably reflects the risk of (treated) hypertension: adjusted for blood pressure, the relative risk lost statistical significance. These findings suggest that elevated blood pressure is a risk for the development of non-insulin dependent diabetes mellitus (NIDDM). This supports the view that NIDDM and hypertension may have a similar origin.