Showing papers by "John H. Eckfeldt published in 1994"
TL;DR: These data confirm the strong relationship between active smoking and carotid artery IMT and provide initial evidence that passive smoking exposure is related to greater IMT.
Abstract: Background: Active cigarette smoking has been established as a potent risk factor for carotid atherosclerosis in clinical populations; however, neither the role of active smoking in general populations nor the impact of environmental tobacco smoke has been well described. Methods: The association between carotid artery wall thickness and cigarette smoking was studied in 12 953 black and white men and women, aged 45 to 65 years, examined in the Atherosclerosis Risk in Communities Study. Participants were classified as current smokers (n=3525), past smokers (n=4315), never smokers reporting weekly exposure to environmental tobacco smoke (ETS or "passive smoking") of at least 1 hour (n=3339), or never smokers reporting no weekly exposure to ETS (n=1774). Carotid artery intimal-medial thickness (IMT) was measured by B-mode ultrasound. Results: Increased IMT was observed in each category, in order from smallest to greatest increase: never smokers not exposed to ETS, never smokers exposed to ETS, past smokers, and current smokers. The larger IMT observed in the nonsmoking group exposed to ETS compared with the nonsmokers not exposed persisted after control for diet, physical activity, body mass index, alcohol intake, education, and major cardiovascular risk factors. Among past and current smokers, increased packyears of exposure was associated with increased IMT. Among nonsmoking men exposed to ETS, there was a significant increase in IMT with increasing number of hours per week of ETS exposure. Conclusions: These data confirm the strong relationship between active smoking and carotid artery IMT and provide initial evidence that passive smoking exposure is related to greater IMT. Increasing exposure to cigarette smoke (either pack-years of active smoking or hours of ETS) was significantly related to increased IMT. (Arch Intern Med. 1994;154:1277-1282)
211 citations
TL;DR: Older subjects of both genders and a variety of racial and ethnic groups can be successfully recruited into a cholesterol-lowering trial and Lovastatin has effects similar to those reported in younger subjects in previous controlled trials.
Abstract: Background: Total and lipoprotein cholesterol levels continue to be predictors of coronary heart disease risk in men and women over 65 years old. Cholesterol-lowering trials, however, while sometimes including such subjects, have not concentrated on this age group. The Cholesterol Reduction in Seniors Program was a five-center pilot study to assess feasibility of recruitment and efficacy of cholesterol lowering in this age group. Methods: The study was a randomized, double-masked clinical trial with placebo, 20-mg lovastatin, and 40-mg lovastatin arms. Major efforts were made to recruit women and minorities. Participants were followed up for 1 year on a cholesterollowering diet plus placebo or study drug. End points were changes in blood lipid levels. Data on other blood chemistry values, as well as quality-of-life measures and coronary heart disease morbidity and mortality, were also collected. Results: Four hundred thirty-one subjects with low-density lipoprotein cholesterol levels greater than 4.1 and less than 5.7 mmol/L (159 and 221 mg/dL) were randomized, of whom 71% were women and 21% were African Americans; the mean age was 71 years. In the 20- and 40-mg lovastatin groups, total cholesterol levels fell 17% and 20%; lowdensity lipoprotein cholesterol levels fell 24% and 28%; triglyceride levels fell 4.4% and 9.9%, respectively. High-density lipoprotein cholesterol levels rose 7.0% and 9.0%, respectively. No changes were observed in the placebo group. Gender, race, and age did not significantly affect responses. Coronary heart disease morbidity and mortality data were collected but not analyzed for this study. Conclusion: Older subjects of both genders and a variety of racial and ethnic groups can be successfully recruited into a cholesterol-lowering trial. Lovastatin has effects similar to those reported in younger subjects in previous controlled trials. There is little advantage to the higher lovastatin daily dose. Side effects were remarkably low in all groups. (Arch Intern Med. 1994;154:529-539)
87 citations
TL;DR: It is concluded that P/S ratios vary by analytical methods, and that HDLC ratios tend to be larger in magnitude and in the opposite direction from TC and TG, which lead to significant biases in computed disease risk.
Abstract: To investigate EDTA-plasma/serum (P/S) differences, we collected paired samples from 25 volunteers and measured total cholesterol (TC), triglyceride (TG) and high-density-lipoprotein cholesterol (HDLC), using the Cobas FARA, Ektachem 700, DuPont Dimension, and Baxter Paramax Analyzers. The mean (SD) P/S ratios for TC, HDLC, and TG concentrations were, respectively: 0.980 (0.0171), 1.063 (0.0704), and 0.961 (0.363) for Paramax; 0.976 (0.0189), 1.034 (0.1091), and 0.950 (0.557) for Dimension; 1.003 (0.0221), 1.059 (0.0304), and 0.988 (0.0179) for Ektachem; and 0.993 (0.0162), 1.063 (0.0830), and 1.013 (0.0410) for Cobas. We conclude that P/S ratios vary by analytical methods, and that HDLC ratios tend to be larger in magnitude and in the opposite direction from TC and TG. Both effects lead to significant biases in computed disease risk.
30 citations