Showing papers in "JAMA in 1979"
TL;DR: After adjustment for other associated risk factors, the relative impact of diabetes on CHD, IC, or stroke incidence was the same for women as for men; for CVD death and CHF, it was greater for women.
Abstract: Based on 20 years of surveillance of the Framingham cohort relating subsequent cardiovascular events to prior evidence of diabetes, a twofold to threefold increased risk of clinical atherosclerotic disease was reported. The relative impact was greatest for intermittent claudication (IC) and congestive heart failure (CHF) and least for coronary heart disease (CHD), which was, nevertheless, on an absolute scale the chief sequela. The relative impact was substantially greater for women than for men. For each of the cardiovascular diseases (CVD), morbidity and mortality were higher for diabetic women than for nondiabetic men. After adjustment for other associated risk factors, the relative impact of diabetes on CHD, IC, or stroke incidence was the same for women as for men; for CVD death and CHF, it was greater for women. Cardiovascular mortality was actually about as great for diabetic women as for diabetic men. ( JAMA 241:2035-2038, 1979)
3,689 citations
TL;DR: It is concluded that ECMO can support respiratory gas exchange but did not increase the probability of long-term survival in patients with severe ARF.
Abstract: Nine medical centers collaborated in a prospective randomized study to evaluate prolonged extracorporeal membrane oxygenation (ECMO) as a therapy for severe acute respiratory failure (ARF). Ninety adult patients were selected by common criteria of arterial hypoxemia and treated with either conventional mechanical ventilation (48 patients) or mechanical ventilation supplemented with partial venoarterial bypass (42 patients). Four patients in each group survived. The majority of patients suffered acute bacterial or viral pneumonia (57%). All nine patients with pulmonary embolism and six patients with posttraumatic acute respiratory failure died. The majority of patients died of progressive reduction of transpulmonary gas exchange and decreased compliance due to diffuse pulmonary inflammation, necrosis, and fibrosis. We conclude that ECMO can support respiratory gas exchange but did not increase the probability of long-term survival in patients with severe ARF. (JAMA242:2193-2196, 1979)
1,194 citations
TL;DR: Physicians are still basing their policies on emotion-laden personal conviction rather than the outcome of properly designed scientific studies, and less likelihood that they would change their present policy or be swayed by research.
Abstract: In answer to a questionnaire administered in 1961, 90% of responding physicians indicated a preference for not telling a cancer patient his diagnosis. To assess attitudinal changes, the same questionnaire was submitted to 699 university-hospital medical staff. Of 264 respondents, 97% indicated a preference for telling a cancer patient his diagnosis—a complete reversal of attitude. As in 1961, clinical experience was the major policy determinant, but the 1977 population emphasized the influence of medical school and hospital training. Our respondents indicated less likelihood that they would change their present policy or be swayed by research. Clinical experience was the determining factor in shaping two opposite policies. Physicians are still basing their policies on emotion-laden personal conviction rather than the outcome of properly designed scientific studies. ( JAMA 241:897-900, 1979)
646 citations
TL;DR: A case-control study of hepatocellular adenoma, a serious though nonmalignant liver tumor, was conducted by the Center for Disease Control and the Armed Forces Institute of Pathology, finding that increasing duration of OC use increases the risk of HCA.
Abstract: A case-control study of hepatocellular adenoma (HCA), a serious though nonmalignant liver tumor, was conducted by the Center for Disease Control and the Armed Forces Institute of Pathology (AFIP). Interviews with 79 women with HCA and with 220 age- and neighborhood-matched controls were completed. Limited information was obtained on nine additional patients who had died. Women with HCA and hemorrhage have a greater risk of morbidity and death than those with other symptoms. Increasing duration of OC use increases the risk of HCA. Use of OCs with high hormonal potency and age over 30 years may further increase a woman's risk of HCA. Long-term users of OCs have an estimated annual incidence of HCA of 3 to 4 per 100,000. ( JAMA 242:644-648, 1979)
524 citations
TL;DR: The long-term survivors were more symptomatic overall, with particular elevations on measures of anxiety and alienation, and substantially higher levels of dysphoric mood (eg, depression, guilt) than the short- term survivors.
Abstract: Thirty-five women with metastatic breast cancer received a battery of baseline psychological tests; results were correlated with length of survival. Patients who died in less than one year from baseline were categorized as short-term survivors, while patients who lived for one year or longer were assigned to the long-term survivor group. The long-term survivors were more symptomatic overall, with particular elevations on measures of anxiety and alienation, and substantially higher levels of dysphoric mood (eg, depression, guilt) than the short-term survivors. Short-term survivors revealed significantly lower levels of hostility, with higher levels of positive mood. Treating oncologists perceived the long-term survivors to show significantly poorer adjustment to their illnesses than the short-term survivors, and an interviewer's ratings indicated that long-term survivors had significantly poorer attitudes toward their physicians. Measures of clinical status and demographic data revealed few differences between the two groups. (JAMA242:1504-1508, 1979)
509 citations
TL;DR: An algorithm is developed that provides detailed operational criteria for ranking the probability of causation when ADR is suspected between a drug and a clinical manifestation.
Abstract: Despite widespread clinical and epidemiologic attention to adverse drug reactions (ADRs), their clinical identification has been a nonreproducible act of unspecified subjective judgment; adequate operational criteria have not been available for diagnostic decisions about the cause of an observed untoward clinical manifestation. To improve scientific precision in the diagnosis of ADRs, we have developed an algorithm that provides detailed operational criteria for ranking the probability of causation when ADR is suspected between a drug and a clinical manifestation. The algorithm provides a scoring system for six axes of decision strategy: previous general experience with the drug, alternative etiologic candidates, timing of events, drug levels and evidence of overdose, dechallenge, and rechallenge. The sum of the scores is ordinally partitioned to rate the candidate ADR as definite, probable, possible, or unlikely. (JAMA242:623-632, 1979)
460 citations
TL;DR: Several time-related variables involving resuscitation from out-of-hospital cardiac arrest were studied, and short time intervals from collapse to initiation of cardiopulmonary resuscitation (CPR) and to provision of definitive care were significantly associated with survival from cardiac arrest.
Abstract: Several time-related variables involving resuscitation from out-of-hospital cardiac arrest were studied Short time intervals from collapse to initiation of cardiopulmonary resuscitation (CPR) and to provision of definitive care were significantly associated with survival from cardiac arrest The two times were jointly related, and one short time without the other was unlikely to result in survival If CPR was initiated within four minutes and if definitive care was provided within eight minutes, 43% of patients survived If either time was exceeded, the chances of survival fell dramatically The time to initiation of CPR and definitive care are factors directly influenced by emergency medical service program decisions A realistic option to improve time to initiation of CPR is widespread citizen CPR training A possible option to improve the time to definitive care is the training of emergency medical technicians in defibrillation ( JAMA 241:1905-1907, 1979)
409 citations
298 citations
TL;DR: Induction of premature, irreversible menopause presents a need for effective hormonal replacement and patient counseling.
Abstract: Forty-one women with advanced Hodgkin's disease were studied to determine the effect of combination chemotherapy on fertility and ovarian function. Histories and pretreatment ovarian biopsy specimens indicated normal fertility before therapy, thus implying no adverse effect of Hodgkin's disease on female gonadal function. Ovarian activity was assessed after therapy by menstrual history, serial basal body temperatures, and hormonal levels. Each case was assigned to one of three categories: primary ovarian failure (failed ovary), irregular ovarian activity (failing ovary), and normal cyclic ovarian activity (functioning ovary). After therapy, 20 of 41 patients (49%) were categorized as failed, 14 (34%) as failing, and only 7 (17%) as functioning. In 16 months of further observation, progressive loss of ovarian function occurred that was clearly age related but not statistically dose related. Induction of premature, irreversible menopause presents a need for effective hormonal replacement and patient counseling. ( JAMA 242:1877-1881, 1979)
286 citations
TL;DR: To the Editor.
Abstract: To the Editor.— The editorial by Samuel Vaisrub, MD, "To the Best of Our Knowledge, Which Is Limited at Best" (241:278, 1979), was delightful, and its point was unhappily correct. It brought to my mind that demolisher of analytical studies, "to the best of our knowledge," or "as far as we know." It goes like this: We treated so many people, and we know this many are well, and so many have died; and this many,from whom we have not heard, are alive and well,as far as we know. Someone from whom you have not heard is more likely to be dead than alive.
282 citations
TL;DR: The low levels of chromium and response to chromium supplementation suggest that chromium deficiency can arise in long-term total parenteral nutrition.
Abstract: Chromium is required for maintenance of normal glucose tolerance. After complete bowel resection and five months of total parenteral nutrition, severe glucose intolerance, weight loss, and a metabolic encephalopathylike confusional state developed in a patient. Serum chromium levels were at the lowest normal level. Supplementation of 150 μg of chromium per day reversed the glucose intolerance, reduced insulin requirements, and resulted in weight gain and the disappearance of encephalopathy. The low levels of chromium and response to chromium supplementation suggest that chromium deficiency can arise in long-term total parenteral nutrition. ( JAMA 241:496-498, 1979)
TL;DR: The evaluation of a computer-based consultation system called MYCIN compared its choice of antimicrobials with the choices of nine human prescribers for ten test cases of meningitis and found it never failed to cover a treatable pathogen while demonstrating efficiency in minimizing the number of antimicrobial prescribed.
Abstract: An evaluation of a computer-based consultation system called MYCIN was made. Eight independent evaluators with special expertise in the management of meningitis compared MYCIN's choice of antimicrobials with the choices of nine human prescribers for ten test cases of meningitis. MYCIN received an acceptability rating of 65% by the evaluators; the corresponding ratings for acceptability of the regimen prescribed by the five faculty specialists ranged from 42.5% to 62.5%. The system never failed to cover a treatable pathogen while demonstrating efficiency in minimizing the number of antimicrobials prescribed. The study design may be useful in assessing the performance of other computer-based clinical decision-making systems. ( JAMA 242:1279-1282, 1979)
TL;DR: A sociologist who joined the teams of two surgical services in a 450-bed hospital for a sufficient time to become thoroughly acquainted with the educational, scientific, and social structure, Charles Bosk's tale and analysis unfold in a frank and revealing account of life in a university hospital.
Abstract: One of the few social organizations remaining in the modern world that resembles the fiefs of the Middle Ages is the surgical service in a teaching hospital. This becomes apparent as Bosk's tale and analysis unfold in a frank and revealing account of life in a university hospital. Charles Bosk is a sociologist who joined the teams of two surgical services in a 450-bed hospital for a sufficient time to become thoroughly acquainted with the educational, scientific, and social structure. He concentrated his attention on the issue of failure and how this is dealt with by the attending physicians, the house staff, and the nurses. Most physicians, whether they be faculty, students, or residents, are too close to the issues and are too absorbed in the technology to stand back and take an objective view of the social structure of academic medicine. Even if they did so, they might be
TL;DR: Of 344 relatively healthy persons older than 60 years, 22 had a clearly elevated level of serum thyrotropin (TSH) (greater than 10 muU/mL), a finding more common in women than in men, and three had low values for serum thyroxine (T4) and free T4 (FT4) index, but only one had a low value for serum triiodothyronines (T3) or free T3 (FT3) index.
Abstract: Of 344 relatively healthy persons older than 60 years, 22 (5.9%) had a clearly elevated level of serum thyrotropin (TSH) (>10 μU/mL), a finding more common in women than in men. Ten of the 22 had low values for serum thyroxine (T 4 ) and free T 4 (FT 4 ) index, but only one had a low value for serum triiodothyronine (T 3 ) or free T 3 (FT 3 ) index. A further 14.4% had a slightly elevated level of serum TSH (>5≤10 μU/mL), but none had low values for serum T 4 or FT 4 index. Age alone has little effect on the measurements of T 4 ; age is associated with slightly lower T 3 levels, but only in men 60 years or older or in women 80 years or older. Longitudinal studies should determine if a slightly elevated serum TSH rises further with age and if there is a causal relationship between a high level of serum TSH and cardiovascular disease. ( JAMA 242:247-250, 1979)
TL;DR: Cigarette smoking was overwhelmingly the most important risk factor for vascular disease in women and should be considered a contraindication to oral contraceptive use, or at the very least, women wishing to use oral contraceptives should be strongly urged not to smoke.
Abstract: We investigated the relation in women of various factors to risk of myocardial infarction, subarachnoid hemorrhage, other strokes, and venous thromboembolism. Smoking significantly increased risk of all four diseases, whereas oral contraceptive use was associated with an increase only in risk of subarachnoid hemorrhage and venous thromboembolism. Use of noncontraceptive estrogens was not associated with increased risk of any of these diseases. Hypertension, hypercholesterolemia, obesity, gallbladder disease, and nondrinking of alcohol were all associated with increased risk of myocardial infarction, whereas only hypertension and hypercholesterolemia were associated with increased risk of other strokes. Cigarette smoking was overwhelmingly the most important risk factor for vascular disease in women. Smoking should be considered a contraindication to oral contraceptive use, or at the very least, women wishing to use oral contraceptives should be strongly urged not to smoke. ( JAMA 242:1150-1154, 1979)
TL;DR: Recently there has been increased Western interest in ginseng, and it is readily available in health food stores, markets, and drugstores in a bewildering assortment of commercial preparations.
Abstract: GINSENG has been used by man for thousands of years, and Oriental folk medicine describes it as both a tonic for restoration of strength and a panacea (hence, the genus Panax , meaning all healing). The term "ginseng" can refer to any of 22 related plants, but it is generally associated with P ginseng . 1 It is widely used in contemporary Chinese medicine as a stimulant to increase metabolism and to regulate blood pressure and blood glucose. 2 The only recognized medical use in the United States is as a demulcent in skin ointments. Recently there has been increased Western interest in ginseng, and it is readily available in health food stores, markets, and drugstores in a bewildering assortment of commercial preparations. Numerous popular books have promoted ginseng as a healthful tonic, stimulant, and aphrodisiac. 3-8 Using current import and sales statistics from members of the Herb Trade Association, I have
TL;DR: The data suggest that the rate of absorption, the peak blood concentration, and the prior use of cocaine all contribute to the possibility of a fatal reaction, and despite current belief, cocaine cannot be considered a safe recreational drug.
Abstract: Sixty-eight deaths associated with the recreational use of illicit cocaine were investigated by the Medical Examiner's Office of Dade County in Florida. Most fatalities occurred since 1975. Although 29 involved the use of other drugs (usually heroin), 24 persons died directly of the toxic effects of cocaine. Respiratory collapse and death occurred rapidly after the intravenous injection of cocaine. Oral or nasal ingestion resulted in a symptom-free interval lasting as long as an hour followed suddenly by generalized seizures and death. Toxicological analysis could not causally relate lidocaine hydrochloride or other adulterants to the untoward reactions. The data suggest that the rate of absorption, the peak blood concentration, and the prior use of cocaine all contribute to the possibility of a fatal reaction. Despite current belief, cocaine cannot be considered a safe recreational drug. (JAMA241:2519-2522, 1979)
TL;DR: Enflurane appears to be a safe general anesthetic for sick, elderly patients and a useful preoperative evaluation scale in predicting death.
Abstract: We studied the outcome of surgery in 500 patients over 80 years of age. Hospital mortality within one month of surgery was 6.2%. The American Society of Anesthesiologists class 1 to 5 preoperative evaluation scale was useful in predicting death—less than 1% of class 2 patients died, 4% of class 3, and 25% of class 4. Six of seven perioperative deaths were caused by mesenteric infarction. Myocardial infarction was the leading cause of postoperative death. Twenty-four percent of 141 patients who underwent upper abdominal surgery required controlled endotracheal ventilation for more than 24 hours postoperatively; 57% after intrathoracic surgery; and only 2% after surgery that did not enter pleura or peritoneum. Forty-seven patients underwent gallbladder surgery, and 27 peripheral underwent vascular surgery without any hospital fatality. Enflurane appears to be a safe general anesthetic for sick, elderly patients. ( JAMA 242:2301-2306, 1979)
TL;DR: The educational program increased reported compliance with medication, improved the proportion of patients losing weight, and improved appointment keeping, and there was a favorable effect on blood pressure control.
Abstract: Three educational interventions for the control of essential hypertension in ambulatory patients were based on analyses of the educational needs of patients and providers. The educational program increased reported compliance with medication, improved the proportion of patients losing weight, and improved appointment keeping. Most important, there was a favorable effect on blood pressure (BP) control. The proportion of patients with BP under control in the group assigned to all three interventions increased by 28% (from 38% to 66%), while the proportion in the control group receiving standard medical therapy with no educational interventions remained unchanged at 42%. (JAMA241:1700-1703, 1979)
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TL;DR: The objective of treatment is to terminate an acute attack rapidly as well as to prevent future attacks of gout, to lower the serum urate concentration to prevent its accumulation in body tissues, to prevent the formation of uric acid calculi, and to treat disorders accompanying hyperuricemia.
Abstract: GOUT is a term describing a heterogeneous group of diseases that, in full development, are manifested by (1) an increase in the serum urate concentration, (2) recurrent attacks of a characteristic type of acute arthritis in which crystals of monosodium urate monohydrate are demonstrable in leukocytes of synovial fluid, (3) aggregate deposits of monosodium urate monohydrate (tophi) occurring chiefly in and around the joints of the extremities and sometimes leading to severe crippling and deformity, (4) renal disease of uncertain cause that involves glomeruli, tubules, interstitial tissues, and blood vessels, and (5) uric acid urolithiasis. 1 These manifestations may occur in different combinations. The objective of treatment is to terminate an acute attack rapidly as well as to prevent future attacks of gout, to lower the serum urate concentration to prevent its accumulation in body tissues, to prevent the formation of uric acid calculi, and to treat disorders accompanying hyperuricemia, eg,
TL;DR: The administration of estrogens was associated with a shorter mean sleep latency, a longer period of rapid eye movement sleep, and a positive correlation between psychological intactness (as clinically ranked) and latency to sleep onset.
Abstract: A double-blind crossover study involving 16 hypogonadal women compared the effects of placebo and cunjugated estrogens, 0.625 mg daily, on gonadotropin levels, symptoms, sleep patterns, and psychological state. After one month, serum concentrations of follicle-stimulating hormone fell 31%, and levels of luteinizing hormone, 19%; the number of vasomotor flushes also decreased. The administration of estrogens was also associated with a shorter mean sleep latency, a longer period of rapid eye movement sleep, and a positive correlation between psychological intactness (as clinically ranked) and latency to sleep onset. Psychological testing, including the Clyde Mood Scale, and the Gottschalk-Gleser Test indicated that estrogens caused this group to be less outwardly aggressive but more inwardly hostile. (JAMA242:2405-2407, 1979)
TL;DR: In areas where GBS disease is prevalent, screening pregnant women and treating those colonized with GBS (with no history of penicillin hypersensitivity) with intravenous ampicillin during labor is recommended.
Abstract: Early-onset group B streptococcus (GBS) disease in the infant is acquired by vertical transmission from the mother colonized with GBS. Thirty-four women colonized with GBS were treated with intravenous ampicillin sodium during labor. None of their infants were colonized with GBS at birth or within 48 hours. Twenty-four women colonized with GBS received no antibiotic therapy; 14 (58%) of their infants were colonized with GBS at birth or by 48 hours. This difference was highly significant. Mechanisms by which this may have occurred were temporary suppression of GBS vaginal and rectal colonization, high concentration of ampicillin in the amniotic fluid, and transplacental transport of the antibiotic to the infant. In areas where GBS disease is prevalent, we recommend screening pregnant women (34 to 36 weeks' gestation) and treating those colonized with GBS (with no history of penicillin hypersensitivity) with intravenous ampicillin during labor. ( JAMA 241:1245-1247, 1979)
TL;DR: The CHD risk factors for the CHD cases did not differ significantly from those for other age-matched, physically active men and women and Physicians and exercising adults should be aware of this fact and give appropriate attention to possible prodromal symptoms.
Abstract: We investigated the circumstances of death and the medical and activity histories of 18 individuals who died during or immediately after jogging. Thirteen men died of coronary heart disease (CHD) and four men and one woman died of other causes. Six CHD subjects had medical histories relevant to the cardiovascular system, but only one had diagnosed CHD. Six CHD subjects experienced prodromal symptoms but continued vigorous exercise programs. Two subjects had exercised less than a month, but most had trained regularly for years. The CHD risk factors for the CHD cases did not differ significantly from those for other age-matched, physically active men. Superior physical fitness does not guarantee protection against exercise deaths. Physicians and exercising adults should be aware of this fact and give appropriate attention to possible prodromal symptoms. ( JAMA 242:1265-1267, 1979)
TL;DR: Several sources of stress (malpractice suits, having to give up certain aspects of medical work, threats of physical harm, and certain features of peer review) are being expressed that were infrequently mentioned in previous studies.
Abstract: Careers of physicians who graduated from Case Western Reserve School of Medicine have been examined in several longitudinal career studies. Physicians have been interviewed in their own offices, have filled out short-answer questionnaires, and have taken four tests. Emphasis has been placed on factors that have made their medical careers particularly satisfying or dissatisfying. Physicians report many satisfactions that evolve around helping patients, solving problems, and developing relationships with patients and their families. A major dissatisfaction relates to time pressures. In the current interviews with graduates, several sources of stress (malpractice suits, having to give up certain aspects of medical work, threats of physical harm, and certain features of peer review) are being expressed that were infrequently mentioned in previous studies. ( JAMA 241:1483-1486, 1979)
TL;DR: It is suggested that roentgenographic study of cases with fasciitis permits earlier diagnosis and favorably affects outcome, and the mortality of the 21 diabetic patients in this series had a mortality of 19%, the lowest yet reported.
Abstract: Twenty-six patients with necrotizing fasciitis were treated during a nine-year period. Twenty-one (81%) had diabetes mellitus and 19 (73%) had gas in their soft tissues from nonclostridial infection. Although crepitation was found by physical examination in only five patients, roentgenographic examination of the involved site disclosed gas in every patient in whom it was subsequently found at surgery. Previous studies have not used roentgenography to search for soft-tissue gas. The 21 diabetic patients in our series had a mortality of 19%, the lowest yet reported. This suggested that roentgenographic study of cases with fasciitis permits earlier diagnosis and favorably affects outcome. (JAMA241:803-806, 1979)
TL;DR: Results fromclinical trials may not be disseminated to practicing physicians and, therefore, not incorporated into practice, and greater attention should be directed toward making findings from clinical trials available to practitioners.
Abstract: Dissemination of new medical information to the practicing physician is a complex and often faulty process. To examine the magnitude of this problem, we surveyed primary care physicians to determine their knowledge of the results of the cooperative trial of photocoagulation in diabetic retinopathy. Despite the acknowledged relevance to their practice, only 28% (38/137) of family physicians and 46% (42/91) of internists were aware of the study results ( P ( JAMA 241:2622-2624, 1979)
TL;DR: The Human Central Nervous System is an excellently diagrammed atlas and brief synopsis of neuroanatomy, extending to and from the cortices, depicting and defining functions of the afferent and efferent tracts.
Abstract: The Human Central Nervous System is an excellently diagrammed atlas and brief synopsis of neuroanatomy, extending to and from the cortices, depicting and defining functions of the afferent and efferent tracts. The descriptive material is at times distant from the diagrams, necessitating some shifting back and forth but preserving the continuity of the graphic and descriptive material. The drawings are well numbered and labeled, but the labels are in Latin and are abbreviated. Three-dimensional diagramming permits the viewer to follow tracts at various levels of the spinal cord or brain. The use of color at least to differentiate some of the nervus tracts would have further enhanced the book. Likewise the anatomy might have been more easily ingested and related had some effort been made to make clinical or physiological correlations. However, whatever deficiencies exist, they are more than compensated for by the beauty and clarity of the drawings. Medical
TL;DR: Marked increases from 1970 to 1976 were found in the incidence of aspergillosis (158%), actinomycosis (92%), cryptococcosis (78%), and coccidioidomyCosis (74%).
Abstract: To measure the incidence in the United States of systemic mycoses necessitating hospitalization, we reviewed discharge records of 1,875 hospitals participating in the Professional Activity Study of the Commission on Professional and Hospital Activities. Projected incidence rates in 1976 ranged from 23.0 per million for histoplasmosis to 0.2 per million for blastomycosis. High prevalences of leukemia or lymphoma (5.9% to 10.2%) or of other malignancies (9.9% to 13.2%) were recorded in patients with aspergillosis, candidiasis, or cryptococcosis. High prevalences of chronic obstructive lung disease (9.6% to 9.9%) were recorded in those with aspergillosis or histoplasmosis. Marked increases from 1970 to 1976 were found in the incidence of aspergillosis (158%), actinomycosis (92%), cryptococcosis (78%), and coccidioidomycosis (74%). Increasing numbers of persons with immunosuppressive conditions, migration of susceptible persons into hyperendemic areas, and aging of the population contributed to the increases. ( JAMA 242:1631-1635, 1979)
TL;DR: Daily consumption of small to moderate amounts of alcohol was inversely related to coronary death, and for heavy drinking, there was no association with coronary death in either crude or adjusted analyses.
Abstract: For a series of 568 married men who died of coronary heart disease and an equal number of matched control subjects, information was collected on a large number of variables, including daily alcohol consumption classified by type of beverage, namely, beer, wine, or liquor. Daily consumption of small to moderate amounts of alcohol (2 oz [59.2 mL] or less daily) was inversely related to coronary death. This inverse relation was present in both crude and adjusted matched-pair analyses and was similar for each type of alcohol, as indicated by adjusted relative risks of 0.3 for beer, 0.3 for wine, and 0.2 for liquor. In contrast, for heavy drinking, there was no association with coronary death in either crude or adjusted analyses. ( JAMA 242:1973-1974, 1979)
TL;DR: Positive family history was associated with hypertension prevalence double that found in persons with negative history and was independent of weight, and nutritional-hygienic recommendations to avoid overweight may be important in reducing the risk of becoming hypertensive.
Abstract: In a nationwide screening program, blood pressure measurements, family (parental) histories of hypertension, and self-evaluations of weight class were obtained for more than a half million people. Positive family history was associated with hypertension prevalence double that found in persons with negative history and was independent of weight. When overweight was also present, however, hypertension prevalence was three to four times as high. Hypertension was more likely to have been previously diagnosed in screenees if family history was positive. However, such screenees did not have a higher proportion receiving effective treatment than those with negative family history. When an index case of hypertension is found, other family members should be examined. For persons with positive family history, nutritional-hygienic recommendations to avoid overweight may be important in reducing the risk of becoming hypertensive. ( JAMA 241:43-46, 1979)