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A Döring

Publications and source records attributed to A Döring.

At least 55 records · Page 3Linked to original sources
PubMed2000

Association between plasma viscosity and all-cause mortality: results from the MONICA-Augsburg Cohort Study 1984-92.

Several studies have reported a strong association between various markers of the acute-phase response and death from cardiovascular diseases and all-cause mortality. Inflammation at a low level of intensity may be a common phenomenon associated with the majority of causes of death owing to chronic diseases. We sought to investigate the association of plasma viscosity with all-cause mortality in a cohort of apparently healthy men. The study population consisted of 964 men aged 45-64 years at entry, randomly selected from the general population and taking part in the first MONICA-Augsburg survey 1984-85. The main outcome measure was all-cause mortality. During 8 years of follow-up, there were 81 deaths (37 cardiovascular deaths, 23 deaths from cancer and 21 deaths from other causes). There was a strong positive and statistically significant age-adjusted relationship between plasma viscosity and all-cause mortality. The relative risk of death for a one standard deviation increase in plasma viscosity (0.070 mPa/s) was 1.45 [95% confidence interval (CI) 1.19-1.76]. After further adjusting for smoking, total cholesterol, body mass index, blood pressure and education, a relative risk of 1.41 (95% CI 1.14-1.74) resulted. Other risk variables had only negligible confounding effects. The relative risk of the median of the top quintile of the plasma viscosity distribution compared with the median of the bottom quintile, computed from the adjusted model, was 2.68 (95% CI 1.63-4.42). These findings suggest that plasma viscosity may have considerable potential to predict death from all causes in middle-aged men.

Acute-Phase Reaction↗
PubMed2000

Haematocrit profoundly affects left ventricular diastolic filling as assessed by Doppler echocardiography.

BACKGROUND: The main determinants of diastolic function--pre- and afterload of the heart--are affected by the haematocrit, but the relation between haematocrit and diastolic function is unclear. OBJECTIVE: To study the association between interindividual haematocrit values and diastolic function, by echocardiography. DESIGN: In a cross-sectional survey, blood pressure, haematocrit values, and high-quality Doppler indexes of left ventricular filling were obtained in 1297 individuals, 25-74 years of age, and analysed by regression analyses. RESULTS: Haematocrit and systolic blood pressure were strongly correlated (r = 0.23; P < 0.0001). Moreover, haematocrit was inversely correlated with the peak velocity of early left ventricular filling and with the peak velocity of early filling divided by late filling (E/A ratio; both P< 0.005). Left ventricular isovolumic relaxation time (IVRT) was positively associated with haematocrit (r= 0.18, P< 0.001). In individuals with an abnormal Doppler filling pattern (E/A(< 50 years) < 1, E/A(> 50 years) < 0.5, or IVRT(< 30 years) > 92 ms, IVRT30-50 years > 100 ms or IVRT> 50 years > 1 05 ms; n = 119), greater haematocrit values were observed than in those with normal diastolic parameters (P< 0.001). Conversely, individuals with an increased haematocrit (> 50% in men, > 45% in women; n = 16) had a greater risk of presenting with abnormal left ventricular filling (31.3%) compared with individuals with normal (12.1%; n = 898;) or low (< 40% in men, < 35% in women: 10.5%, n = 38; P = 0.07) haematocrit. Strong and significant associations between haematocrit and Doppler indexes of left ventricular filling were confirmed after adjustment for multiple potential confounders including blood pressure, antihypertensive medication and body mass index. Similarly, blood pressure and parameters of diastolic filling were strongly associated correlations that were not affected by inclusion of haematocrit values into the regression model. CONCLUSION: The data point to substantial adaptations of diastolic filling in response to both blood pressure and the characteristics of the medium that is propelled by the heart Therefore, in addition to blood pressure values, the variability of haematocrit values should be considered when diastolic function is being evaluated by Doppler echocardiography.

Adult↗
PubMed1999

Increases in heart rate during an air pollution episode.

This paper assesses whether air pollution increases resting heart rates in 2,681 men and women aged 25-64 years who participated in the MONICA (monitoring of trends and determinants in cardiovascular disease) Augsburg cohort. Increases in heart rate were observed during the air pollution episode in January 1985 compared with non-episode days adjusted for cardiovascular risk factors and meteorologic parameters. Consistently, heart rates were also elevated at high concentrations of sulfur dioxide, total suspended particulates, or carbon monoxide. Acceleration in heart rates indicates an altered autonomic control of the heart in association with air pollution, which may contribute to the observed health effects in association with air pollution.

Adult↗
PubMed1999

Lack of association between a polymorphism of the aldosterone synthase gene and left ventricular structure.

BACKGROUND: Cardiac growth and function may be modulated in part by trophic effects of neurohormones. Specifically, aldosterone has been shown to stimulate the growth of cardiac myocytes and the accumulation of cardiac extracellular matrix proteins. Moreover, a variant of the aldosterone synthase gene (a cytosine/thymidine exchange at position -344 in the transcriptional regulatory region) has been associated with enlargement and disturbed filling of the left ventricle (LV) in a small sample of young white adults. The aim of the present study was to reinvestigate the implications of aldosterone synthase -344C/T allele status for serum aldosterone levels, blood pressure, and LV structure and function in large population-based samples. METHODS AND RESULTS: Individuals who participated in the echocardiographic substudy of the third MONICA (MONitoring trends and determinants in CArdiovascular disease) survey (n=1445) or in the second follow-up of the first MONICA survey (n=562) were studied by standardized anthropometric, echocardiographic, and biochemical measurements as well as genotyping for aldosterone synthase -344C/T allele status. In both surveys, the distribution of sex, age, arterial blood pressure, and body mass index was homogeneous in the aldosterone synthase genotype groups. Echocardiographic LV wall thicknesses, dimensions, and mass indexes were not significantly associated with a specific aldosterone synthase genotype. Likewise, no association was detectable with echocardiographic measures of LV systolic or diastolic function. Data were consistent in both samples and not materially different in subgroups defined by age, sex, or intake of antihypertensive medication. Finally, no significant association was observed for aldosterone synthase allele status and serum aldosterone levels in the group of 562 individuals. CONCLUSIONS: The data are not in favor of a significant contribution of the C/T exchange at position -344 in the aldosterone synthase transcriptional regulatory region to the variability of serum aldosterone levels, blood pressure, or cardiac size or function as found in 2 white population-based samples.

Adult↗
PubMed1999

C-Reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992.

BACKGROUND: Inflammatory reactions in coronary plaques play an important role in the pathogenesis of acute atherothrombotic events; inflammation elsewhere is also associated with both atherogenesis generally and its thrombotic complications. Recent studies indicate that systemic markers of inflammation can identify subjects at high risk of coronary events. METHODS AND RESULTS: We used a sensitive immunoradiometric assay to examine the association of serum C-reactive protein (CRP) with the incidence of first major coronary heart disease (CHD) event in 936 men 45 to 64 years of age. The subjects, who were sampled at random from the general population, participated in the first MONICA Augsburg survey (1984 to 1985) and were followed for 8 years. There was a positive and statistically significant unadjusted relationship, which was linear on the log-hazards scale, between CRP values and the incidence of CHD events (n=53). The hazard rate ratio (HRR) of CHD events associated with a 1-SD increase in log-CRP level was 1.67 (95% CI, 1.29 to 2. 17). After adjustment for age, the HRR was 1.60 (95% CI, 1.23 to 2. 08). Adjusting further for smoking behavior, the only variable selected from a variety of potential confounders by a forward stepping process with a 5% change in the relative risk of CRP as the selection criterion, yielded an HRR of 1.50 (95% CI, 1.14 to 1.97). CONCLUSIONS: These results confirm the prognostic relevance of CRP, a sensitive systemic marker of inflammation, to the risk of CHD in a large, randomly selected cohort of initially healthy middle-aged men. They suggest that low-grade inflammation is involved in pathogenesis of atherosclerosis, especially its thrombo-occlusive complications.

Biomarkers↗
PubMed1999

Meal patterns in middle-aged men in Southern Germany: results from the MONICA Augsburg dietary survey 1984/85.

Seven-day food records of the MONICA project Augsburg dietary survey, which were collected in 1984/85 from 899 men aged 45-64 years (random sample), were used to analyse meal patterns. The combination of the three traditional meals (breakfast, lunch, dinner) with one eating event between was most frequent, followed by two meals with two eating events between and three main meals without any other eating event (31.4 vs. 31.0 vs. 15.6% of all reported days). Breakfast delivered 17, lunch 29 and dinner 33% of the total daily energy intake; all other eating events delivered 21%. The mean contribution of the three meals, breakfast, lunch and dinner to daily protein intake was 14, 36 and 36%, to fat intake 17, 33 and 35% and to carbohydrate intake 23, 25 and 29%, respectively. Data on meal patterns are important in a comprehensive description of dietary habits of a population for a variety of reasons.

Diet↗
PubMed1999

Familial predisposition of left ventricular hypertrophy.

OBJECTIVES: The study evaluated the contribution of familial predisposition to the risk of left ventricular hypertrophy (LVH). BACKGROUND: Left ventricular hypertrophy is a multifactorial condition that serves as an important predictor of cardiovascular mortality. At present it is unclear whether familial predisposition contributes to the manifestation of LVH. Thus, we determined whether siblings of subjects with LVH are at increased risk to present with an elevation of LV mass or an abnormal LV geometry. METHODS: Echocardiographic and anthropometric measurements were performed in 2,293 individuals who participated in the echocardiographic substudies of population-based MONICA Augsburg surveys. In addition, a total of 319 siblings of survey participants with echocardiographic evidence of LVH were evaluated. The risk of these siblings to present with LVH or abnormal LV geometry was estimated by comparison with 636 subjects matched for gender and age that were selected from the entire echocardiography study base. RESULTS: Blood pressure, body mass index, age, and gender (i.e., known determinants of LV mass) were comparable in LVH-siblings and the matched comparison group. However, septal and posterior wall thicknesses, relative wall thickness as well as LV mass index were significantly elevated in LVH-siblings (p < 0.001, each) whereas LV dimensions did not differ. Likewise, the prevalence of LVH was raised in LVH-siblings, as was the relative risk of LVH after adjustment for confounders (p < 0.05). More specifically, LVH-siblings displayed increased prevalences of concentric remodeling and concentric LVH (p < 0.05) but not of eccentric LVH. CONCLUSIONS: Familial predisposition appears to contribute to increased LV wall thickness, to the development of LV hypertrophy and abnormal LV geometry.

Adult↗
PubMed1999

Population trends in antihypertensive drug use: results from the MONICA Augsburg Project 1984 to 1995.

Trends in antihypertensive drug use were assessed among 25- to 64-year-old participants of three independent surveys of the MONICA Augsburg region in 1984/85, 1989/90, and in 1994/95. Despite constant prevalences of hypertension, the percentage of hypertensives taking medication increased over the study period. The latter was mainly due to significant rises in antihypertensive monotherapy. By contrast, the use of combination treatments with two or more agents remained constant; however, although combinations composed of only two drugs were taken more often in 1995, those with three or more agents and fixed-dose preparations decreased substantially. Beta-blockers were most frequently, and with a rising tendency, taken as antihypertensive monotherapy. Newer drug classes like calcium channel blockers and ACE-inhibitors were introduced as monotherapy more hesitantly. Diuretics persisted as the basis of antihypertensive combination therapy. The use of combination therapies containing obsolete drugs, like reserpine, declined significantly with corresponding increases in drug combinations of, in particular, calcium channel blockers or ACE-inhibitors. We conclude that monotherapies account for most of the rising antihypertensive treatment rates and probably reflect intensified therapy of borderline hypertensives. The trends in antihypertensive drug classes and treatment regimens reflect a less rapid adoption of novel therapeutic concepts but a fairly close adherence to national and international guidelines.

Adult↗
PubMed1999

Association of serum uric acid with all-cause and cardiovascular disease mortality and incident myocardial infarction in the MONICA Augsburg cohort. World Health Organization Monitoring Trends and Determinants in Cardiovascular Diseases.

Because previous findings have been inconsistent, we explored the association of serum concentrations of uric acid with all-cause and cardiovascular disease mortality and myocardial infarction prospectively. We used data from 1,044 men who are members of the World Health Organization Monitoring Trends and Determinants in Cardiovascular Diseases (MONICA) Augsburg cohort. The men, 45-64 years of age in 1984-1985, were followed through 1992. There were 90 deaths, 44 of which were related to cardiovascular disease; 60 men developed incident nonfatal or fatal myocardial infarction. We estimated hazard rate ratios from Cox proportional hazard models. Uric acid levels > or =373 micromol/liter (fourth quartile) vs < or =319 micromol/liter (first and second quartile) independently predicted all-cause mortality [hazard rate ratio = 2.8; 95% confidence interval (CI) = 1.6-5.0] after adjustment for alcohol, total cholesterol/high-density lipoprotein cholesterol ratio, hypertension, use of diuretic drugs, smoking, body mass index, and education. The adjusted risk of cardiovascular disease mortality was 2.2 (95% CI = 1.0-4.8), and that of myocardial infarction was 1.7 (95% CI = 0.8-3.3). Although residual confounding cannot be excluded, our results are among the few, in men, demonstrating a strong positive association of elevated serum uric acid with all-cause mortality. Future investigations may be able to evaluate whether uric acid contributes independently to the development of cardiovascular disease or is simply a component of the atherogenic metabolic condition known as the insulin resistance syndrome.

Cardiovascular Diseases↗
PubMed1998

Changes in left ventricular structure and function in patients with white coat hypertension: cross sectional survey.

OBJECTIVES: To assess the relation between white coat hypertension and alterations of left ventricular structure and function. DESIGN: Cross sectional survey. SETTING: Augsburg, Germany. SUBJECTS: 1677 subjects, aged 25 to 74 years, who participated in an echocardiographic substudy of the monitoring of trends and determinants in cardiovascular disease Augsburg study during 1994-5. OUTCOME MEASURES: Blood pressure measurements and M mode, two dimensional, and Doppler echocardiography. After at least 30 minutes' rest blood pressure was measured three times by a technician, and once by a physician after echocardiography. Subjects were classified as normotensive (technician <140/90 mm Hg, physician <160/95 mm Hg; n=849), white coat hypertensive (technician <140/90 mm Hg, physician >=160/95 mm Hg; n=160), mildly hypertensive (technician >=140/90 mm Hg, physician <160/95 mm Hg; n=129), and sustained hypertensive (taking antihypertensive drugs or blood pressure measured by a technician >=140/90 mm Hg, and physician >=160/95 mm Hg; n=538). RESULTS: White coat hypertension was more common in men than women (10.9% versus 8.2% respectively) and positively related to age and body mass index. After adjustment for these variables, white coat hypertension was associated with an increase in left ventricular mass and an increased prevalence of left ventricular hypertrophy (odds ratio 1.9, 95% confidence interval 1.2 to 3.2; P=0.009) compared with normotensive patients. The increase in left ventricular mass was secondary to significantly increased septal and posterior wall thicknesses whereas end diastolic diameters were similar in both groups with white coat hypertension or normotension. Additionally, the systolic white coat effect (difference between blood pressures recorded by a technician and physician) was associated with increased left ventricular mass and increased prevalence of left ventricular hypertrophy (P<0.05 each). Values for systolic left ventricular function (M mode fractional shortening) were above normal in subjects with white coat hypertension whereas diastolic filling and left atrial size were similar to those in normotension. CONCLUSION: About 10% of the general population show exaggerated inotropic and blood pressure responses when mildly stressed. This is associated with an increased risk of left ventricular hypertrophy.

Adult↗
PubMed1998

Validation of a short qualitative food frequency list used in several German large scale surveys.

Our study aimed to test the validity of a short, qualitative food frequency list (FFL) used in several German large scale surveys. In the surveys of the MONICA project Augsburg, the FFL was used in randomly selected adults. In 1984/85, a dietary survey with 7-day records (DR) was conducted within the subsample of men aged 45 to 64 (response 70%). The 899 DR were used to validate the FFL. Mean weekly food intake frequency and mean daily food intake were compared and Spearman rank order correlation coefficients and classification into tertiles with values of the statistic Kappa were calculated. Spearman correlations range between 0.15 for the item "Other sweets (candies, compote)" and 0.60 for the items "Curds, yoghurt, sour milk", "Milk including butter milk" and "Mineral water"; values for statistic Kappa vary between 0.04 ("White bread, brown bread, crispbread") and 0.41 ("Flaked oats, muesli, cornflakes" and "milk including butter milk"). With the exception of two items, FFL data can be used for analysis on group level. Analysis on individual level should be done with caution. It seems, as if some food groups are generally easier to ask for in FFL than others.

Adult↗
PubMed1998

[Use of vitamins and minerals all food supplements from the MONICA cross-sectional study of 1994/95 from the Augsburg study region].

The intake of vitamin and mineral supplements was examined in a southern German population. Analyses are based on data from the 3rd survey of the MONICA Project Augsburg which took place from 1994 to 1995. The study population were 4,856 persons aged 25 to 74 years of a representative sample (net response 74.9%). During a standardized interview, participants were asked about their intake of vitamin or mineral supplments in the previous week (information available from 4,854 persons). To evaluate this information, a database on vitamin and mineral contents of about 500 supplements was established. The prevalence of supplement users is significantly higher among women than among men: more than a quarter of women (27.5%) versus nearly a fifth of men (18.1%). With increasing age women take supplements more frequently, especially minerals. Male supplement usage increases up to the age group 35-44 years and then remains constant. Vitamin C (women 12.8%, men 9.4%), magnesium (women 12.4%, men 8.7%), vitamin E (women 9.8%, men 7.8%), and calcium (women 10.7%, men 4.9%) are the vitamins and minerals supplemented most often. Among supplement users, 46.5% of women and 52.1% of men reported taking vitamin C. The median daily intake of vitamins--except biotin and niacin in men and folic acid and biotin in women--is at least 100% of the recommendations of the German Society for Nutrition for both men and women. All of the median intake values for minerals were less or equal than 100% of the recommendations.

Adult↗
PubMed1998

Supplements as a source of micronutrient intake in middle-aged men in southern Germany: results of the MONICA dietary survey 1994/95.

Survey data on contemporary supplement intake in Germany are scarce, and the contribution of supplements to nutrient intake is especially unclear. In the MONICA Project Augsburg a dietary survey using 7-day weighed records was carried out in a subsample of 607 eligible men aged 45-64 years from the city of Augsburg (participation 430 men = 71%) in 1994/95. Participants also reported their intake of supplements. The German national food data base BLS (version 2.1), which was used to code the records and calculate the nutrients, had to be complemented by nutrient data of supplements and fortified foods. On a group level the maximum mean percentage contribution of supplements to the intake of a micro nutrient was 4.0% (vitamin C). On an individual level, however, up to 4.0% of the men were found to receive more than 50% of their intake of selected micronutrients from supplements. It is, therefore, recommended to ask for supplement intake in future dietary surveys within Germany.

Databases, Factual↗
PubMed1998

Dietary intake of middle-aged men from an East and a West German city after the German reunification: do differences still exist?

OBJECTIVE: To compare the diets of men from East and West Germany after the reunification under the new food market conditions in the East. DESIGN: Both dietary surveys were part of the third MONICA surveys in population based random samples. SETTING: City of Erfurt in the Federal State of Thuringia, East Germany (dietary survey in 1991/92) and city of Augsburg in the Federal State of Bavaria, West Germany (dietary survey in 1994/95). SUBJECTS: Comparable samples of 185 Erfurt vs 331 Augsburg men, aged 45-64 y. MEASURES: Data on food and nutrient intakes and percentage of users of foods are derived from 3 d weighed records from Erfurt and three matching days of 7 d weighed records from Augsburg. RESULTS: Nutrient intakes show the pattern of a typical Western diet in both samples with 15.2 en% from protein, 39.5 en% from fat, 38.8 en% from carbohydrates and 6.2 en% from alcohol in Erfurt. Corresponding figures for Augsburg are 16.4 en%, 37.9 en%, 39.0 en% and 6.5 en%. Intake of animal protein, cholesterol, water and selected micronutrients is distinctly higher in Augsburg. CONCLUSIONS: Dietary differences still exist, but the pattern of difference has changed. It is unclear, whether differences between East and West exceed regional differences in the West.

Alcohol Drinking↗
PubMed1998

Gender specific differences in left ventricular adaptation to obesity and hypertension.

Recent reports indicate that the prognostic implications of left ventricular hypertrophy (LVH) are more profound in women than in men. The prognosis of LVH is also related to the underlying geometric pattern. We therefore assessed the relation of separate and concurrent influences of obesity and hypertension on gender-specific patterns of LV adaptation. Five hundred and twenty participants of a community-based study (aged 52 to 67 years) were examined by M-mode echocardiography. Study subjects were divided into four groups: normals, obese, hypertensives, and subjects presenting with both obesity and hypertension. The groups were compared for various measures of left ventricular mass (LVM) and geometry. Relative to normal subjects, the increments in wall thickness, ventricle diameters, and LVM were all significant and of similar magnitude for obese men and women. Likewise, hypertensive men and women showed similar relative increments of LVM and wall thickness but no changes in end-diastolic internal diameters. Accordingly, obesity was predominantly associated with eccentric hypertrophy (men +/- 14%, women +17%, P<0.05 vs normals) and hypertension with concentric hypertrophy (men +16%, women +30%, P<0.01 vs normals). Women with concurrent obesity and hypertension presented with a further increase of LVM and wall thickness above values in the merely obese or hypertensive (P<0.001) and they displayed LVH more frequently than only obese or hypertensive women (P<0.05). We conclude that the hearts of postmenopausal women respond more susceptibly to the concurrence of hypertension and obesity. In particular the prognostically less favourable concentric LVH is a common finding. Our study may help to explain the higher risk associated with LVH in women.

Adaptation, Physiological↗
PubMed1998

Effects of hormone replacement therapies on fibrinogen and plasma viscosity in postmenopausal women.

In women, cardiovascular morbidity and mortality sharply increase after the onset of menopause. There is substantial evidence that hormone replacement therapy (HRT) may decrease the risk of coronary heart disease (CHD); however, the mechanisms of this preventive effect are unclear. We investigated the association between HRT and plasma viscosity as well as fibrinogen levels in postmenopausal women of a population-based sample (n=300, age 52-65 years). A total of 94 women used HRT; of these, 50 took oestrogen monotherapy and 44 used oestrogen-progesterone combinations. HRT was associated with significantly lower fibrinogen concentrations (2.32 v 2.68 g/l, P<0.001) and decreased plasma viscosity (1.147 v 1.176 mPa/s, P=0.01). Multivariate analyses controlling simultaneously for the effects of age, smoking, body mass index, and use of diuretics confirmed decreased fibrinogen and plasma viscosity values in women using HRT. A trend towards lower plasma viscosity (1.139 v 1.160 mPa/s) and plasma fibrinogen (2.28 v 2.44 g/l) was observed in women on oestrogen-progesterone combinations as compared with oestrogen monotherapy users: however, after controlling for the above-mentioned variables these differences were not statistically significant. This study demonstrates decreased plasma viscosity in women on HRT. Improved rheology offers a mechanism by which HRT lowers the risk of CHD in postmenopausal women.

Aged↗
PubMed1998

Classical risk factors and their impact on incident non-fatal and fatal myocardial infarction and all-cause mortality in southern Germany. Results from the MONICA Augsburg cohort study 1984-1992. Monitoring Trends and Determinants in Cardiovascular Diseases.

BACKGROUND: The MONICA (Monitoring Trends and Determinants in Cardiovascular Diseases) project in Augsburg provides the first population-based cohort study in Germany to quantify the associations of the risk factors hypertension, hypercholesterolaemia and smoking with incident non-fatal and fatal myocardial infarction and all-cause mortality, and to assess their impact at the population level. METHODS: The cohort comprises 1074 men and 1013 women aged 45-64 years; they were followed over 8 years from 1984-1992. In the men, there were 61 non-fatal and fatal myocardial infarctions and 92 all-cause mortality events over this period; in the women the number of deaths from all causes was 45. Incidence rates, hazard rate ratios, population attributable fractions and rate advancement periods were calculated. RESULTS: Adjusting for confounders, the myocardial infarction hazard rate ratios for men with hypertension, or a total cholesterol/HDL-cholesterol ratio > or =5.5, or smoking > or =20 cigarettes/day, were 2.0 (95% CI 1.2-3.5), 2.9 (95%, CI 1.7-5.0), and 2.7 (95% confidence interval (CI) 1 4-5.0), respectively. The risk factor combination total cholesterol/HDL cholesterol ratio > or = 5.5 and cigarette smoking was particularly hazardous. The three risk factors contributed 65% of the burden of myocardial infarction in the population. The rate advancement period for myocardial infarction associated with hypertension, total cholesterol/HDL cholesterol ratio > or =5.5 or smoking > or =20 cigarettes/day was 8.3, 12.4 and 11.5 years, respectively. In women, these risk factors were similarly predictive of all-cause mortality. Comparing the cohort data from Augsburg with those of two occupational cohorts from Germany reveals higher absolute myocardial infarction risks in the Augsburg population; however, the relative risk estimates in the Augsburg and the two occupational cohorts were very similar. CONCLUSION: Our results confirm the important contribution of the classical risk factors to the risk of myocardial infarction and all-cause mortality in Germany. The results pertaining to the concept of rate advancement periods particularly demonstrate the great potential for prevention.

Cause of Death↗