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Biomedical subjects

C G Hames

Publications and source records attributed to C G Hames.

At least 19 recordsLinked to original sources
PubMed1995

Coronary disease mortality and risk factors in black and white men. Results from the combined Charleston, SC, and Evans County, Georgia, heart studies.

BACKGROUND: Epidemiologic studies begun in the southeastern United States in the 1960s indicated that the prevalence of coronary disease was two to three times greater among white men than black men and also showed an excess incidence of coronary disease among white men, although hypertension was twice as prevalent among blacks. This study was conducted to determine if racial differences exist in coronary heart disease mortality and coronary risk factors. METHODS: Data from the two population-based cohorts of the Charleston, SC, and Evans County, Georgia, Heart Studies were pooled to make comparisons of coronary disease mortality and its risk factors. A total of 726 black men and 1346 white men aged 35 years or older in 1960 in the combined cohort were followed up for 30 years. RESULTS: There were 125 deaths among the black men and 323 deaths among the white men attributable to coronary disease; the age-adjusted rates were 5.0 per 1000 person-years in the black men and 6.5 per 1000 person-years in white men. Black-white coronary mortality risk ratios were 0.8 when age adjusted and 0.7 when also adjusted for other cardiovascular risk factors. Elevated systolic blood pressure and cigarette smoking were significant predictors of coronary mortality in black and white men. Serum total cholesterol level was a statistically significant risk factor only in white men. Higher education level was significantly protective in black and white men. CONCLUSIONS: Black men experienced significantly less coronary disease mortality than white men. Except for cholesterol level, the risk factors for coronary mortality in black and white men were similar.

Adult↗
PubMed1992

Greater incidence of electrocardiographic left ventricular hypertrophy in black men than in white men in Evans County, Georgia.

Population-based studies of black populations in the United States and Puerto Rico have reported higher prevalences of electrocardiographic left ventricular hypertrophy compared to white or lighter-skinned populations residing in the same areas. This study examines the incidence and correlates of electrocardiographic left ventricular hypertrophy in a population-based, biracial cohort of 435 white and 163 black men from the Evans County, Georgia, Heart Study, who were examined at entry in 1960 and reexamined in 1967. Only men over 35 years of age who were free of cardiovascular disease and had normal electrocardiograms at entry were eligible. Black men had a nearly fourfold greater incidence of electrocardiographic left ventricular hypertrophy compared to white men (13.5% vs 3.7%, respectively; incidence ratio 3.7; 95% CI 3.2-4.4). After statistically adjusting for age, systolic blood pressure, weight, and the change in weight and blood pressure, black men had a threefold greater incidence of electrocardiographic left ventricular hypertrophy compared to white men (logistic odds ratio 3.0; 95% CI 1.6-6.1). In summary, black men showed a significantly greater risk of developing electrocardiographic left ventricular hypertrophy at 7-year follow-up in Evans County compared to their white counterparts. This elevated risk could not be explained by the independent or joint effects of risks factors for electrocardiographic left ventricular hypertrophy.

Adult↗
PubMed1991

Socioeconomic status and morbidity and mortality in hypertensive blacks.

Despite an overall limited range of social and economic opportunities in the recent past, blacks of lower socioeconomic status have experienced marked excesses in hypertension-related burdens compared with their more advantaged peers: the incidence, prevalence, and severity of hypertension and its end-organ sequelae increased with decreasing educational achievement and the 5-year mortality was two times higher for black hypertensives of lower than higher educational achievement under conditions of usual care in U.S. communities in the 1970s. The Stepped Care program of antihypertensive pharmacologic therapy of the HDFP reduced all-cause mortality by 19% for black hypertensive men and 28% for black women. The HDFP also eliminated the association of mortality with educational achievement; the favorable impact of the program was greatest in the group at highest risk, blacks of lowest socioeconomic status.

Adult↗
PubMed1990

Biochemical, endocrine, and mineral effects of indapamide in black women.

Black women with established essential hypertension, without renal insufficiency or diabetes mellitus, were withdrawn from their usual antihypertensive therapy for 2-3 weeks prior to entry into a study to evaluate pertinent biochemical and mineral effects of indapamide treatment. Twenty patients with a sitting diastolic blood pressure greater than 90 mm Hg had baseline measurements of plasma total cholesterol, HDL cholesterol, triglycerides, glucose, uric acid, potassium, magnesium, calcium, selenium, renin, norepinephrine, whole blood ionized calcium, and glycosylated hemoglobin. Low-density lipoprotein (LDL) cholesterol was calculated by the Friedewald equation. The patients were placed on a fixed daily dose of 2.5 mg indapamide. Blood pressure and blood tests were repeated at 4, 8, and 12 weeks of treatment. The systolic and diastolic blood pressure were both lowered significantly at week 12. Plasma renin activity was significantly increased. There was no significant change in norepinephrine, glucose, glycosylated hemoglobin, uric acid, ionized calcium, calcium, triglycerides, potassium, magnesium, or selenium. Total cholesterol increased with an increase in both high-density lipoprotein (HDL) and LDL cholesterol; however, these increases did not alter significantly either the total/HDL cholesterol or LDL/HDL cholesterol ratios. It is concluded that 2.5 mg of indapamide per day effectively lowers blood pressure with no significant adverse metabolic effects.

Adult↗
PubMed1990

Passive smoking and 20-year cardiovascular disease mortality among nonsmoking wives, Evans County, Georgia.

The association of passive smoking and cardiovascular disease (CVD) mortality was assessed in a cohort of 513 rural, married Black and White women who were disease-free and self-described as never-smokers at baseline in 1960. Over a 20-year period, 76 of 147 total deaths were attributed to CVD. Relative risk estimates adjusted for age, cholesterol, blood pressure, and body mass from proportional hazards models were 1.59 for CVD (95% CI = 0.99, 2.57) and 1.39 (CI = 0.99, 1.94) for all cause mortality among women with husbands who smoked cigarettes.

Adolescent↗
PubMed1988

Race and sex differences in the correlates of blood pressure change.

Potential predictors of systolic and diastolic blood pressure change between 1960 and 1967 in the biracial population of Evans County, Georgia, were investigated. An all possible regressions multiple linear regression analysis was used. For systolic blood pressure change, the level of systolic blood pressure, age, and change in Quetelet index were significant (p less than 0.05) correlates in white men. The level of systolic blood pressure, the level and change of socioeconomic status, change in Quetelet index, and change in cholesterol were significant correlates for white women. The level of Quetelet index was of borderline significance (p less than 0.055) when the other significant variables were included in the model for white women. The change in Quetelet index was the only significant correlate of systolic blood pressure change in blacks. For diastolic blood pressure change, age, change in hematocrit, and change in Quetelet index were significant correlates for white men. Age, level and change of socioeconomic status, level and change of Quetelet index, and change in hematocrit were the significant correlates in white women. In black men, change in Quetelet index and age were significant. In black women, only age was a significant correlate of diastolic blood pressure change. These results indicate that there may be important differences in these correlates between race-sex groups and thus in the mechanism of blood pressure change for different race-sex groups. groups.

Adult↗
PubMed1988

Status of patients seven years after completion of the hypertension detection and follow-up program in Evans County, Georgia.

The Evans County, Georgia, cohort of the Hypertension Detection and Follow-up Program (HDFP) was reexamined seven years after termination of the trial in 1979. Of the 510 survivors, 91 percent of the black and 91 percent of the white hypertensive subjects were evaluated by blood pressure (BP) levels, electrocardiograms (ECG), height-weight measurements, and questionnaire. The HDFP had treated a randomly selected half of the patients in an intensive stepped care (SC) program and the other half was referred to usual care (RC). At the beginning of the five-year trial, diastolic blood pressure (DBP) levels were higher in blacks in both SC and RC. At the completion of the trial in 1979, black women had mean DBP levels comparable to whites in both SC and RC, but black men displayed higher levels. During the five years of the trial there were no cases of left ventricular hypertrophy (LVH) in SC in either race. In RC the incidence of LVH was slightly higher in blacks than in whites. During the seven-year post-trial period, the incidence of LVH in blacks rose to 13 percent, more than double that of whites. Medication compliance was reduced in black men during this time, most likely because of removal of the supporting elements of HDFP (frequent medical contacts, free medication).In both races, hypertensive subjects underwent weight changes during the seven years of the post-trial period. Weight loss of 15 lb was associated with normotension. Weight gain of 9 to 10 lb over seven years was associated with hypertensive BP levels.The supportive or detrimental effect of weight loss or weight gain on BP levels was thus reconfirmed in this biracial cohort.

Adult↗
PubMed1987

Genetic analysis of serum lipid levels and blood pressure in a large kindred.

A 267-member Caucasian kindred with a high incidence of cardiovascular disease, originally from Evans County, Georgia, was chosen for genetic analysis of serum lipid levels and blood pressure. Total serum cholesterol, triglycerides, high density lipoprotein cholesterol (HDL), and systolic and diastolic blood pressures were natural logarithm transformed and then adjusted for significant age, sex, and behavioral trait effects. Major gene pedigree analysis was used to estimate genetic parameters and to test hypotheses about the mode of transmission of each trait. Multivariate methods were also used to estimate linear combinations of the variables that best fit genetic models. The data were consistent with a major gene segregating for high levels of triglycerides in this kindred. However, dominant and recessive hypotheses could not be distinguished. Although diastolic blood pressure fit a mixture of two distributions significantly better than a single normal, major gene hypotheses could be rejected while the no-transmission hypothesis could not. There was no evidence of a major gene effect on cholesterol, HDL, systolic blood pressure, or any of the hypothetical traits represented by linear functions of the physical-lipid traits.

Adult↗
PubMed1987

Electrocardiographic abnormalities and mortality among middle-aged black men and white men of Evans County, Georgia.

The distribution of electrocardiographic (ECG) abnormalities and the relationship between ECG abnormalities and mortality after 20 years of follow-up were examined among 40-64-year-old black men and white men enrolled in the Evans County Heart Study. Major or minor ECG abnormalities, as defined in the Pooling Project, were present at entry for 53% of blacks (164 of 308) and 31% of whites (159 of 511). For both races, the presence of ECG abnormalities was directly related to age, blood pressure, and Quetelet's index at baseline. After adjustment for these and other risk factors, major ECG abnormalities were similarly predictive of all-cause mortality for blacks [rate ratio (RR) = 1.7 (1.1.2.8)] and whites [RR = 2.2 (1.4, 3.4)]. Associations of similar magnitude were observed in relationship to deaths from all cardiovascular diseases and deaths from coronary heart disease. These results are consistent with the hypothesis that ECG abnormalities convey risk for blacks as well as whites.

Adult↗
PubMed1986

Cardiovascular disease risk factors and mortality among black women and white women aged 40-64 years in Evans County, Georgia.

There have been few prospective studies of the epidemiology of cardiovascular disease in women, especially black women. The authors report the 20-year mortality experience of 391 black and 549 white women aged 40-64 years recruited in 1960-1961 into the Evans County Cardiovascular Study. The vital status of 98.9% of the white women and 96.2% of the black women had been determined as of May 1, 1980. Using Cox' proportional hazards model, the authors estimated that black women had a 70% excess risk of cardiovascular disease mortality compared with white women, unadjusted for any risk factors. At entry, black women had higher systolic blood pressure, higher Quetelet index, lower serum cholesterol, lower social status, and similar age distribution and prevalence of cigarette smoking compared with white women. Cardiovascular disease mortality was significantly associated with systolic pressure in all women, serum cholesterol in white women, and Quetelet index in low social status white women. Adjustment for cardiovascular disease risk factors and social status explained most of the difference in cardiovascular disease mortality between blacks and whites.

Adult↗
PubMed1985

Is serum selenium a risk factor for cancer?

A narrow band of counties extending along the southeastern Atlantic coast from Jacksonville, Florida to Charleston, South Carolina were found to have excessively high incidence rates for esophageal cancer in non-white males. White males in the same areas have a 30% higher incidence rate for lung cancer but only average incidence rates were found for non-white males. Selenium is considered to decrease cancer risk in the animal model. In this coastal region, a study of 130 cancer patients who developed a malignancy 2-12 years after baseline examination showed no dose response relationship between baseline serum selenium levels and risk of subsequent cancer.

Black People↗
PubMed1985

The relationship of weight change to changes in blood pressure, serum uric acid, cholesterol and glucose in the treatment of hypertension.

In the Hypertension Detection and Follow-up Program (HDFP), elevated blood pressure (BP) was treated by rigorous, stepped care (SC) therapy among half the participants, while the other half were referred to usual sources of care (referred care, RC). There was no program to reduce weight, however, some participants changed weight voluntarily over the first 2 yr, providing an opportunity to examine the role of weight change in the development of diuretic-induced hyperuricemia, hyperglycemia and hypercholesterolemia. There was a stepwise progression from decreased glucose, uric acid and cholesterol concentrations, and BP associated with maximum weight loss to increased values with maximum weight gain. In SC, systolic BP declined by 22.4% among weight-losers and by 17.1% among weight-gainers; in RC, it was 14.4 and 8.1%, respectively. The pattern in diastolic blood pressure and weight change was similar but not as marked. These findings suggest the potential importance of weight loss in enhancing effectiveness of antihypertensive drug treatment and attenuating increases in glucose, uric acid, and cholesterol associated with diuretic treatment of hypertension. The weight change analyses are based on postrandomization observations and do not reflect experimental changes.

Blood Glucose↗
PubMed1985

The black/white mortality crossover: investigation in a community-based study.

The black/white mortality crossover at about age 75, a result of lower white mortality rates at younger ages and lower black rates at the oldest ages, has been observed in U.S. vital statistics since 1900. Though a persistant observation in such data, its validity has been challenged by questions about census enumeration and age reporting on death certificates. Analyses of 20 years experience of all-cause mortality in the community-based Evans County Study using a Weibull model of age specific mortality rates showed a statistically significant black/white mortality crossover for both men (at age 73) and women (at age 85). The finding of a crossover in this longitudinally followed population is significant because the age reporting for both survivors and age at death for nonsurvivors were obtained in the study protocol and did not rely on age reporting either in census data or on the death certificate. Differences in the age and sex patterns of mortality between two populations living in the same geographic region are relevant to questions about the etiology of the major age-related chronic diseases as well as to topics of current interest in health care policy.

Adult↗
PubMed1985

Menopausal change in serum cholesterol. Black/white differences in Evans County, Georgia.

The relationship between menopausal status and total serum cholesterol was examined cross-sectionally in a population of 40- to 54-year-old black and white women of Evans County, Georgia. The relationship differed in blacks and whites as assessed by a significant interaction term in linear regression. Controlling for age, Quetelet index, and smoking status, white postmenopausal women showed an estimated increase in total serum cholesterol of 25 mg/dl (p less than 0.001) compared with premenopausal whites, whereas black postmenopausal women showed no significant increase in total serum cholesterol compared with premenopausal blacks. The authors were unable to attribute the lack of menopausal effect in blacks to selection or measurement bias, nor did confounding or effect modification by obesity or social status negate their findings. Of six other populations in which menopausal influence on total serum cholesterol has been examined, only Pima Indians failed to show a significant increase.

Adult↗
PubMed1984

Relation of serum vitamins A and E and carotenoids to the risk of cancer.

Epidemiologic studies suggest that low carotene intake and low levels of serum retinol may be associated with an increased risk of cancer. Likewise, in some animal studies vitamin E has been associated with a reduced rate of induced cancers. Therefore, we measured retinol, retinol-binding protein, vitamin E (alpha-tocopherol), and total carotenoids in serum collected in 1973 from 111 participants in the Hypertension Detection and Follow-up Program who were free of cancer at the time but were diagnosed as having cancer during the subsequent five years. These measurements were compared with those in 210 controls who were matched for age, sex, race, and time of blood collection, and who remained free of cancer. Mean values for retinol were similar for cases and controls (67.3 and 68.7 micrograms per deciliter, respectively [95 per cent confidence limits for case-control difference, -6.7 to 3.5]). Values were also similar for retinol-binding protein (6.01 and 5.94 mg per deciliter [-0.42 to 0.56]), and carotenoids (114.5 and 111.6 micrograms per deciliter [-9.1 to 15.9]). The mean base-line retinol level in the 18 subjects with subsequent lung cancer was higher than that in their matched controls (79.0 vs. 71.4 micrograms per deciliter, -4.9 to 19.7). Serum vitamin E levels were somewhat lower in subjects who later had cancer than in controls (1.16 and 1.26 mg per deciliter, -0.22 to 0.02), in part because of the confounding effect of serum cholesterol levels (when adjusted for lipid levels, the case-control difference was -0.05 mg per deciliter; -0.17 to 0.07). These data do not support hypotheses relating intake or serum levels of antioxidant vitamins to a reduced cancer risk.

Adult↗
PubMed1984

Ischemic heart disease risk factors and twenty-year mortality in middle-age Evans County black males.

Ischemic heart disease (IHD) risk factors and 20-year mortality rates were studied in middle-aged Evans County black males. We hypothesized, a priori, that blood pressure, cholesterol, and smoking would be predictive of mortality in black males; that black-white differences in mortality would be due to differences in risk factor levels and not risk functions per se; and that social status would be associated with risk factor levels and would be a predictor of mortality. Multivariate analyses of cumulative risk of dying and time to death suggest that the major IHD risk factors are predictors of all-cause and IHD mortality in black males. Black-white differences in risk functions, specifically for cholesterol, were explained by social status: black males and lower social status white males had similar risk functions, different from those of higher social status white males. Black males and lower social status white males had almost identical survival curves, each less favorable than those of higher social status white males.

Adult↗
PubMed1984

Black-white differences in plasma levels of apolipoproteins: the Evans County Heart Study.

Evans County black males had lower ischemic heart disease (IHD) prevalence, incidence, and mortality than white males. High-density lipoprotein (HDL) cholesterol was lower in IHD cases than in subjects without IHD. HDL cholesterol and apolipoprotein A-I (Apo A-I) were higher and low-density lipoprotein (LDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol, and Apo C-II were lower in black than white males. Of the black-white male HDL cholesterol difference, 22% was statistically explained by Apo A-I. Controlling for Apo C-II reduced the black-white differences in total cholesterol 87%, LDL cholesterol 44%, VLDL cholesterol 83%, and total triglyceride 83%. There were negative associations between Apo A-I and age, Quetelet index, and cigarettes smoked; the association between Apo A-I and alcohol was positive. Only body mass index and race were strong correlates of Apo C-II. The ratios of Apo A-I to Apo A-II and of HDL cholesterol to Apo A-II were higher in black than white males with adjustment for age, body mass, and cigarette and alcohol consumption. Thus black-white differences in total lipids, lipoprotein lipids, and lipoprotein apoproteins were observed, indicating a relatively antiatherogenic profile in black males only partially explained by known correlates.

Adult↗