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Biomedical subjects

D R Jacobs

Publications and source records attributed to D R Jacobs.

At least 199 records · Page 11Linked to original sources
PubMed1989

Ethnic differences in blood pressure, pulse rate, and related characteristics in young adults. The CARDIA study.

This study examined ethnic differences in blood pressure and pulse rate in young adults to see whether the differences, if they exist, can be explained by differences in body mass index, lifestyle, psychological, and socioeconomic characteristics. Data used were from the baseline examination of the Coronary Artery Risk Development in (Young) Adults Study (CARDIA). CARDIA is a longitudinal study of lifestyle and evolution of cardiovascular disease risk factors in 5,116 young adults, black and white, men and women, aged 18-30 years, of varying socioeconomic status. Young black adults had higher mean systolic blood pressure and slightly higher mean diastolic blood pressure than young white adults. For both men and women, the blood pressure differences between blacks and whites tended to be greater for the age group 25-30 than for the age group 18-24 years. Among the variables studied, body mass index, duration of exercise on the treadmill, number of cigarettes smoked per day, and number of alcoholic drinks per week were consistently associated with blood pressure. The blood pressure differences were greatly reduced after adjusting for these variables. Black participants had lower mean pulse rate than white participants. The differences tended to be greater for the age group 18-24 than for the age group 25-30 years. Among the variables studied, only duration on treadmill and number of cigarettes smoked per day were consistently correlated with pulse rate. With adjustment for duration on treadmill, the differences in pulse rate increased. These results suggest that differences in ethnic pattern of blood pressures and pulse rate with age may be due in part to obesity, physical fitness, alcohol consumption, and cigarette smoking.

Adolescent↗
PubMed1989

Is early natural menopause a biologic marker of health and aging?

The relation between age at natural menopause and all-cause mortality was investigated in a sample of 5,287 White women, ages 55 to 100 years, naturally-postmenopausal, Seventh-day Adventists who had completed mailed questionnaires in 1976. The age-adjusted odds ratio of death during 1976-82 in women with natural menopause before age 40 was 1.95 (95% confidence interval = 1.24, 3.07), compared to the reference group of women reporting natural menopause at ages 50 to 54. Corresponding odds ratios of death were 1.39 (95% CI = 1.06, 1.81) for natural menopause at ages 40 to 44, and 1.03 (95% CI = 0.84, 1.25) for natural menopause at ages 45 to 49. Among 3,166 White, 55- to 100-year-old, surgically-postmenopausal, Adventist women, there was no relation between age at surgical menopause and mortality. Logistic regression analyses indicated that findings from this study were apparently not due to confounding by smoking, over- or underweight, reproductive history, or replacement estrogen use.

Adult↗
PubMed1989

The relationship between social status and body mass index in the Minnesota Heart Health Program.

This study investigated relationships between social variables and body mass index (BMI) in 2465 men and 2792 women aged 25 to 74 in six upper midwestern communities. After controlling for age and cigarette smoking status, BMI was significantly related to education, income, occupation, and marital status in both men and women. SES variables tended to be inversely related to BMI, with a steeper gradient for women than for men. A curvilinear trend was noted, however, in that social status tended to be lower at both ends of weight distribution than in the middle. The relationship between marital status and BMI was also found to be curvilinear. Highest rates of marriage were in the middle portion of the weight distribution for both sexes.

Adult↗
PubMed1988

A statewide approach to adolescent tobacco-use prevention: the Minnesota-Wisconsin Adolescent Tobacco-Use Research Project.

Adolescent smoking rates remain high and the use of smokeless tobacco is increasing, especially among males. Despite this continuing public health problem and the recent development of more effective prevention programs, few adolescents now participate in such programs at school. Recent legislation in Minnesota established guidelines for tobacco-use prevention programming and provides financial incentives to school districts to use more effective methods. The Minnesota-Wisconsin Adolescent Tobacco-Use Research Project has implemented an evaluation design that will provide data on the efficacy of this statewide approach to the prevention of tobacco use among adolescents. This article describes the current state of tobacco-use prevention programming in Minnesota schools, current efforts to improve on that record, and the research design set up to evaluate these strategies.

Adolescent↗
PubMed1988

CARDIA: study design, recruitment, and some characteristics of the examined subjects.

In 1984, a prospective cohort study, Coronary Artery Risk Development in Young Adults (CARDIA) was initiated to investigate life-style and other factors that influence, favorably and unfavorably, the evolution of coronary heart disease risk factors during young adulthood. After a year of planning and protocol development, 5,116 black and white women and men, age 18-30 years, were recruited and examined in four urban areas: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota, and Oakland, California. The initial examination included carefully standardized measurements of major risk factors as well as assessments of psychosocial, dietary, and exercise-related characteristics that might influence them, or that might be independent risk factors. This report presents the recruitment and examination methods as well as the mean levels of blood pressure, total plasma cholesterol, height, weight and body mass index, and the prevalence of cigarette smoking by age, sex, race and educational level. Compared to recent national samples, smoking is less prevalent in CARDIA participants, and weight tends to be greater. Cholesterol levels are representative and somewhat lower blood pressures in CARDIA are probably, at least in part, due to differences in measurement methods. Especially noteworthy among several differences in risk factor levels by demographic subgroup, were a higher body mass index among black than white women and much higher prevalence of cigarette smoking among persons with no more than a high school education than among those with more education.

Adult↗
PubMed1988

Cardiovascular risk factor change--1973-74 to 1980-82: the Minnesota Heart Survey.

Reductions in population risk factor levels, including blood pressure, blood cholesterol, and cigarette smoking may be associated with the observed decline in cardiovascular disease (CVD) mortality rates. However, few recent population-based comparisons of risk trends are available. To evaluate changes in these risk characteristics in the recent period, data were compared from two surveys performed in the same metropolitan area using similar methods. The Lipid Research Clinic (LRC) Prevalence Study surveyed a population sample of 4185 adults aged 25-59 in 1973-74. The Minnesota Heart Survey (MHS) surveyed a population sample of 2914 adults of the same age in the same metropolitan area in 1980-82. The average systolic and diastolic blood pressures were significantly lower in the 1980-82 survey averaging 1.5/3.8 mmHg for men and 1.6/2.8 mmHg for women. The use of anti-hypertensive medications increased significantly over the period while the prevalence of hypertension was similar. Significant declines in mean serum cholesterol were also observed in 1980-82, averaging 3.3 mg/dl for men and 5.5 mg/dl women. The prevalence of regular cigarette smoking in men was also lower in 1980-82, 36.3 vs 42.1% in 1973-74. Women had a lower prevalence of smoking (38.8-35.6%) but the average woman smoker increased consumption of cigarettes while the average man did not. These observations suggest that population risk defined by these characteristics is declining which may explain part of recent Minnesota trends in CVD mortality and could have a favorable effect on future disease patterns.

Adult↗
PubMed1988

Cyclic seasonal variation in plasma lipid and lipoprotein levels: the Lipid Research Clinics Coronary Primary Prevention Trial Placebo Group.

Seasonal plasma lipid and lipoprotein cycles were studied in 1446 hypercholesterolemic 35-59 year-old men followed for 7 years as the placebo group of the Lipid Research Clinics (LRC) Coronary Primary Prevention Trial (CPPT). Separate periodic time series were calculated for each study participant; mean parameter estimates were obtained by vector algebra. Highly significant (p less than 0.001) synchronous sinusoidal seasonal cycles, peaking in the first month of winter, were demonstrated for plasma levels of total (TOT-C), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) cholesterol. Their mean seasonal changes (nadir to zenith) were 7.4, 6.4, and 0.8 mg/dl, respectively. An irregular but statistically significant seasonal pattern was also observed for plasma triglyceride (TG) levels, with peak levels in the autumn. The variation of these seasonal effects among subgroups and geographic locales and their correlation with seasonal weight and dietary patterns yielded few clues as to their underlying etiologic mechanisms.

Adult↗
PubMed1988

Physical fitness and cardiovascular disease mortality. The US Railroad Study.

The relation between physical fitness and cardiovascular disease mortality was examined in US railroad workers, as a part of the Seven Countries Study. A cohort of 3,043 white, middle-aged men initially aged 22-79 years were first examined in 1957-1960 and re-examined in 1962-1964. Men with clinically diagnosed cardiovascular disease (n = 465) were excluded from this study. This cohort was followed until death or 1977. Mortality was monitored through the Railroad Retirement Board. Physical fitness was ascertained by a sub-maximal treadmill test administered in a Pullman Car converted to a survey laboratory. Exercise heart rate was directly and significantly related to coronary heart disease mortality, cardiovascular disease mortality, and all-cause mortality after adjusting for age. These relations were greatly attenuated when adjusted for blood pressure level. The risk for coronary heart disease when an exercise test heart rate of 135 beats per minute was compared with a rate of 105 beats per minute was 1.43, after adjusting for age, and 1.20, after adjusting for blood pressure, serum cholesterol levels, and smoking, as well as age. Results from this study suggest that middle-aged men with lower levels of physical fitness, as shown by higher sub-maximal exercise test heart rates, are at greater risk of dying of coronary heart disease, cardiovascular disease, and all causes in an average follow-up of 20 years. This greater risk is largely due to higher blood pressure levels.

Adult↗
PubMed1988

Parent involvement with children's health promotion: the Minnesota Home Team.

This study compares the efficacy of a school-based program to an equivalent home-based program with 2,250 third grade students in 31 urban schools in Minnesota in order to detect changes in dietary fat and sodium consumption. The school-based program, Hearty Heart and Friends, involved 15 sessions over five weeks in the third grade classrooms. The home-based program, the Home Team, involved a five-week correspondence course with the third graders, where parental involvement was necessary in order to complete the activities. Outcome measures included anthropometric, psychosocial and behavioral assessments at school, and dietary recall, food shelf inventories, and urinary sodium data collected in the students' homes. Participation rates for all aspects of the study were notably high. Eighty-six per cent of the parents participated in the Home Team and 71 per cent (nearly 1,000 families) completed the five-week course. Students in the school-based program had gained more knowledge at posttest than students in the home-based program or controls. Students in the home-based program, however, reported more behavior change, had reduced the total fat, saturated fat, and monounsaturated fat in their diets, and had more of the encouraged foods on their food shelves. The data converge to suggest the feasibility and importance of parental involvement for health behavior changes with children of this age.

Child↗
PubMed1988

Educational attainment and nutrient consumption patterns: the Minnesota Heart Survey.

To explore whether dietary patterns differ according to educational attainment, we examined the associations of nutrient intake with educational level in a sample of 825 male and 893 female Twin Cities (Minneapolis and St. Paul) residents aged 25 to 74 years who were surveyed between 1980 and 1982. Of particular interest was the pattern of macronutrient consumption, since the proportion of fat and type of fat in the diet is thought to be related to the development of chronic disease. Estimates of nutrient intake were based on 24-hour dietary recalls, while information on education was obtained through interview. Educational attainment was positively associated with nutrient consumption patterns that may decrease risk of chronic disease for both men and women. For women, the proportion of dietary fat was less (p = .03) and carbohydrate greater (p = .004) with increasing education. For men, the Keys dietary score decreased as education increased (p = .05) (high scores indicate greater blood cholesterol-raising effect of the diet). Inverse associations of average total serum cholesterol level with education in both men (p = .02) and women (p = .06) support these dietary associations. These results suggest that educational attainment is related positively to eating patterns that may carry a decreased risk of cardiovascular and other chronic disease. Whether or not this association is causal, it would appear to point to a need for more effective nutrition education strategies for those with less education.

Adult↗
PubMed1988

Relationships of low density lipoprotein cholesterol with age and other factors: a cross-sectional analysis of the CARDIA study.

Presumed evolution of low density lipoprotein cholesterol (LDL-C) was studied in a baseline cross-sectional survey of 4955 18-30 year old men and women of various sociodemographic backgrounds. Specifically studied were the influences on LDL-C and the change of LDL-C with age of race, gender, education, diet, physical activity, fatness and fitness. Men increased about 20 mg/dl per 10 years of age, while women increased about 3 mg/dl. Increasing education was found to be associated with higher LDL-C in blacks, but with lower LDL-C in whites. Higher Keys diet score and body mass index were positively associated with LDL-C, while higher total caloric intake, vigorous physical activity, duration on a treadmill exercise test and usual intake of alcohol were negatively associated with LDL-C. The finding of a different relationship of LDL-C to increasing education in whites than in blacks suggests a cultural or behavioral influence in rate of increase in LDL-C.

Adolescent↗
PubMed1987

Leisure-time physical activity levels and risk of coronary heart disease and death. The Multiple Risk Factor Intervention Trial.

The relation of self-selected leisure-time physical activity (LTPA) to first major coronary heart disease (CHD) events and overall mortality was studied in 12,138 middle-aged men participating in the Multiple Risk Factor Intervention Trial. Total LTPA over the preceding year was quantitated in mean minutes per day at baseline by questionnaire, with subjects classified into tertiles (low, moderate, and high) based on LTPA distribution. During seven years of follow-up, moderate LTPA was associated with 63% as many fatal CHD events and sudden deaths, and 70% as many total deaths as low LTPA (P less than .01). Mortality rates with high LTPA were similar to those in moderate LTPA; however, combined fatal and nonfatal major CHD events were 20% lower with high as compared with low LTPA (P less than .05). These risk differentials persisted after statistical adjustments for possible confounding variables, including other baseline risk factors and Multiple Risk Factor Intervention Trial group assignments. It is concluded that LTPA has a modest inverse relation to CHD and overall mortality in middle-aged men at high risk for CHD.

Adult↗
PubMed1987

Relation between ventricular premature complexes and sudden cardiac death in apparently healthy men.

The association between ventricular premature complexes (VPCs) detected on a rest 2-minute lead I electrocardiographic rhythm strip and sudden cardiac death (SCD), occurring within 1 hour of onset of symptoms, was evaluated in a prospective study of 15,637 apparently healthy white men, aged 35 to 57 years, at the first screening examination (1973 to 1975) to determine eligibility for the Multiple Risk Factor Intervention Trial in Minneapolis/St. Paul, Minnesota. The prevalence of any VPC was 4.4% (681 of 15,637). Over an average follow-up period of 7.5 years, a total of 381 deaths occurred. Of these, 34% (131 of 381) were ascribed to coronary artery disease (CAD) and 31% of the CAD deaths (41 of 131) occurred suddenly. The presence of any VPC was associated with a significantly higher risk for SCD (adjusted relative risk = 3.0; p less than 0.025). On the other hand, the presence of any VPC was not associated with any significant increase in the risk of non-SCD or of total deaths from CAD (adjusted relative risk = 1.0 and 1.6, respectively). When VPC characteristics such as frequency (2 or more uniform VPCs every 2 minutes) and complexity (multiforms, pairs, runs, R-on-T) were examined, those with frequent or complex VPCs were at a significantly increased risk of SCD (adjusted relative risk = 4.2; p less than 0.005), whereas for non-SCD no significant increase in risk was found (adjusted relative risk = 1.6; p = 0.28).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Improvement in long-term survival among patients hospitalized with acute myocardial infarction, 1970 to 1980. The Minnesota Heart Survey.

The mortality rate associated with coronary heart disease in the United States has declined steadily since 1968, but the reasons for this favorable trend have not been completely elucidated. In particular, it is not clear to what extent the decline reflects decreasing incidence as opposed to improved survival. To assess whether improved survival after myocardial infarction has contributed to the decline, the Minnesota Heart Survey compared the four-year survival rate in patients discharged with a diagnosis of acute myocardial infarction from hospitals in the Twin Cities area in 1970 and 1980. After adjustment for clinical characteristics related to outcome, the survival rate among patients with a definite myocardial infarction was significantly higher in the 1980 than in the 1970 group. The four-year survival for men was 35 percent better in the 1980 than in the 1970 group (95 percent confidence interval, 21 to 50 percent), and for women it was 27 percent better (95 percent confidence interval, 1 to 46 percent). Improvement in survival during the period of hospitalization accounted for 70 percent of the overall gain in survival between 1970 and 1980 in men and for virtually all of the gain in women. We conclude that improved long-term survival among patients with acute myocardial infarction has made an important contribution to the decline in mortality from coronary disease.

Female↗
PubMed1987

Relationships among type A behavior, employment experiences, and gender: the Minnesota Heart Survey.

Previous studies indicate that Type A behavior is more prevalent among men than women. This sex difference may reflect variations in men's and women's job experiences, some of which may act as catalysts for Type A behavior. This study examines the relationship of Type A behavior (measured by the Jenkins Activity Survey) to men's and women's work hours, occupational mobility, and job-related interactions, using data from a population-based survey of 2512 employed men and women conducted in Minneapolis-St. Paul, Minnesota, between 1980 and 1982. Among both sexes, Type A behavior is related to long work hours, high occupational mobility, and nonsupportive interactions with co-workers, all job experiences more common for men than for women. No sex differences are found in the relationships between Type A behavior and these job experiences. Also, no sex difference is observed in the unadjusted Type A scores or in these scores when either age, education, or marital status is taken into account. The expected direction of the sex difference in Type A behavior is reversed when work hours are controlled: women have a higher Type A score than men when work hours are considered.

Adult↗
PubMed1987

Recruitment in the Coronary Artery Disease Risk Development in Young Adults (Cardia) Study.

Coronary Artery Disease Risk Development in Young Adults (CARDIA) is a longitudinal study designed to trace the development of risk factors for coronary heart disease in 5100 individuals 18-30 years old. The study will compare, by cross-sectional and longitudinal analyses, trends and processes involved in risk factor development by sex, race, age, and other sociodemographic characteristics. Participants for the approximately 4 1/2-hour baseline examination were randomly selected and recruited by telephone from census tracts in Minneapolis and Chicago, by telephone exchanges within the Birmingham city limit, and from lists of the Kaiser-Permanente Health Plan membership in Oakland and Berkeley. A major issue was the desirability of sampling approximately equal numbers by age, race, sex, and education as compared with sampling numbers representative of the population base. The recruitment goal of 5100 was achieved on schedule.

Adolescent↗
PubMed1987

Nutrient intake in a metropolitan area, 1973-74 vs 1980-82: the Minnesota Heart Survey.

Trends in dietary intake in the Twin Cities metropolitan area were measured by comparing data from two independent surveys conducted in 1973-74 and 1980-82. Dietary information was collected by 24-h recall and coded by a single coding center. For men reported caloric intake declined significantly and fat, protein, and carbohydrate each declined approximately 6%; changes in reported dietary intake for women were smaller and mostly nonsignificant. Few trends were observed for either sex in nutrient intake relative to energy intake. Changes in mean serum total-cholesterol levels and body mass indices between 1973-74 and 1980-82 were not consistent with the direction of dietary trends. The proportion of subjects whose 24-h intake met five selected US dietary goals was calculated. In 1980-82, less than 15% of persons reached the goals for carbohydrate and fat intake on the day surveyed; the cholesterol-intake goal (less than or equal to 300 mg/d) was met by 39% of men and 64% of women during the 24-h period surveyed.

Adult↗