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D T Lackland

Publications and source records attributed to D T Lackland.

At least 55 records · Page 3Linked to original sources
PubMed1992

Are race differences in the prevalence of hypertension explained by body mass and fat distribution? A survey in a biracial population.

Body mass and body fat distribution are important considerations in the study of hypertension. However, few studies have investigated the relationships with regards to race differences in elevated arterial pressure. A population-based sample of black and white adults was assessed by interview and physical measurement. The prevalence of hypertension (defined as 140/90 mmHg and/or medically treated) was disproportionately higher among blacks than whites. In addition, blacks had a higher prevalence of the more severe hypertension (160/95 mmHg) and hypertension with higher prevalence at earlier ages than whites. Black females had a significantly higher distribution of body mass index (BMI) than white females, while no difference was found in the distributions of males. White males had a higher distribution of waist to hip ratio (WHR) than black males, while black females had the higher values compared to white females. The prevalence of hypertension increased with BMI and WHR. Blacks maintained higher rates of hypertension after controlling for BMI and WHR, however, the margin of difference diminished when BMI and WHR was considered together. The black-white difference in hypertension was not completely explained by BMI and WHR. In addition, the strength of the association of hypertension and body size was different for blacks and whites which suggests possible differences in the mechanisms regulating blood pressure.

Adipose Tissue↗
PubMed1991

Breast cancer screening in a biracial community: the Charleston tricounty experience.

Breast cancer remains a major cause of death among women in South Carolina. Mammography, breast self-examination, and clinical breast examination are effective methods for early detection and subsequent mortality reduction. The Tricounty Breast Cancer Screening Survey assessed knowledge of these methods and recommendations among 503 women in the Charleston area. While 57% of all respondents reported performing breast self-examination at least once per month, 13% of blacks and 6% of whites reported that they do not know how to perform the procedure. Clinical breast examinations within the past year were reported by 69%, yet 11% of blacks and 4% of whites reported that they had never had the examination. More than one third (40%) of all 503 women reported ever having had a mammogram, and 22% reported having had one within the past year. However, 18% of the blacks and 5% of whites reported never having heard of the procedure. The major barriers to mammography appear to be the belief that women do not need regular mammograms and the lack of recommendations by their physicians. Survey results support the need for educating women about what the procedures are, the importance of using them regularly, and the means to comply with them.

Adult↗
PubMed1990

The need for accurate nutrition survey methodology: the South Carolina experience.

Assessment of two nutrition-related risk factors, obesity and fat intake, was completed on a representative sample of South Carolina adults. Obesity estimates determined from self-reported heights and weights were less than prevalences determined from direct measurements (white males 21.4% vs. 28.2%; white females 20.8% vs. 24.5%; black males 29.2% vs. 30.1%; black females 43.6% vs. 50.6%; and total 24.9 vs. 29.8%). Nine fat-intake habits were identified from dietary mannerisms involving the consumption of red meat, fat on meat, fried fish/chicken, butter, eggs, whole milk, bacon/sausage, and cheese and the use of solid fats when cooking vegetables. The mean number of the nine habits exhibited was four. The total number of habits did not correlate well with serum cholesterol, as 27% of the individuals with none of the nine fat intake habits had blood cholesterol values greater than 6.2 mmol/L (239 mg/100 mL), while only 17% of the individuals with seven habits had the high level of cholesterol. These nine habits explained less than 10% of the variability of serum cholesterol values.

Black People↗
PubMed1989

Changing patterns of acute myocardial infarction: decline in period prevalence and delay in onset.

The rural Pee Dee area of South Carolina has had the highest mortality rate in the nation for coronary heart disease. Community surveillance shows a 22.7% (p = 0.0008) decline in fatal and nonfatal acute myocardial infarction (AMI) rates during the period 1978 to 1985 in the Pee Dee area. Rates for white men decreased 32% (p = 0.001), whereas in other race-sex groups changes were not significant, although there was a downward trend (p = 0.18) among black men. Among white men decreases in the AMI rates occurred in each of the decades of age 35 to 64 years. In all race-sex groups there was a sharp increase in rates between 1978 and 1985 for those 65 to 74 years of age, suggesting that the incidence of AMI was delayed to a later age. Out-of-hospital AMI death rates declined markedly in all race-sex groups: 63% for white men, 62% for white women, 49% for black men, and 39% for black women. Overall case fatality rates declined from 14% (27 of 193) to 10% (23 of 232), but the decrease was not statistically significant.

Adult↗
PubMed1989

Trends in public knowledge and attitudes about AIDS, South Carolina, 1987-1988.

The South Carolina Department of Health and Environmental Control AIDS Program assessed the state population's knowledge and attitudes about AIDS and HIV transmission in 1987 and 1988. Each year approximately 1,800 adults were selected by a random 3-stage cluster design and asked seventeen questions by telephone about AIDS and HIV. Questions addressed attitudes, general knowledge, HIV transmission by casual contact, HIV transmission by sex and IV drug contact, and HIV transmission by blood donation and transfusion. Over 90 percent of respondents were knowledgeable about HIV transmission by high risk behaviors addressed in the questionnaire. Respondents were less knowledgeable about HIV transmission by casual contact (12 to 41 percent gave incorrect answers), HIV testing (45 to 48 percent gave incorrect answers), and transmission by blood donation (43 to 52 percent gave incorrect answers). In general, a higher percentage of correct responses were given in 1988 than in 1987. In regard to responses measured by this survey, we conclude that: (1) there is a high level of knowledge in the state about transmission by high risk behaviors, (2) there are still many misconceptions about casual transmission, HIV testing, and blood donation, and (3) there was improvement in knowledge about AIDS and HIV from 1987 to 1988.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Acute myocardial infarction: period prevalence, case fatality, and comparison of black and white cases in urban and rural areas of South Carolina.

Community surveillance revealed 1085 prevalent cases of acute myocardial infarction (AMI) during 1978 in urban metropolitan Columbia and rural Pee Dee areas of South Carolina. Six hundred fifty-eight hospitalized cases met our criteria and were classified as definite or probable. Death certificates identified 427 who died before admission to the hospital and who were classified as unvalidated. However, there is need to verify death certificate diagnosis in out-of-hospital deaths which account for approximately two thirds of total cases in blacks and about one third of white cases. Other findings were: White males had higher AMI rates in the rural Pee Dee area than in urban Columbia, while black males and black females had higher rates in Columbia than in the Pee Dee area and white females had similar rates in both areas. Rates for out-of-hospital AMI mortality were higher in blacks than in whites. Out-of-hospital AMI mortality rates in Columbia and the Pee Dee area were four times higher than in Minneapolis-St. Paul in 1978. For definite and all criteria AMI, white males had the highest rates, double the black male rate except for all criteria AMI in Columbia, where white male and black male rates were similar. Urban cases of both races experienced more anterior infarctions than rural cases.

Adult↗
PubMed1985

Sodium in drinking water in South Carolina.

The potential contribution of drinking water sodium to total consumption and to blood pressure levels is explored in a South Carolina survey. Most (96 per cent) of the population was served by drinking water containing less than 100 mg/l Na (median 14.8 mg/l). For households with water sources containing greater than or equal to 100 mg/l Na, drinking water accounted for approximately 8.5 per cent of total estimated consumption. After adjustment for age, sex, race, body mass index, education, and dietary sodium, a negative association between diastolic blood pressure and drinking water sodium levels was found.

Adolescent↗
PubMed1981

Increased fatality and difficult diagnosis of in-hospital acute myocardial infarction: comparison to lower mortality and more easily recognized pre-hospital infarction.

We studied 510 patients in the Columbia, South Carolina metropolitan area with documented acute myocardial infarction (AMI) in 1978 to investigate differences in clinical characteristics and outcome between patients who experienced AMI while inside the hospital (IN-AMI) and those who experienced AMI outside the hospital environment (EX-AMI). Mortality for IN-AMI patients (66%) was significantly higher (p less than 0.0001) than for EX-AMI patients (22%), and remained higher (p less than 0.05) even after exclusion of high-risk IN-AMI patients (surgical patients, those with serious underlying noncardiac illness, and those with underlying cardiac illness as the reason for hospital admission). Medical IN-AMI patients experienced fewer typical forms of AMI symptoms (p less than 0.05) and did not reach an intensive care unit significantly sooner than did EX-AMI patients. Time from onset of AMI symptoms to death was not significantly different between IN-AMI and EX-AMI groups (p = 0.22). Therefore AMI occurring during hospitalization was associated with poor early prognosis even after exclusion of high-risk patients. These results emphasize the need for improved approaches to prevention, identification, and management of AMI patients.

Acute Disease↗
PubMedDate not supplied

Health care improvement and cost reduction opportunities in hypertensive Medicaid beneficiaries.

Hypertension and its complications are more frequent and occur about a decade earlier in life among high-risk groups, especially in the Southeast. Moreover, socioeconomic status is inversely related to hypertension and cardiovascular complications. Low-income, young and middle-aged adults living in the Southeast may be at especially high risk. Data on inpatient admissions among hypertensive Medicaid beneficiaries living in this region may provide insights on the burden of hypertension-related disease and on opportunities for successful intervention. A study of hospitalization rates and costs among 44,440 hypertensive Medicaid beneficiaries in South Carolina from 1993-1996 showed that 16,883 (38%) were continuously enrolled in Medicaid. Of this group, 63% were African American and 74% were women. Among the continuously enrolled patients, 7637, or about 45%, were hospitalized during the 4-year period. These 7637 individuals accounted for 20,698 hospital admissions, i.e., 2.7 admissions per person, over the 4-year interval. Nearly two thirds of the hospitalizations included a cardiovascular or renal diagnosis. Hospital claims paid reached nearly $90 million for the 7637 hypertensive Medicaid recipients during the 4-year period. Among patients discharged from the hospital with congestive heart failure, 33% filled a prescription for an angiotensin-converting enzyme inhibitor within 90 days; 13% of patients discharged with an acute myocardial infarction filled a prescription for a beta blocker within 90 days. The data confirm that hypertensive Medicaid beneficiaries in the Southeast are hospitalized at high rates. Cardiovascular and renal morbidity account for the majority of the inpatient admissions. The findings suggest that the application of evidence-based guidelines would improve health, avoid cost, and reduce racial disparities in health outcomes.

Cardiovascular Diseases↗
PubMedDate not supplied

Low birth weight contributes to the excess prevalence of end-stage renal disease in African Americans.

The risk of hypertension and related target organ damage is much greater in African Americans than in Caucasians. The risk of hypertensive end-stage renal disease is approximately five-fold higher in African Americans. Many studies have shown that low birth weight is strongly associated with increased risk of hypertension, stroke, and myocardial infarction. However, until recently the relationship between birth weight and hypertension-related diseases was not clearly established in African Americans. Moreover, it was also unclear if low birth weight in humans heightened the risk for end-stage renal disease. This is a critical gap in the literature, since low birth weight occurs at twice the rate in African Americans as among Caucasians. We identified a significant relationship between end-stage renal disease and low birth weight in both African Americans and Caucasians. Given the higher rates of low birth weight in African Americans, differences in fetal development may, therefore, contribute to the racial disparity in end-stage renal disease. Continued study of the biological factors linking early development with later risk of hypertension-related diseases is important and may shed light on racial disparities in health outcomes. (c)2001 by Le Jacq Communications, Inc.

Adult↗
PubMedDate not supplied

Low birth weight as a risk factor for hypertension.

While the geographic and demographic disparities in the prevalence of hypertension have been recognized for decades, the reasons for these differences in disease risks remain unknown. The demographic and geographic patterns of hypertension are similar to those of low birth weight, giving support to the "Barker Hypothesis" which proposes a fetal origin of adult-onset disease. In fact, ecologic and observational studies throughout the world have detected significant associations of low birth weight and increased risks of hypertension. Nonetheless, the mechanisms for the association have not been fully described and documented. With some supportive evidence, proposed mechanisms include reduced nephrogenesis with a higher threshold for pressure natriuresis and greater susceptibility to progressive renal disease, impaired development of the endothelium, and increased sensitivity to glucocorticoids. Still, considerable work needs to be done to explain the birth weight/blood pressure relationship. The findings to date and the clinical significance warrant continued research in this intriguing area of study.

Animals↗