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E Greiser

Publications and source records attributed to E Greiser.

At least 37 records · Page 2Linked to original sources

Variation in coronary risk factor levels of men and women between the German-speaking MONICA centres.

The aim of this analysis was to compare levels of risk factors for coronary heart disease (CHD) in men and women aged 25-64 years between German-speaking MONICA collaborating centres, the German Democratic Republic (GDR), Augsburg - the Federal Republic of Germany (FRG)(Au), Bremen - FRG (Br), Heidelberg - FRG (He), and Vaud/Fribourg - Switzerland (CH, with a German-speaking minority). Prevalence of cigarette smoking in men showed little variation in four centres (34 to 40%) and was higher in BR men (49%), while it varied from 17% (GDR) to 33% (BR) in women. Mean total serum cholesterol values (mmol/L) were highest in GDR and CH men (both 6.2) and GDR women (6.1), and lowest in both He men (5.7) and He women (5.6). The proportion with cholesterol values greater than or equal to 6.7 mmol/L was largest in CH men (34%) and smallest in FRG (He) women (17%), while lowering the cut-off point from 6.7 to 6.5 mmol/L raised the prevalence of hypercholesterolaemia in all centres by 5 to 10%. Mean values (mmHg) of blood pressure (BP) were highest in both GDR men (140/88) and women (138/86), as was the prevalence of hypertensive BP values. In all centres, women aged 25-34 had BP values approximately 12/5 mmHg lower than age-matched men, but BP values similar to men at age 55-64, which indicates that age-parallel increase in BP was steeper in women than men.(ABSTRACT TRUNCATED AT 250 WORDS)

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Social class and risk factors for coronary heart disease in the Federal Republic of Germany. Results of the baseline survey of the German Cardiovascular Prevention Study (GCP).

The relationship between social class and seven important risk factors for coronary heart disease has been evaluated utilising data from the German Cardiovascular Prevention Study baseline survey. Of German residents aged 25 to 69 years, 16,430 were randomly selected from both the six intervention regions and the Federal Republic of Germany to undergo the screening procedures between 1984 and 1986. Among males the prevalence of cigarette smoking and lack of physical activity was associated with social class. For females, overweight and physical activity demonstrated a strong social gradient. No relationship existed between social class and hypercholesterolaemia. The prevalence of Type A behaviour was significantly higher for the upper social classes. The number of CHD risk factors per study subject increased with decreasing social class. Predicted cardiovascular mortality was clearly higher for the lower social class among males in general and for females younger than 60 years. These findings point to the need for risk factor intervention strategies focusing more on the lower social classes in order to achieve more adequate prevention of coronary heart disease.

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Regular analgesic intake and the risk of end-stage renal failure.

The strength of the association between regular analgesic intake (RAI) and end-stage renal failure (EF) has been insufficiently established until now. A case-control study was conducted to estimate the relative risks (RR) of EF after RAI (defined as consumption of 15 or more analgesic doses per month for a continuous period of at least 1 year) for cumulative drug intake, single-ingredient analgesics, combinations, and specific compounds. The case group included all patients with EF undergoing renal replacement therapy in the area of West Berlin (1984-1986, n = 921). Control subjects, matched to cases by sex, age, and nationality, were selected from a group of patients in outpatient clinics. Matching was possible for 517 cases. The RR of EF after RAI of any analgesic was 2.44 (95% confidence interval: 1.77-3.39) and after RAI of combination drugs 2.65 (95% confidence interval 1.91-3.67). No significant increase was found, however, after RAI of single-ingredient analgesics. The RR after RAI of combination drugs and for the most preferred analgesic ingredients (phenacetin, paracetamol, acetylsalicylic acid, phenazones, caffeine) increased with dose. Furthermore, a dose-time-related RR after RAI of the longest used preparation was found. Thus, the results clearly show an increased RR of EF after RAI related to both dose and exposure time of mixed analgesic compounds, but not for the use of only single-ingredient analgesics.

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Primary prevention of coronary heart disease versus health promotion--a contradiction?

The German Cardiovascular Prevention Study is a multicentre community-based intervention study with the primary goal of reducing cardiovascular mortality by primary prevention measures. The intervention strategy comprises improving people's life styles as well as health promotion so as to modify cardiovascular risk factors (hypercholesterolemia, cigarette smoking, arterial hypertension, physical inactivity and over-weight). Design elements of the German Cardiovascular Prevention Study, now in its fifth year, were adopted from well known community intervention studies, including monitoring of mortality and morbidity, health examination surveys to assess distribution of cardiovascular risk factors, health attitudes and health behaviour in the community and use of formative and process evaluation to monitor the effects of intervention policies in the community. To identify risk factor profiles a cluster analysis was carried out from survey data. Four clusters were identified: a) people with none or few risk factors; b) those with high prevalence of smoking; c) those with high prevalence of hypercholesterolemia and hypertension; d) high risk factor exposure individuals. The clusters are different along social indicators like age, sex and social status. Process evaluation data show that special strategies like interventive blood pressure screenings reached a relatively high proportion of people from lower socioeconomic status. But they also indicate that there is a long way to go from publicity of intervention programs to lasting changes in behaviour.

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[Coding of cause of death for mortality statistics--a comparison with results of coding by various statistical offices of West Germany and West Berlin].

1.136 death certificates representing all 1985 Bremen cardiovascular deaths and a 50%-sample of non-cardiovascular deaths in the age group 25-69 years were analyzed for reliability of nosologists' coding according to ICD-coding rules (9th revision). The 1.136 photocopied death certificates were used to assess intra-observer-variation in Bremen and to determine inter-observer-variation among 7 nosologists from 6 different State Statistical Offices and the Federal Statistical Office. Intra-observer-agreement in Bremen was found to be similar to the results presented in a comparable US-study: Bremen: 92.1%; Curb et al. 1983: 94.8%-96.1%; 3-digit-ICD-Code. Inter-observer-agreement was found to be much lower in Germany than in two US-studies: 3 coders agreeing on 3-digit-ICD-Code: Bremen: 67.7% (average, 3 coders out of 7); Curb et al.: 90.2% (3 coders); 3 coders agreeing on 4-digit-ICD-Code: Bremen: 61.5%; NCHS 1980: 90.3%. Agreement-rates were also much lower in Germany than in the USA (Curb et al.) when particular disease groups were analysed: Ischaemic heart disease (ICD 410-414): Bremen: 82.7% (average); USA: 97.2%; cerebrovascular disease (ICD 430-438): Bremen 65.6% (average); USA: 93.2%; neoplasms (ICD 140-239): Bremen: 94.0% (average); USA: 97.8%. We conclude that training, individual characteristics of nosologists, and other factors may cause important artifacts when comparing German mortality statistics on a regional level or during different time intervals.

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Cardiovascular disease risk factors, CHD morbidity and mortality in the Federal Republic of Germany.

Analyses of data from the first National Health Examination Survey undertaken from 1984-1986 within the framework of the German Cardiovascular Prevention Study, show the following risk factor prevalences in 25-69 year-old men and women: overweight (BMI males: greater than 25, females greater than 24) or obese (BMI greater than 30): men 65.0%, women 57.6%; total serum cholesterol (less than 5.17 mmol/dl): men 73.7%, women 74.0%; normal blood pressure (according to JNC definitions): men 45.0%, women 59.1%; hypertension according to WHO criteria: men 26.0%, women 21.1%; controlled hypertensives (WHO criteria): men 19.9%, women 33.9%; current smoking: men 40.8%, women 26.1%. For most of the cardiovascular risk factors there is a clear negative association between prevalence and length of school education. Three myocardial infarction (MI) registries (WHO MONICA Project) are operating in the Federal Republic of Germany. Incidence and case-fatality data are within comparable ranges. Coronary heart disease (CHD) mortality has been relatively stable in both sexes from 1970 to 1986 with a minor peak in 1976 and a slight downward trend since then. A study of the reliability of coding procedures in West German state statistical offices revealed major disagreements so that trends derived from national mortality data as aggregate data of the federal states might be spurious. An ecological correlation of regional smoking prevalences (1978) and regional CHD mortality rates (1977-9) showed significant coefficients in men, but not in women.

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[Are females healthier than males? On the health status of females in West Germany].

Women live longer than men - are they healthier than men or do they live better than men? Morbidity data indicate that men and women differ regarding the types of illnesses they undergo. The life-expectancy for females is not the only indicator for a better or healthier life. Women feel more affected by health problems than man (indicators a.o.: complaints, handicaps to daily activities, use of medication). Objective morbidity data are insufficient but indicate significant disease occurrence in women (indicators a.o.: contacts with the physicians, self-reported history of diseases). Based on epidemiological studies the hypotheses of biological protective factors have not been proved or refuted. Women have a lower CVD-risk factor profile than men. Cluster analyses of the first Bremen health survey separated women into four groups related to health behaviour and risk status. The group with the highest risk factor prevalence had also the most social and family stress. For further research about women we have to work on epidemiological data as well as on qualitative and theoretical research on women and health.

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[Social class and risk factors for coronary heart disease--results of the Regional DHP(German Cardiovascular Prevention) Health Surveys].

Prior to the start of the intervention activities in the five study regions of the German Cardiovascular Prevention Study (GCP), health surveys of representative samples of the population (25 to 69 years) were carried out between 1984 and 1986. In all, 11,527 persons participated in the study. Important socio-structural differences existed between the five study regions. An ecological analysis relating social class characteristics to the prevalence of CHD-risk factors did not show any significant findings. However, a pooling of the data of the five study regions resulted in the demonstration, for both sexes, of a significant association of social class with cigarette smoking and overweight. Hypertension and hypercholesterolemia were not related to social class. The proportion of persons with three or more CHD-risk factors was clearly higher in lower social classes. These findings point to the need for risk factor intervention strategies focusing more on the lower social classes in order to achieve more adequate prevention of coronary heart disease.

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Cardiovascular risk factors in gross obesity.

In 500 obese patients (146 men, mean age 37 +/- 13 years, Broca index 147 +/- 24; 354 women, mean age 36 +/- 14 years, Broca index 151 +/- 28) cardiovascular risk factors (RF) were investigated. The most frequent RF was hypertension (71 per cent), followed by glucose intolerance (49 per cent), hypertriglyceridemia (31 per cent), hypercholesterolemia (22 per cent) and hyperuricemia (22 per cent). Only 12 per cent of the patients were without RF. These patients were younger and less obese than the patients with RF. The prevalence of RF increased with increasing age and overweight. Analysis revealed significant correlations between overweight and blood pressure, blood glucose, insulin and age. Significant correlations between age and hypertension, blood glucose cholesterol, triglycerides and overweight were detected. The correlation between overweight and the sum of all RF was higher (r = 0.35) than the one between age and the sum of all (r = 0.23). Obese patients had a high prevalence of RF. Increasing overweight and (to a lesser extent) age are both associated with increased prevalence of RF. On the basis of the prevalence of RF, patients with gross obesity (Broca index greater than around 150) were considered to be at a high risk in respect of coronary heart disease.

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Spontaneous tumors and common diseases in two colonies of Syrian hamsters. I. Incidence and sites.

Syrian hamsters from two colonies [Eppley colony (EC); Hannover colony (HC)] were examined for spontaneous neoplastic and noneoplastic diseases. Significant differences were found in tumor incidence (30%, EC' 42%, HC), occurrence of malignant neoplasms (15%, EC; 32%, HC), appearance of multiple primary tumors in different organs (42%, EC; 30%, HC), average survival rates of tumor-bearing animals, organ distribution and histologic types, and average survival rates of all animals. The frequencies of nonneoplastic diseases also varied between the two colonies. The findings indicated a need for precise histologic evaluation to generate information for comparative purposes regarding the use of hamsters in experimental pathology and carcinogenesis studies.

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