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Biomedical subjects

G Beevers

Publications and source records attributed to G Beevers.

34 records · Page 2Linked to original sources
PubMed1995

Dietary fat purchasing habits in whites, blacks and Asian peoples in England--implications for heart disease prevention.

The mortality and morbidity from coronary heart disease (CHD) is higher in people of South Asian origin than in whites, but is significantly lower in the black (Afro-Caribbean origin) community in the United Kingdom. To investigate whether this may be related to differences in fatty food intake, we performed a questionnaire survey of the weekly food purchasing habits and preparation methods in white, black (Caribbean) and Asian households in Birmingham. We interviewed 224 housewives from three ethnic groups (84 white, 76 black/Afro-Caribbean and 72 Asian). The highest quantity of fat in foods purchased per week was found in the Asian population (median 1409 g/week per person, interquartile range (IQR) 850-1952), which was significantly greater than black subjects, who had the lowest quantity of fat in foods purchased (1012 g/week per person, IQR 835-1388) (Mann-Whitney test:median differences 300.5, 95% C.I. 23.3-600.4, P = 0.029). The median quantity of fat in foods purchased by the white households was intermediate, at 1186 g/week per person (IQR 861-1711). There was a higher quantity of fat in foods purchased in the lower social classes (IV and V) in both the white and Asian populations. Butter, egg and milk consumption was significantly greater in Asians; with ghee consumption almost exclusive amongst this group (98%). Amongst whites and blacks, the commonest food preparation methods were grilling, boiling or poaching; whilst amongst Asians, frying was more common (chi 2 = 81.25, d.f. = 4, P < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Hormone replacement therapy and cardiovascular risk: the cardiovascular physicians' viewpoint.

Sufficient evidence has accumulated showing that hormone replacement therapy (HRT) does protect against cardiovascular disease in women, although data regarding the true magnitude of that protection remains incomplete. There is no evidence that HRT increases the risk of hypertension or thromboembolism, and beneficial effects have been found for plasma lipids, clotting factors and cardiovascular haemodynamics. However, the evidence is not convincing of any beneficial effect of HRT in preventing strokes, and concerns about the risk of cancer with HRT remain. Despite this, considerable uncertainty continues to exist amongst clinicians as to the balance of beneficial and harmful effects from administering HRT. Overall, HRT seems to do no harm and may be protective. A much greater awareness of the long-term consequences of the menopause and the potential benefits of HRT should be encouraged so that women (and their doctors) can make informed decisions about their requirements.

Adult↗
PubMed1995

Body fat and stroke: unmasking the hazards of overweight and obesity.

STUDY OBJECTIVE: It has been frequently noted that overweight and obesity have a stronger relationship to hypertension and diabetes mellitus than to the risk of stroke. The reason for this observation has not been clear. This study aimed to examine the lifelong relation between body fat and stroke to shed light on why the public health risks of overweight and obesity have tended to be obscured in previous epidemiological studies. DESIGN: Case-control study. SETTING: Eleven general practices in west Birmingham. PARTICIPANTS: Altogether 125 men and women who had just had their first stroke and were aged 35-74 years and 198 controls frequency matched for age and sex were recruited over 24 months during 1988-90. MAIN RESULTS: Those in both the thinnest and fattest quartiles of subscapular skinfold thickness were at increased risk of stroke compared with those in the middle quartiles (age adjusted odds ratios 2.12 (95% confidence interval (CI) 1.2, 3.9) and 2.08 (1.1, 3.8) respectively). When lifelong maximum reported body mass index was assessed the hazards of obesity but not leanness were seen (odds ratio for the highest versus the lowest quartile were--age adjusted, 1.54 (0.8, 3.0) and multiple risk factor adjusted, 2.25 (1.1, 4.5). This lifelong pattern of risk seemed to be established early, the odds ratios for the highest versus the lowest quartile of reported body mass index aged 21 years were--age adjusted, 2.18 (1.1, 4.4) and multiple risk factor adjusted 2.13 (1.1, 4.2). The risks of both maximum reported body mass index and reported body mass index aged 21 years were more clear in those who had never smoked cigarettes (test for trend in odds ratio, p = 0.009 and p = 0.02 respectively). CONCLUSIONS: Potentially important risks of excessive body fat for stroke can be obscured by both a history of cigarette smoking and thinness associated with deteriorating health. The results seem to explain why excess body fat has previously been consistently related to hypertension and diabetes mellitus but less consistently to stroke. Avoiding overweight and obesity during adult life offers protection against stroke.

Adult↗
PubMed1995

Risk factors for ischaemic heart disease and stroke mortality in young and old hypertensive patients.

We investigated the predictors of cardiovascular mortality at different ages in a longitudinal study of 10186 hypertensive patients attending clinics in the UK. There were 7374 patients (51% were men) < 60 years of age and 2799 patients (44% men) were > or = 60 years. For IHD death the age-adjusted relative risks (RRs) and 95% confidence intervals (CI) for a 1 mmol/l increase in cholesterol were RR = 1.17 (1.07, 1.27) (men) and RR = 1.22 (1.12, 1.33) (women). The RRs for stroke were 0.99 (men) and 1.07 (women). In men and younger women, urea and smoking were important predictors of IHD and stroke death. Age differences were present in women for both urea and smoking. For IHD in women, smoking: RR = 2.65 (1.80, 3.89) (< 60 years) and RR = 1.38 (1.01, 1.88) (> or = 60 years). For stroke in women, smoking: RR = 2.03 (1.23, 3.35) (< 60 years) and RR = 1.06 (0.70, 1.61) (> or = 60 years). We conclude that urea and smoking are important risk factors for stroke and IHD death in hypertensive women aged < 60 years, but are less important in those aged over 60 years. Cholesterol predicted IHD death in all men and women, but did not predict stroke death.

Adult↗
PubMed1994

The failure of malignant hypertension to decline: a survey of 24 years' experience in a multiracial population in England.

INTRODUCTION: The widespread use of antihypertensive medication and the increasing frequency of diagnosis of mild-to-moderate hypertension should mean that malignant-phase hypertension should be becoming less common, and this trend has been reported elsewhere. No decline in the incidence of malignant hypertension has been apparent in our practice in a district general hospital in a city centre. OBJECTIVE AND METHODS: To investigate the incidence and mode of clinical presentation of patients presenting with malignant hypertension, we performed a retrospective survey of the number of patients presenting with malignant hypertension to our hospital, over the 24-year period from 1970 to 1993. We identified a total of 242 patients (155 male, 87 female; mean +/- SD age 50.1 +/- 13.3 years) with malignant hypertension. RESULTS: There were no significant differences in the number of patients presenting each year, the mean age or the presenting systolic and diastolic blood pressures over the period surveyed. At presentation, 131 patients (54.1%) had no previous history of hypertension; 161 (66.5%) were receiving no antihypertensive therapy and only 70 (28.9%) were receiving antihypertensive treatment (with no record of therapy in 11 patients). The most common presenting symptoms included visual disturbance in 62 (25.6%), headaches in 29 (12.0%), headaches and visual disturbance in 24 (9.9%), heart failure in 19 (7.9%), stroke or transient ischaemic attack in 17 (7.0%) and dyspnoea in 13 (5.4%), although 23 patients (9.5%) were asymptomatic. The most common presenting complications were heart failure [27 patients (11.1%)], stroke [23 patients (9.5%)], angina [10 patients (4.1%)], myocardial infarction [nine patients (3.7%)] and chronic renal failure [77 patients (31.7%)]. In the whole group the majority (147 patients, 60.5%) had no complicating clinical features. Primary or essential hypertension was the most common underlying cause in 137 patients (56.4%). Secondary causes of hypertension (mainly renal disease) were identified in 97 patients (39.9%). CONCLUSION: Our experience suggests that malignant hypertension is still common, with a small proportion of hypertensives presenting each year. In particular, the incidence has failed to decline in Birmingham. The incidence rate in the population served by our hospital is approximately 1-2 cases per 100,000 per year. An awareness of the different presenting clinical features is required to allow better recognition and management of this life-threatening condition.

Aged↗
PubMed1993

Management guidelines in essential hypertension: report of the second working party of the British Hypertension Society.

Several important new issues have arisen in the management of patients with hypertension. A working party of the British Hypertension Society has therefore reviewed available intervention studies on anti-hypertensive treatment and made recommendations on blood pressure thresholds for intervention, on non-pharmacological and pharmacological treatments, and on treatment goals. This report also provides guidelines on blood pressure measurement, essential investigations, referrals for specialist advice, follow up, and stopping treatment.

Aged↗
PubMed1993

The relation of alcohol consumption to cardiovascular risk factors and stroke. The west Birmingham stroke project.

The disputed relation between recent alcohol consumption and stroke was examined in a community case control study. One hundred and twenty five incident first time stroke patients and 198 controls, aged 35 to 74 years, were recruited over two years from a general practice population. The age and sex adjusted relative risks for stroke by recent weekly "drinks" of alcohol were; 0-1.0 (reference), 1 to 14-0.57, 15 to 29-0.63, and > 29-0.99. Among the controls it was noted that non-drinkers were more likely than light/moderate drinkers (1 to 29 drinks per week) to have the following characteristics; history of obesity (p < 0.001), not a recent walker (p < 0.05), and no vigorous exercise in early adulthood (p < 0.01). The apparent association of light and moderate alcohol consumption with decreased stroke risk disappeared when these variables were included in the multiple risk factor adjusted analysis; 0-1.0, 1 to 14-0.88, 15 to 29-1.11, and > 29-1.23. The pattern for proved cerebral infarction (n = 81) was similar. The results of this study do not support the idea that recent heavy alcohol consumption is an important cause of either overall stroke or cerebral infarction. The association of non-drinking with a history of overweight and inactivity may explain the apparent protective effect of lighter alcohol consumption on the risks of both stroke and coronary heart disease.

Adult↗
PubMed1990

Is serum gamma-glutamyl transferase a good marker of alcohol intake in stroke patients?

Serial serum gamma-glutamyl transferase (GGT) levels were estimated in 23 consecutive patients admitted to hospital with a diagnosis of acute stroke. The proportion of patients with elevated GGT levels in the initial, 36-hour and 72-hour samples was 13%, 30% and 24% respectively, suggesting a transient rise following a stroke. Patients with a history of diabetes mellitus had an initial serum GGT level 21 IU/l (95% confidence interval 6 to 37) higher than non-diabetics. We conclude that GGT levels after a stroke may reflect a history of diabetes and cerebral damage as well as the usual more established causes. Physicians, therefore, should be wary of attributing all unexplained high GGT levels in stroke patients to alcohol.

Acute Disease↗
PubMed1989

Meta-analysis of relation between cigarette smoking and stroke.

There is a lack of consensus among studies on the possible risks of stroke from cigarette smoking; because of this a meta-analysis was conducted. All published data on the association were sought and the relative risk for each study obtained whenever possible. The pooled relative risks were calculated by using estimates of the precision of the individual relative risks to weight their contribution to the meta-analysis. Thirty two separate studies were analysed. The overall relative risk of stroke associated with cigarette smoking was 1.5 (95% confidence interval 1.4 to 1.6). Considerable differences were seen in relative risks among the subtypes: cerebral infarction 1.9, cerebral haemorrhage 0.7, and subarachnoid haemorrhage 2.9. An effect of age on the relative risk was also noted; less than 55 years 2.9, 55-74 years 1.8, and greater than or equal to 75 years 1.1. A dose response between the number of cigarettes smoked and relative risk was noted, and there was a small increased risk in women compared with men. Ex-smokers under the age of 75 seemed to retain an appreciably increased risk of stroke (1.5); for all ages the relative risk in ex-smokers was 1.2. The meta-analysis provides strong evidence of an excess risk of stroke among cigarette smokers. Stroke should therefore be added to the list of diseases related to smoking.

Age Factors↗
PubMed1984

The Quantab strip in the measurement of urinary chloride and sodium concentrations.

The "Quantab" strip (Ames) measures chloride in fluids. For sodium chloride solutions and urine we found very good correlations between the Quantab reading and the chloride concentration as measured by chemical assay (r = 0.95 for chloride and r = 0.85 for sodium in urine). The strip gave reproducible results over the temperature range 4 to 37 degrees C. There was very little inter- and intra-observer variation in reading the strip. Although 10 to 23 min is required to complete the reaction, the strip reading is stable thereafter. We suggest that the strip could be useful in epidemiological studies of urinary sodium concentration and clinically in helping patients adhere to a low-salt diet.

Chlorides↗