PubMed Health⌕ Search

Biomedical subjects

H T Pedoe

Publications and source records attributed to H T Pedoe.

12 recordsLinked to original sources

Ayrshire and Arran coronary prevention programme--baseline risk factor survey.

Scotland has very high mortality rates for coronary heart disease in both men and women. The Ayrshire and Arran health Board Area is co-terminus with four local government districts which all have male coronary mortality rates above the Scottish average. A survey of lifestyle and coronary risk factors was conducted in these four districts in preparation for the launch of a Prevention Programme's 'Healthy Heart Campaign'. This survey will be used as a baseline for evaluation of lifestyle modification and risk factor change over the next 5-10 years. The information provided by the survey is valuable to the direction and targeting of the Prevention Programme. The methods developed in this survey could be used for evaluation of other coronary prevention programmes. Similar data has been collected from another 20 districts as part of the Scottish Heart Health Study and has been distributed to all the Scottish mainland health boards.

Adult↗

International differences in coronary heart disease mortality and consumption of fish and other foodstuffs.

The relationship between fish consumption and coronary heart disease mortality was investigated using data on foodstuff consumption and mortality from 21 countries. A moderate negative association was found which appeared stable over different periods. This association disappeared when the effects of other foodstuffs were controlled for in multiple regression analysis. One feature to emerge was the anomalous position of Japan in consumption of several foodstuffs. Inclusive or exclusion of this country from regression analysis had a powerful effect on which independent variables entered the model. This illustrates the danger of using single countries, for example Japan with a high fish consumption and low CHD mortality, to support causal hypotheses about diet and disease.

Animals↗

Audit of an inner city coronary unit.

The performance of the St Mary's Hospital London W2 coronary care unit was studied in each of 2 years, 1969 and 1975, results of which could be compared with each other and with national figures from the annual reports of the Hospital In-patient Enquiry. In 1975 the admissions were 42% more than in 1969; the increase was confined to mild cases over 45 years of age, and was out of proportion to national trends. The hospital fatality rate was unchanged and when age-standardized was 69% and 78% of contemporaneous national rates. In both years, 50% of the patients admitted came from outside the health district and 10% of local admissions were visitors from abroad. In 1975 there was an increased proportion of ex-smokers among the patients and more gave a history of previous myocardial infarction. The value and limitations of this kind of surveillance of a clinical unit are argued.

Adult↗

Heart disease prevention project: a randomised controlled trial in industry.

Twenty-four factories or other occupational groups, employing 18 210 men aged 40 to 59, were formed into matched pairs. One of each pair was allocated randomly to receive a five to six year programme of medical examinations and intervention to reduce the levels of the main coronary risk factors. Men at factories in the intervention group were given advice on dietary reduction of plasma cholesterol concentrations, stopping or reducing cigarette smoking, regular exercies for the sedentary and reduced energy intake for the overweight, and hypertension was treated. The programme was delivered mainly through existing occupational medical services, helped by a small central staff. Personal consultations were largely confined to men with a high risk of developing coronary heart disease. Changes in risk factors were assessed by regular standardised examinations of random samples of men. The spread of information by general propaganda proved easy, but a change in habits seemed to require personal contact. Small but significant reductions occurred, mainly in the high-risk group, but these were not sustained when pressure was relaxed.

Adult↗

Uses of coronary heart attack registers.

By studying all coronary heart attacks presenting within defined communities it should be possible to avoid the distortions and omissions inherent in hospital-based case series. In practice the technique presents several problems. Measures of frequency and outcome are very sensitive to the diagnostic criteria used. Data of varying quality are mixed and specific attack rates can be calculated only for items for which the census provides a denominator. Patients presenting to different medical services have different outcomes, but probably less because of treatment than because the severity of the attack affects behaviour in it. Despite these problems, some such intelligence system is of value in any comprehensive strategy for coronary heart disease.

Adult↗

Coronary heart-attacks in East London.

All cases of cardiac infarction, acute coronary insufficiency and sudden death occurring in residents of the London Borough of Tower Hamlets below age 65 were registered over nearly three years, and survivors were followed up for one year. The attack-rate in men aged 45-64 years was 1 per 100 per annum but the recurrence-rate in survivors was 1 per 100 per month. Immigrants from Asia had more than the average, and those from the Carribean one tenth of the average attack-rate. Although it was unusual for general practitioners to manage cases at home by choice, nonetheless two-thirds of the deaths happened outside hospital and half of these were not witnessed. Half of those suffering coronary heart-attacks had a previous history of coronary disease and a sizable minority were already unfit for work. Approximately half of those attacked were alive at one year.

Acute Disease↗