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Biomedical subjects

J L Pinsky

Publications and source records attributed to J L Pinsky.

11 recordsLinked to original sources
PubMed1999

Retinal arteriolar diameters and elevated blood pressure: the Atherosclerosis Risk in Communities Study.

Narrowing and other changes in retinal arterioles may reflect damage due to hypertension, which may predict stroke and other cardiovascular diseases independently of blood pressure level. Newly developed quantitative methods of assessing retinal narrowing are used to determine whether this sign is related only to current blood pressure or whether it also independently reflects the effects of previous blood pressure. Retinal photography was performed at the third examination of Atherosclerosis Risk in Communities (ARIC) Study in 1993-1995, and results are presented for the 9,300 nondiabetic participants aged 50-71 years. Generalized narrowing of smaller arterioles was strongly and monotonically related to current blood pressure in men and women, whether they were taking antihypertensive medications or not, and, independent of current blood pressure, was consistently and monotonically related to blood pressure levels measured 3 and 6 years before the retinal assessment. Arteriovenous nicking was also independently related to both current and previous blood pressures. The patterns of association suggested that these signs reflect both transient and persisting structural effects of elevated blood pressure, in agreement with the scant pathologic literature available. The findings suggest that retinal assessment may be useful for research on the microvascular contributions to clinical cardiovascular diseases.

Aged↗
PubMed1997

Pulmonary function testing in population-based studies.

A wealth of information on pulmonary function is currently available in NHLBI-sponsored, population-based studies. These data can be used to address critically important questions in pulmonary and cardiovascular disease research, but their potential cannot be realized without the active collaboration of pulmonary- and cardiovascular-disease researchers. Investigators interested in analyzing these data in collaboration with the parent study investigators are invited to contact these investigators directly (see APPENDIX). Results of analyses recommended in the workshop should be used to identify hypotheses for future efforts in collecting data on the epidemiology of pulmonary diseases and their relationship to cardiovascular disease.

Adolescent↗
PubMed1993

The epidemiology of heart failure: the Framingham Study.

Congestive heart failure has become an increasingly frequent reason for hospital admission during the last 2 decades and clearly represents a major health problem. Data from the Framingham Heart Study indicate that the incidence of congestive heart failure increases with age and is higher in men than in women. Hypertension and coronary heart disease are the two most common conditions predating its onset. Diabetes mellitus and electrocardiographic left ventricular hypertrophy are also associated with an increased risk of heart failure. During the 1980s, the annual age-adjusted incidence of congestive heart failure among persons aged > or = 45 years was 7.2 cases/1,000 in men and 4.7 cases/1,000 in women, whereas the age-adjusted prevalence of overt heart failure was 24/1,000 in men and 25/1,000 in women. Despite improved treatments for ischemic heart disease and hypertension, the age-adjusted incidence of heart failure has declined by only 11%/calendar decade in men and by 17%/calendar decade in women during a 40-year period of observation. In addition, congestive heart failure remains highly lethal, with a median survival time of 1.7 years in men and 3.2 years in women and a 5-year survival rate of 25% in men and 38% in women.

Adult↗
PubMed1990

The Framingham Disability Study: relationship of various coronary heart disease manifestations to disability in older persons living in the community.

The relation between coronary heart disease and disability was examined in 2,576 community-dwelling women and men ages 55-88 years. These Framingham Study participants were originally recruited in 1948-51 for an examination of cardiovascular disease. Twenty-seven years later, remaining members of the cohort were interviewed to ascertain physical abilities, and a score on a disability scale was assigned. Multivariate logistic analyses examined disability in relation to uncomplicated angina pectoris (AP), complicated AP, and coronary heart disease other than AP, controlling for possible confounders. In younger and older women and men, uncomplicated and complicated AP were associated with disability. Coronary heart disease other than AP was associated with disability only in the younger men. Congestive heart failure predicted disability only in the women. These results suggest that onset of AP should be recognized as a critical point in the development of disability and that AP is a better predictor of disability than is myocardial infarction or coronary insufficiency.

Aged↗
PubMed1988

The Framingham Disability Study: physical disability among community-dwelling survivors of stroke.

The relationship between stroke and physical disability was examined in a cohort of adult, Framingham, Massachusetts, residents who, between 1948 and 1951, were assembled for a longitudinal examination of cardiovascular disease. Multivariate analyses examined the amount of residual disability attributable to stroke among 2540 community-dwelling survivors, 27 years after their initial examination, after controlling for age, cardiovascular risk factors, other cardiovascular diseases, and eight general health conditions related to physical disability. Among men living in the community, a history of stroke explained 12% of the variance in physical disability. Suffering a stroke, however, was not as strongly related to physical disability among women living in the community, accounting for only 3% of the variance. Results suggest that although older men and women die from the same major causes, they may not be disabled by the same conditions.

Activities of Daily Living↗
PubMed1987

Predictors of good function: the Framingham Study.

This paper asks the question: among 1474 Framingham Study participants aged 35-68 years who were healthy at their fourth examination (1954-1958), what are the physiologic, behavioral, and demographic characteristics that distinguish those who survive and report good function from those who do not after 21 years of biennial observations? Although a larger proportion of women than men survived, their functional status was not as good. Multiple logistic regression analysis revealed that age, alcohol intake, cigarette smoking, ventricular rate, and education were all significantly related to functional status for men, with all but the last of these factors inversely related to good function. For women, the only significant predictor other than age was education, which, as with men, was directly associated with good function. The effect of education is probably mediated by numerous factors such as availability and use of health care services, quality of health care, occupation, and lifestyle.

Adult↗
PubMed1986

Nutrition education at the point of purchase: the foods for health project evaluated.

Foods for Health, a nutrition education and research program sponsored by the National Heart, Lung, and Blood Institute and Giant Food, Inc., was designed to demonstrate the feasibility of cardiovascular nutrition education at the point of purchase, specifically, in the supermarket. To evaluate the program's effectiveness, measures of consumer awareness, knowledge, and food purchases were determined before, during, and after the campaign. The program was conducted in the Washington, D.C., area, with Baltimore, Maryland, area stores serving as controls. At the conclusion of the campaign, Washington shoppers showed a significant increase in knowledge scores, while these scores decreased in the Baltimore area. The gain in correct knowledge scores for Washington shoppers compared with Baltimore shoppers was 9% for food fat and cholesterol content and 11% for the relationship between dietary fat and blood cholesterols levels. The food sales data indicate no apparent differences attributable to the intervention. Issues that might account for the lack of a significant change in food purchases, such as cost and the markets' individual sales promotion campaigns, are discussed, and recommendations for the design of future projects are made.

Community Participation↗
PubMed1985

Framingham Disability Study: relationship of disability to cardiovascular risk factors among persons free of diagnosed cardiovascular disease.

The relationship between physical disability and cardiovascular risk factors among persons free of diagnosed cardiovascular disease was examined. Between 1948 and 1951, a cohort of adult, Framingham, Massachusetts, residents was assembled for a longitudinal examination of cardiovascular disease. Twenty-seven years after the participants' initial examination (between 1976 and 1978), members of the cohort who were still participating in the Framingham Heart Study were interviewed to ascertain their self-assessed ability to perform various physical activities. A score on the cumulative disability index was assigned to 2,021 persons free of diagnosed cardiovascular disease. Analyses controlled for noncardiovascular health conditions which were identified as related to disability. Among women, both long-term and current hypertension and body mass index, as well as diabetes, were associated with disability. Among men, long-term hypertension was related to disability. Age-specific analyses indicated that, for women, current hypertension was statistically significantly related to disability in the middle and oldest age groups; long-term hypertension was related to disability in the middle age group. Both long-term and current measures of diabetes in the oldest age group and long-term measure of cigarette use in the middle age group of women were also related to disability. Age-specific analyses among men indicated that the only statistically significant risk factor was long-term hypertension in the youngest age group. Cholesterol was not related to disability. Results suggest that certain cardiovascular risk factors should be considered in efforts to understand further the development of disability.

Age Factors↗
PubMed1980

Influence of ecologic events on cafeteria food selections: understanding food habits.

Our data confirm that, in terms of eating, people are creatures of habit. Most food selections in an employee cafeteria showed remarkable stability across time, appearing relatively immune to such naturalistic changes as seasons, outdoor temperature, and day of the week. A rew seasonal variations were observed, but these resulted largely from changes in food availability. A tendency for lower calorie food selection was observed during late spring and the summer months. This finding should caution researchers, when evaluating any public health intervention program designed to reduce caloric consumption which is conducted during the spring-summer time period. An inventory control cash register system provides a promising methodology for conducting public health field experiments on food selection. Daily information on food purchases allows food selections of large population groups to be intensively scrutinized. This methodology can be readily applied to improve our understanding of the process of food selection in public and to evaluate ways of promoting healthy eating habits.

Animals↗
PubMed1980

A new direction for public health care: changing cafeteria eating habits.

A "Food for Thought" game, an eight-week, media-based nutrition program designed to influence food choices in a cafeteria setting, was conducted in a National Institutes of Health employee cafeteria. Its purpose was to encourage customers to select lower-caloric food during lunch. The effects of the program on food choices and total calories of food purchased each day were measured by time series analyses. During the eight-week intervention period, skim milk purchases increased, and dessert and bread sales, as well as average number of calories purchased per day per person, declined significantly. Some evidence for a maintenance effect over a ten-week follow-up period was obtained. The "Food for Thought" game delivered nutrition education in an upbeat but unobtrusive way. Although people patronize cafeterias to eat, socialize, and relax and not to be educated, this program had only minimal requirements for participation. The result was a high level of interest and involvement. People can "learn while they eat," if careful attention is paid to customer needs and principles of effective communication.

Diet↗