Biomedical subjects

Michael E Mussolino

Publications and source records attributed to Michael E Mussolino.

9 recordsLinked to original sources

PubMed2005

Bone mineral density and hypertension prevalence in postmenopausal women: results from the Third National Health and Nutrition Examination Survey.

PURPOSE: We sought to corroborate a reported association of hypertension with bone mineral density (BMD) in postmenopausal women. METHODS: Data are from a nationally representative sample of 2738 women aged 50 years and older from the Third National Health and Nutrition Examination Survey. Total proximal femoral bone mineral density was measured by using dual-energy x-ray absorptiometry. Hypertension is defined as blood pressure of 140/90 mm Hg or greater or recent blood pressure medication use. RESULTS: Compared with the fourth quartile of BMD, age- and race-adjusted relative odds of hypertension were decreased in the first quartile (odds ratio [OR], 0.50; 95% confidence interval [CI], 0.38-0.67; p < 0.01). However, the association was diminished and no longer significant after adjusting for body mass index (OR, 0.96; 95% CI, 0.69-1.36; p = 0.83) and additional risk factors in multivariate models (OR, 0.92; 95% CI, 0.65-1.30; p = 0.62). CONCLUSIONS: No association between hypertension and BMD was observed after controlling for body mass index and other confounders.

Absorptiometry, Photon↗

PubMed2005

Counts of neutrophils, lymphocytes, and monocytes, cause-specific mortality and coronary heart disease: the NHANES-I epidemiologic follow-up study.

PURPOSE: To examine the association of elevated counts of white blood cell types with increased risk of coronary heart disease (CHD) and death. METHODS: Data were examined from the NHANES-I Epidemiologic Follow-up Study. RESULTS: Relative risks for death at ages 25 to 74 comparing the upper and lower tertiles of neutrophil count were: all causes 1.29 (95% CL, 1.14, 1.47), and cardiovascular causes 1.39 (95% CL, 1.15, 1.67) after adjusting for baseline risk factors. CONCLUSIONS: The increased risk of CHD and death from all causes and cardiovascular diseases appeared to be only partially due to effects of smoking. No association was seen for lymphocytes or monocytes.

Adult↗

PubMed2004

Associations between differential leucocyte count and incident coronary heart disease: 1764 incident cases from seven prospective studies of 30,374 individuals.

AIMS: We aimed to assess potential associations between different leucocyte components and coronary heart disease (CHD) in a prospective cohort study, and to put these findings in context of other relevant prospective studies in a meta-analysis. METHODS AND RESULTS: We report data on differential leucocyte count and CHD derived from the first National Health and Nutrition Examination Survey (NHANES I) and the NHANES 1 Epidemiologic Follow-up Study (NHEFS) involving 4625 individuals followed, on average, for 18 years. The NHEFS involved 914 incident CHD cases and yielded an adjusted risk ratio of 1.09 (0.93-1.29) comparing individuals with neutrophil counts in the top third versus those in the bottom third of the population. In a meta-analysis involving the NHEFS and four other studies comprising a total of 1764 incident CHD cases, the association of CHD with neutrophil counts was somewhat stronger than those with other specific leucocyte components (combined risk ratio=1.33 [1.17-1.50]) but there was substantial heterogeneity between the separate studies (Chi2(4), p <0.001). CONCLUSIONS: Although the present synthesis provides the most comprehensive assessment so far of specific leucocyte components in CHD, additional prospective data will be needed to resolve whether neutrophil counts are much stronger predictors of CHD risk than other components.

Cohort Studies↗

PubMed2004

Relation between region of residence in the United States and hypertension incidence--the NHANES I epidemiologic follow-up study.

A number of studies have found hypertension prevalence to be higher in the southeast region of the United States than in other U.S. regions. To test the hypotheses that hypertension incidence is higher in the southeast than in other regions, and that higher levels of known hypertension risk factors in the southeast explain the difference in incidence, data from a nationally representative, longitudinal cohort study of a sample drawn from the U.S. population, the NHANES I Epidemiologic Follow-Up Study (1971-1984), were analyzed. In the United States, age-adjusted relative odds of incident hypertension between 1971 and 1984 did not vary consistently with region or with urbanization level. There was only a trend of higher relative odds in nonmetropolitan areas than in suburbs in the southeast in younger white men and older white women. Thus, convincing evidence to support the hypothesis of elevated hypertension incidence in the southeast region or in nonmetropolitan areas was not obtained. Further studies of region and hypertension incidence are needed to assess regional variation in larger, more recent cohorts.

Adult↗

PubMed2003

Bone mineral density and stroke.

BACKGROUND AND PURPOSE: We sought to assess the long-term predictive usefulness of bone mineral density (BMD) for stroke incidence and stroke mortality. METHODS: The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of noninstitutionalized civilians. A cohort of 3402 white and black subjects 45 through 74 years of age at baseline (1971 to 1975) was observed through 1992. Hospital records and death certificates were used to identify a total of 416 new stroke cases. RESULTS: Results were evaluated to determine the relative risk (RR) for stroke per 1-SD decrease in BMD, after controlling for age at baseline, smoking status, alcohol consumption, history of diabetes, history of heart disease, education, body mass index, recreational physical activity, and blood pressure medication. In Cox proportional-hazards analyses, incidence of stroke was not associated with a decrease in BMD in any of the 3 race-sex groups: white men (RR, 1.01; 95% CI, 0.86 to 1.19; P=0.88), white women (RR, 1.13; 95% CI, 0.93 to 1.38; P=0.21), or blacks (RR, 0.93; 95% CI, 0.72 to 1.21; P=0.60). No association between BMD and stroke mortality was found (RR, 1.03; 95% CI, 0.86 to 1.23; P=0.77). CONCLUSIONS: In a large national study, no significant associations of BMD and stroke incidence or mortality were found for whites or blacks.

Aged↗

PubMed2003

Education, poverty, and stroke incidence in whites and blacks: the NHANES I Epidemiologic Follow-up Study.

The purpose of this study was to test the hypothesis that educational attainment and poverty index are inversely associated with incidence of stroke in blacks and in whites. The NHANES I Epidemiologic Follow-up Study data were analyzed. We analyzed 2953 women and 2661 men with no history of stroke before baseline (1971-1975), using the incidence of stroke through 1992, years of education, and poverty index at baseline. In white men aged 45 to 74, Cox regression models showed an inverse age-adjusted association with education that did not attain statistical significance. In white women, those with 12 or more years of education had significantly lower age-adjusted risk of stroke compared with those with less than 8 years. A test for linear trend was significant when adjusting for age (P = 0.0005). In blacks, stroke risk was significantly lower in those with 8 or more years of education than in those with <8 years in adjusted models. In each group, Cox regression models showed an inverse, graded, age-adjusted association with poverty index that attained statistical significance. After controlling for multiple confounders and risk mediators, the association was diminished and nonsignificant.

Black or African American↗

PubMed2003

Bone mineral density and mortality in women and men: the NHANES I epidemiologic follow-up study.

PURPOSE: We sought to assess the long-term association of bone mineral density with total, cardiovascular, and non-cardiovascular mortality. METHODS: The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of non-institutionalized civilians. A cohort aged 45 through 74 years at baseline (1971-1975) was observed through 1992. Subjects were followed for a maximum of 22 years. Included in the analyses were 3501 white and black subjects. Death certificates were used to identify a total of 1530 deaths. RESULTS: Results were evaluated to determine the relative risk for death per 1 SD lower bone mineral density, after controlling for age at baseline, smoking status, alcohol consumption, history of diabetes, history of heart disease, education, body mass index, recreational physical activity, and blood pressure medication. Bone mineral density showed a significant inverse relationship to mortality in white men and blacks, but did not reach significance in white women. Based on 1 SD lower bone mineral density, the relative risk for white men was 1.16 (95% confidence interval (CI), 1.07-1.26, p<.01), while for white women the relative risk was 1.10 (95% CI, 0.99-1.23, p=.07), and in blacks the relative risk was 1.22 (95% CI, 1.05-1.42, p<.01). Bone mineral density was also associated with non-cardiovascular mortality in all three race-gender groups. An association between bone mineral density and cardiovascular mortality was found only in white men. CONCLUSIONS: Bone mineral density is a significant predictor of death from all causes (white men, blacks), cardiovascular (white men only) and other causes combined, in whites and blacks.

Aged↗

PubMedDate not supplied

Depression and bone mineral density in young adults: results from NHANES III.

OBJECTIVE: The purpose of this cross-sectional population-based study was to assess the association of major depressive episode (MDE) and dysthymia with bone mineral density (BMD) in young adults. METHODS: Data are from a nationally representative sample of 5,171 people aged 20 to 39 years from the Third National Health and Nutrition Examination Survey. Total proximal femoral BMD was measured using dual energy x-ray absorptiometry. MDE and dysthymia were measured using the Diagnostic Interview Schedule. RESULTS: MDE was associated with lower BMD in multivariate models in men (mean BMD = 1.038 vs. 1.068 g/cm(2); odds ratio (OR) per 1 SD decline in BMD = 1.65, 95% confidence interval (CI) = 1.08-2.52; p = 0.02) but not in women (mean BMD = 0.982 vs. 0.979 g/cm(2); OR = 0.96, 95% CI = 0.71-1.30; p =.79). The same divergence by gender was seen for dysthymia. CONCLUSION: The relationship between BMD and MDE or dysthymia in young adults varies by gender.

Absorptiometry, Photon↗

PubMedDate not supplied

Depression and hip fracture risk: the NHANES I epidemiologic follow-up study.

OBJECTIVE: Since hip fracture is the most devastating consequence of osteoporosis from a public health standpoint, addressing whether depression is predictive of fracture risk is important. The purpose of this study is to determine whether individuals with high depressive symptomatology are more likely to suffer an osteoporotic hip fracture than subjects with intermediate or low depressive symptomatology. METHODS: Data from the first National Health and Nutrition Examination Survey (NHANES I) were obtained from a nationally representative sample of noninstitutionalized civilians. A cohort aged 25 through 74 at baseline (1971-1975) was observed through 1992. Subjects were followed-up for a maximum of 22 years. Included in the analyses were 6,195 white and black subjects. Ninety-five percent of the original cohort completed the study. Hospital records and death certificates were used to identify a total of 122 hip fracture cases. RESULTS: In an unadjusted Cox proportional hazards regression model for all individuals, depression was predictive of hip fracture (hazard ratio [HR]=1.90; 95% confidence interval [CI]=1.13, 3.21; p=0.016). In a multivariate proportional hazards model controlling for (1) age at baseline, (2) gender, (3) race, (4) body mass index, (5) smoking status, (6) alcohol consumption, and (7) physical activity level, high depressive symptomatology remained predictive of hip fracture (HR=1.70; 95% CI=0.99, 2.91; p=0.055). CONCLUSIONS: This study gives evidence of a prospective association between depression and hip fracture. Additional studies are needed to verify these findings and to elucidate the pathways for the effects of depression on hip fracture incidence.

Adult↗