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Biomedical subjects

R J Garrison

Publications and source records attributed to R J Garrison.

At least 37 records · Page 2Linked to original sources
PubMed1989

Is coffee consumption a contributor to cardiovascular disease? Insights from the Framingham Study.

Reported coffee consumption during 1954 to 1958 and 1971 to 1973 was used to test for association with cardiovascular disease (CVD) incidence and lipid values in the Framingham cohort. Multivariate analysis was employed, regressing CVD on age, systolic pressure, cigarette use, body mass index, total cholesterol, and coffee intake. In pooled analyses (2648 men with 549 CVD cases and 3566 women with 462 CVD cases) coffee intake was not associated with CVD incidence in either smokers or nonsmokers, irrespective of sex. Similarly, multivariate analyses for individuals with existing cardiovascular disease showed no association between coffee intake and subsequent cardiovascular disease. In men significant negative associations between coffee and total cholesterol, and very-low-density lipoprotein cholesterol were seen, whereas in women positive associations with low-density lipoprotein cholesterol were observed. Although inconsistent effects on the lipid profile were seen, no increase in primary or secondary CVD was seen with coffee drinking.

Adult↗
PubMed1988

Incidence of hypertension in the Framingham Study.

Incidence and trends in incidence of definite hypertension were analyzed based on 30 years follow-up of 5,209 subjects in the Framingham Heart Study cohort. Based on pooling of 15 two-year periods, hypertension incidence per biennium increased with age in men from 3.3 per cent at ages 30-39 to 6.2 per cent at ages 70-79, and in women from 1.5 per cent at ages 30-39 to 8.6 per cent at ages 70-79. No consistent trend in incidence rates was evident for either sex from the 1950s through the 1970s. The proportion of hypertensive subjects receiving antihypertensive medication has increased since 1954-58 and exceeded 80 per cent for both men and women ages 60-89 years in 1979-81. Incidence data presented in this report may serve as a baseline for assessing the impact of future public health efforts in the primary prevention of hypertension.

Adult↗
PubMed1987

Echocardiographic criteria for left ventricular hypertrophy: the Framingham Heart Study.

Of 6,148 original cohort and offspring subjects of the Framingham Heart Study who underwent routine evaluation, a healthy group of 347 men (aged 42 +/- 12 years) and 517 women (aged 43 +/- 12 years) was identified to develop echocardiographic criteria for left ventricular (LV) hypertrophy. Healthy subjects were defined as normotensive, receiving no cardiac or antihypertensive medications, nonobese and free of cardiopulmonary disease. Echocardiographic criteria (in accordance with the American Society of Echocardiography convention) for LV hypertrophy, based on mean plus 2 standard deviations for LV mass, LV mass corrected for body surface area and LV mass corrected for height in this healthy sample are, respectively: 294 g, 150 g/m2 and 163 g/m in men and 198 g, 120 g/m2 and 121 g/m in women. Criteria based on LV mass/height result in higher prevalence rates of LV hypertrophy than LV mass/body surface area while still correcting for body size. The prevalence of LV hypertrophy in the entire study population (using LV mass/height criteria) is 16% in men and 19% in women. Until outcome guided criteria for LV hypertrophy are developed, application of sex-specific criteria based on a healthy population distribution of LV mass offer the best approach to echocardiographic diagnosis of LV hypertrophy.

Adult↗
PubMed1987

Longitudinal and secular trends in lipoprotein cholesterol measurements in a general population sample. The Framingham Offspring Study.

Two fasting lipoprotein cholesterol measurements have been made on Framingham Offspring Study participants, first in 1971-75 and again in 1979-83. Longitudinal analysis (n = 2433, age 20-49 at first exam) using multivariate regression found aging, weight gain, vasectomy, menopause, and increased smoking are associated with worsening lipoprotein profiles, while increased alcohol consumption is associated with increased high density lipoprotein cholesterol (HDL-C). Average increases in low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) in women accelerate with age; in men the increases are similar or perhaps decelerate with age. Secular trends were measured using age-adjusted mean values for individuals aged 25-54. Averages of total cholesterol, LDL-C (men only), systolic and diastolic blood pressure, body mass index, number of cigarettes per day, and alcohol consumption were lower at the second examination. Two secular trends in women indicate a possible worsening of population lipoprotein profiles: mean VLDL-C was higher and mean HDL-C lower at the second exam.

Adult↗
PubMed1987

Incidence and precursors of hypertension in young adults: the Framingham Offspring Study.

The occurrence of hypertension and its precursors is examined in the Framingham Offspring Study of 2,027 men and 2,267 women ages 20-49 years followed for 8 years. The age-specific prevalence of hypertension was similar at both the first (1971-1975) and the second (1979-1983) examination for both men and women. Prevalence rates were higher among men than among women, and there was a higher rate of hypertension treatment at the second exam, particularly among women, 75% of whom reported being treated for hypertension. The incidence of hypertension in participants free from hypertension at the first examination increased threefold from the second to the fifth age decades in men and eight-fold in women. Under age 40, men were twice as likely as women to develop hypertension, but after age 40, 8-year incidence rates were similar in men (14.2%) and women (12.9%). Adiposity, relative weight, heart rate, alcohol intake, hematocrit, blood sugar, serum protein, triglyceride, and phosphorous were all related to hypertension occurrence in one or both sexes, controlling for age. In multivariate analysis, adiposity (P less than 0.01), heart rate (P less than 0.01), and triglyceride (P less than 0.05) were all significant independent predictors of hypertension in men. In women, adiposity (P less than 0.001), heart rate (P less than 0.01), hematocrit (P less than 0.05), and alcohol consumption (P less than 0.05) were independent contributors. When controlling for blood pressure measured at the first examination, the best single predictor of hypertension incidence, the multivariate assessment changed very little. Adiposity stands out as a major controllable contributor to hypertension. Changes in body fat over 8 years were related to changes in both systolic and diastolic blood pressure. Markedly obese women in their fourth decade were seven times more likely to develop hypertension than were lean women of the same age. Weight control deserves a high priority in efforts to prevent hypertension in the general population.

Adult↗
PubMed1987

Life-style correlates of risk factor change in young adults: an eight-year study of coronary heart disease risk factors in the Framingham offspring.

This paper describes the life-style and behavioral correlates of change in coronary heart disease risk factors measured eight years apart in the young adult offspring of the Framingham Heart Study cohort. Changes in total cholesterol, lipoprotein cholesterols (high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, very low density lipoprotein (VLDL) cholesterol), and blood pressure were observed longitudinally in 397 men and 497 women who were aged 20-29 years at entry into the study. Stepwise multiple linear regression procedures were used to identify characteristics and their changes that were significantly associated with risk factor changes in each sex. The attribute most strongly and consistently related to lipoprotein and blood pressure changes in both sexes was change in body mass index (p less than or equal to 0.01 or p less than or equal to 0.001). In addition to weight gain, increases in alcohol consumption in men (p less than or equal to 0.001) and beginning oral contraceptive use in women (p less than or equal to 0.01) were associated with increases in blood pressure over the study period. Weight loss, stopping or decreasing cigarette consumption (p less than or equal to 0.01), increasing alcohol intake (p less than or equal to 0.01), and, in women, discontinuing oral contraceptive use (p less than or equal to 0.01) also were independently related to improvements in lipoprotein profiles during follow-up. After adjustment for all life-style correlates of risk factor change, simple self-assessments of physical activity or activity change were negatively associated with changes in VLDL cholesterol (p less than or equal to 0.01) and the total cholesterol/HDL cholesterol ratio (p less than or equal to 0.05) in men and positively associated with changes in HDL cholesterol (p less than or equal to 0.05) in women. Sociodemographic and behavioral characteristics that made a further independent contribution to increases in the total cholesterol/HDL cholesterol ratio in men were blue-collar occupation and trait Type A behavior pattern (p less than or equal to 0.05). Unexplained, but provocative, results of this study included the associations of interim vasectomy with increases in total cholesterol in men (p less than or equal to 0.05) and of number of livebirths with decreases in total cholesterol and HDL cholesterol in women (p less than or equal to 0.01). These findings are among the first to offer prospective evidence which suggests that habits and behaviors during young adulthood have a substantial effect on lipid and lipoprotein profiles in men and women.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1987

Considerations in the use of echocardiography in epidemiology. The Framingham Study.

To quantify potential biases in the use of echocardiography in epidemiologic studies, we assessed the relationship of sex, age, vital capacity, body fatness, and overt cardiovascular disease to prevalence of acceptable echocardiograms in 6148 Framingham men and women aged 17 to 90 years. Echocardiograms adequate to assess left ventricular chamber dimensions and wall thickness, aortic root, and left atrial dimensions as well as mitral and aortic valves were obtained in 4947 (80%) of the 6148 subjects. The prevalence of acceptable echocardiograms ranged from less than 50% for those more than 80 years of age to more than 96% for subjects under 30 years of age. A significant learning curve was apparent, particularly in the older subjects (more than 60 years of age) for whom prevalence of acceptable echocardiograms rose from a minimum of 28% during the first 5 months of studies to a maximum of 74 to 81% during studies 2 years later. The likelihood of unacceptable echocardiograms was slightly greater in men. Obesity (in subjects younger than 60 years of age), lower vital capacity, and overt cardiovascular disease were associated with unacceptable echocardiograms, independent of age. Consideration of these biases should aid in the interpretation and planning of epidemiologic and other studies using echocardiography.

Adult↗
PubMed1987

The spectrum of left ventricular hypertrophy in a general population sample: the Framingham Study.

To assess the prevalence, characteristics, and correlates of echocardiographically determined left ventricular hypertrophy (echo LVH) in a free-living population, 510 men and 855 women from the original Framingham cohort (age 59 to 90 years) were studied by M-mode echocardiography. Offspring and offspring spouses (1718 men and 1892 women; age 17 to 75 years) were similarly studied. The severity of echo LVH, as reflected by left ventricular mass indexed to body surface area, ranged from 101 g/m2 (women) and 132 g/m2 (men) to more than 400 g/m2. The prevalence of electrocardiographically assessed LVH increased proportionately with increased echocardiographic left ventricular mass. Women with echocardiographic left ventricular mass indexes exceeding 200 g/m2 were three to four times more likely to have electrocardiographic LVH than men with similar elevations of echocardiographic left ventricular mass index. The prevalence of echo LVH ranged from 6.6% in the younger (offspring study) women to 33% in the older (original cohort) women (8.6% and 23.7%, respectively, for men) and included a spectrum of forms--eccentric-dilated, eccentric-nondilated, concentric, and disproportionate septal thickness--which varied in prevalence in the various age-sex groups. Each of these forms of echo LVH was associated with higher systolic blood pressures at the time of echocardiographic examination and over the previous 30 years when compared with blood pressures of Framingham subjects without echo LVH.

Adult↗
PubMed1987

Electrocardiographic changes with advancing age. A cross-sectional study of the association of age with QRS axis, duration and voltage.

In order to examine the electrocardiographic (ECG) changes which occur with advancing age we defined an apparently healthy reference population derived from prospectively followed subjects of the Framingham Heart Study. Healthy subjects were clinically free of hypertension, coronary artery disease, congestive heart failure and valve disease and were not taking antihypertensive or other cardiac medications. ECG tracings were analyzed by the IBM Bonner (V2) program. Mean values and correlations with age for PR duration, QRS duration and axis, S wave voltage V1 and R wave voltage V5 are presented. With advancing age in men there is a narrowing of QRS, a leftward QRS axis shift, and a loss of S V1 and R V5 amplitude. In women only a leftward QRS axis shift is associated with advancing age. These changes should be considered in defining normal age- and sex-specific reference values. These findings underscore theoretical limitations of commonly-used criteria for the ECG diagnosis of conditions such as left ventricular hypertrophy.

Adult↗
PubMed1986

Incidence of coronary heart disease and lipoprotein cholesterol levels. The Framingham Study.

The first report from the Framingham Study that demonstrated an inverse relationship between high-density lipoprotein cholesterol (HDL-C) and the incidence of coronary heart disease (CHD) was based on four years of surveillance. These participants, aged 49 to 82 years, have now been followed up for 12 years, and this report shows that the relationship between the fasting HDL-C level and subsequent incidence of CHD does not diminish appreciably with time. Since a second measurement of HDL-C is available eight years after the initial determination, the relationship of HDL-C measurements on the same subjects at two points in time is examined. This second HDL-C measurement is also used in a multivariate model that includes cigarette smoking, relative weight, alcohol consumption, casual blood glucose, total cholesterol, and blood pressure. It is concluded that even after these adjustments, nonfasting HDL-C and total cholesterol levels are related to development of CHD in both men and women aged 49 years and older. Study participants at the 80th percentile of HDL-C were found to have half the risk of CHD developing when compared with subjects at the 20th percentile of HDL-C.

Body Weight↗
PubMed1986

Obesity and nutrition in elderly diabetic patients.

Obesity and lipid abnormalities are powerful independent predictors of both diabetes and cardiovascular disease. Nutrition affects the rate of atherogenesis in elderly patients with diabetes. Excess calories worsen glucose tolerance; recent studies relate dietary fats both to serum cholesterol levels within populations and to the development of coronary disease. Dietary and drug interventions for hypercholesterolemia have been found to reduce coronary disease rates. Some nutrients also elevate blood pressure, which further accelerates diabetic atherogenesis. For elderly diabetic patients who are at high risk of atherosclerotic cardiovascular disease, control of diabetes should include--in addition to normalization of blood sugar levels--correction of blood lipids and control of weight and blood pressure.

Adult↗
PubMed1985

Postmenopausal estrogen use, cigarette smoking, and cardiovascular morbidity in women over 50. The Framingham Study.

We studied the effect of estrogen use on morbidity from cardiovascular disease in 1234 postmenopausal women, aged 50 to 83 years, participating in the Framingham Heart Study's 12th biennial examination (index examination). The medication history recorded at biennial examinations 8 through 12 was used to classify the degree of estrogen exposure before eight years of observation for cardiovascular morbidity and mortality. Despite a favorable cardiovascular risk profile and control for the major known risk factors for heart disease, women reporting postmenopausal estrogen use at one or more examinations had over a 50 per cent elevated risk of cardiovascular morbidity (P less than 0.01) and more than a twofold risk for cerebrovascular disease (P less than 0.01) after the index examination. Increased rates for myocardial infarction (P less than 0.05) were observed particularly among the estrogen users who smoked cigarettes. Conversely, among nonsmokers estrogen use was associated only with an increased incidence of stroke (P less than 0.05). No benefits from estrogen use were observed in the study group; in particular, mortality from all causes and from cardiovascular disease did not differ for estrogen users and nonusers.

Aged↗
PubMed1985

Weight and thirty-year mortality of men in the Framingham Study.

Data from 30 years of biennial examinations and mortality information on the men who participated in the Framingham Study were analyzed to explore the relation between relative weight and longevity. Metropolitan Relative Weight, as measured at the baseline examination, was strongly related to mortality in the subsequent 30 years, with men weighing between 100% and 109% having minimum mortality. In addition, interim relative weights were related to death in the next 2-year period by cross-sectional pooling analysis. Multivariate analysis showed a strong positive relationship between baseline relative weight and death occurring in any interval, despite an inverse relation between interim weight and death. Overweight (weight greater than 110%) nonsmoking men in the Framingham Study had 30-year mortality rates up to 3.9 higher than men of desirable weight (weight, 100% to 109%). No evidence was seen that weight gains during middle age increased longevity or that desirable weights increased with age.

Adipose Tissue↗
PubMed1984

Family resemblances in height and relative weight in the Framingham Heart Study.

The correlations of both height and relative weight (the Quetelet Index: wt/ht2) were studied amongst adult relatives in the Framingham Heart Study. The parental generation was first examined starting in 1949 when they were aged 30-62 years. The offspring (and their spouses) were examined beginning in 1971 when they were aged 20-49 years. Thus, it was possible to compare adult levels of body size in two generations. For height there are correlations between relatives that suggest large genetic variation for adult body height. For relative weight as measured by Quetelet's Index, the associations between relatives show a pattern that is more difficult to interpret and gives little support for sizable contributions of genetic differences to the population variation in relative weight. Although there is little evidence for large genetic variation for obesity, there is marked resemblance for obesity among first-degree relatives. This fact may be used to advance the family-based approach to screening, identification and intervention on the cardiovascular complications of obesity.

Adult↗
PubMed1983

Does change in blood pressure predict heart disease?

Whether a change in blood pressure is related to the occurrence of cardiovascular disease, independent of blood pressure level, was investigated using data collected in the Framingham heart study on 5209 subjects. The follow up period of 26 years was divided into a first period of 12 years in which the blood pressure change was computed for each individual and a subsequent period of 14 years in which the risk of cardiovascular disease was determined. Blood pressure change was positively related to risk of cardiovascular disease. This association remained when blood pressure level at the start of the study was taken into account but disappeared when the level attained after the first 12 years was taken into consideration. For the clinician this suggests that the decision to treat high blood pressure is best guided by the actual level of pressure and not by its long term trend in the past.

Adult↗
PubMed1983

Prevalence of submitral (anular) calcium and its correlates in a general population-based sample (the Framingham Study).

To obtain epidemiologic information on submitral calcium, 2,069 subjects in the original Framingham Study cohort (mean age 70 +/- 7 years) and 3,625 of the offspring of the cohort and their spouses (mean age 44 +/- 10 years) with adequate echocardiograms were evaluated. Submitral calcium was detected in 162 (2.8%) of the 5,694 subjects; greater than 90% of the subjects with such calcium came from the 40% of the study group greater than 59 years of age. Women were more than twice as likely to have such calcium as men. Age in both sexes, systolic blood pressure in men, and obesity in women were significantly and independently associated with submitral calcium. There was a 12-fold excess of atrial fibrillation in subjects with (20 of 162, 12%) compared with those without (53 of 5,532, 1%) submitral calcium.

Adult↗