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Biomedical subjects

R Stamler

Publications and source records attributed to R Stamler.

At least 91 records · Page 5Linked to original sources
PubMed1980

Prevention and control of hypertension by nutritional-hygienic means. Long-term experience of the Chicago Coronary Prevention Evaluation Program.

In the Chicago Coronary Prevention Evaluation Program (CPEP), 115 men had definite mild hypertension at entry; another 101 men had high-normal diastolic blood pressure (BP). The nutritional-hygienic nonpharmacologic CPEP regimen achieved years-long moderate weight loss, slowing of pulse rate, and reduction in serum cholesterol levels. Sustained falls in BP were recorded-about 10/13 mm Hg for hypertensive men, resulting in long-term normalization of BP, and about 7/4 mm Hg for men with high-normal BP at entry. Change in weight and change in BP were significantly correlated. Long-term improvements in eating and exercise habits yielding moderate sustained weight loss are apparently useful in preventing high BP in hypertension-prone persons and in controlling established "mild" hypertension.

Adult↗
PubMed1979

Family (parental) history and prevalence of hypertension. Results of a nationwide screening program.

In a nationwide screening program, blood pressure measurements, family (parental) histories of hypertension, and self-evaluations of weight class were obtained for more than a half million people. Positive family history was associated with hypertension prevalence double that found in persons with negative history and was independent of weight. When overweight was also present, however, hypertension prevalence was three to four times as high. Hypertension was more likely to have been previously diagnosed in screenees if family history was positive. However, such screenees did not have a higher proportion receiving effective treatment than those with negative family history. When an index case of hypertension is found, other family members should be examined. For persons with positive family history, nutritional-hygienic recommendations to avoid overweight may be important in reducing the risk of becoming hypertensive.

Adult↗
PubMed1979

Assessment of the association between habitual salt intake and high blood pressure: methodological problems.

Despite the finding in cross-cultural comparisons that habitual sodium intake correlates with levels of blood pressure, similar studies from within population groups have yielded inconsistent results. The data presented in this report indicate that in industrialized societies the high degree of intra-individual variability of sodium intake, compared to much smaller inter-individual differences, may obscure potential biological correlations. A quantitative statistical method is presented to assess and minimize the effect of the large intra-individual variation in daily urinary sodium excretion.

Adult↗
PubMed1978

Weight and blood pressure. Findings in hypertension screening of 1 million Americans.

In the nationwide Community Hypertension Evaluation Clinic screening of more than 1 million people, the group classifying itself as overweight had prevalence rates of hypertension 50% to 300% higher than other screenees. Frequency of hypertension in overweight persons aged 20 to 39 years was double that of normal weight and triple that of underweight persons. Among those aged 40 to 64 years, the overweight group had a 50% higher hypertension prevalence rate than the normal-weight group and 100% higher than the underweight group. With each higher degree of blood pressure elevation, relative frequency of hypertension with overweight was larger. Thus this study confirms, in the largest group surveyed to date, similar findings in previous cross-sectional surveys. It is also consistent with data from longitudinal and intervention studies on the importance of overweight in relation to hypertension.

Adult↗
PubMed1978

A hypertension control program based on the workplace. Report on the Chicago Center.

In several large Chicago companies and institutions, workplace screening of 7,151 persons yielded 833 suspect hypertensives. Of these, 91% attended a follow-up verification visit, where for 513 persons high diastolic pressure was confirmed. One-half of these persons were referred to their physicians for treatment and one-half were randomly assigned to be treated directly by HDFP, in a step-wise pharmacologic regimen to normalize diastolic pressure. Of the 257 persons assigned to program treatment, 94% accepted such treatment, and over 90% of these still living in the community were active participants at one year. Average diastolic pressure of these active participants was 83.1 mm Hg at one year, compared to 102.6 at first screen and 98.8 at the second confirmatory screening. A strenuous effort has been made to reduce or eliminate obstacles to treatment, including lack of understanding of the need for long-term therapy, cost barriers and barriers of inconvenience of treatment. The medical team conducting the program combined physicians with nonphysician therapist-health counselors, plus "outreach" staff, to maximize program adherence. Preliminary experiences in the Chicago Center of the Hypertension Detection and Follow-Up Program (HDFP) give encouraging evidence that the workplace is a useful base for successful hypertension control efforts.

Chicago↗
PubMed1976

Hypertension screening of 1 million Americans. Community Hypertension Evaluation Clinic (CHEC) program, 1973 through 1975.

During 1973 through 1975, more than 1 million persons were screened in the nationwide Community Hypertension Evaluation Clinic (CHEC) program at 1,171 sites. While those screened were not from defined populations, findings paralleled those of recent surveys of US population samples. First, CHEC confirmed the scope of the problem of elevated blood pressure in the United States. Of those screened, 247 of 1,000 had a diastolic reading of 90 mm Hg or higher; 116 of 1,000 had a reading of 95 mm Hg or greater. Prevalence of elevated blood pressure rose with age up to age 50 years, was higher in blacks than in whites, and was higher in men than in women. Second, CHEC data confirmed the challenge of undetected, untreated, and uncontrolled hypertension. Previously undetected hypertension was present in 27.7% of hypertensive people, detected but untreated in 10.7%, and treated but uncontrolled in 16.7%--totaling 55.1%.

Adult↗
PubMed1976

Epidemiologic findings on the relationship of time of day and time since last meal to glucose tolerance.

Data from 10,559 men and women, age 30-64, participating in the morning and afternoon in a Chicago Health Department multiphasic screening project, were used to determine the effects of time of day and time since last meal on the values for plasma glucose one and two hours following oral challenge with 100 gm. of glucose. Mean plasma glucose values and rates of suspect glucose intolerance (based on several cutpoints) were sizeably higher in the afternoon than in the morning. In addition, plasma glucose values increased with time elapsed since the last meal, up to 10 hours postprandially. Thereafter, both one- and two-hour plasma glucose values tended to exhibit a decline. Analysis of covariance confirmed that fluctuations in glucose tolerance were related to time of day and time since last meal, but the effects of each parameter were exerted independently.

Adult↗
PubMed1975

Adherence and blood-pressure response to hypertension treatment.

2 years of experience in the first phase of a large cooperative national hypertension programme yielded data indicating that a good level of patient adherence can be achieved and that satisfactory blood-pressure control can be maintained long term. For 116 participants, all employed persons, dropout in the first year was 20% but only 3% dropped out in the second year. At the second annual examination, 82% of those still in the programme had diastolic pressures under 90 mm Hg, with an average reduction of 18 mm Hg. Thus, nearly two-thirds (64%) of all patients originally enrolled were both active and with normal levels of blood-pressure after two years. Only 18% of active programme-treated patients had diastolic pressure 90 mm Hg or higher at the second anniversary in contrast with 33% of patients referred to their own doctors. In programme-treated patients, standard medication was used; diuretics effectively lowered blood-pressure in a third of patients, and diuretics plus reserpine were effective for another 20%. Special features of the programme included assistance to physicians by health counsellor therapists. Methods for achieving a high adherence-rate and satisfactory blood-pressure control probably have wider applicability.

Adult↗