Does the Dundee Step Test predict outcome in treated hypertension? A sub-study protocol for the ASCOT trial. Anglo-Scandinavian Cardiac Outcome Trial.

Treated hypertensive subjects may remain five times more likely to die of cardiac and cerebrovascular diseases than normotensive subjects with equivalent resting blood pressure (BP) levels. Research evidence suggests that exercise BP is a better predictor of end-organ damage and mortality than resting BP, and data from our centre show that a significant proportion of treated hypertensives have uncontrolled BP during a 5-min Dundee Step Test. The prognostic usefulness of exercise BP has yet to be translated into clinical practice because of the lack of a suitable technique.

Social deprivation increases cardiac hospitalisations in chronic heart failure independent of disease severity and diuretic non-adherence.

Objective: To examine whether social deprivation has any independent effect on emergency cardiac hospitalisations in patients with chronic heart failure (CHF).

Design: Cohort study of 478 patients with CHF who had been hospitalised before 1993 and who were followed up during 1993 and 1994.

Setting: Emergency admissions within Tayside acute hospitals.

Training pharmacists and pharmacy assistants in the stage-of-change model of smoking cessation: a randomised controlled trial in Scotland.

Objective: To evaluate a training workshop for community pharmacy personnel to improve their counselling in smoking cessation based on the stage-of-change model.

Design: A randomised controlled trial of community pharmacies and pharmacy customers.

Setting: All 76 non-city community pharmacies registered in Grampian, Scotland, were invited to participate.

Alcohol intake as a risk factor for peripheral arterial disease in the general population in the Edinburgh Artery Study.

The aim of this study was to determine the relationship between alcohol consumption and occurrence of peripheral arterial disease in the general population. During 1988 in a cross sectional survey, the Edinburgh Artery Study, 1,592 men and women aged 55-74 years were selected at random from the age-sex registers of ten general practices distributed geographically and socio-economically across the city. participants were asked to recall the number of units of wine, beer and spirits consumed in the previous week and whether or not this was typical.

Sex differences in susceptibility to etiologic factors for peripheral atherosclerosis. Importance of plasma fibrinogen and blood viscosity.

Cardiovascular risk factors in men, such as cigarette smoking, hypercholesterolemia, and hypertension, also increase risk in women, but the relative susceptibility to risk factors between the sexes is not established. Our aim was to investigate a wide range of possible etiologic factors in a single population study and identify those that were more strongly related to peripheral atherosclerosis in men or women. We studied personal factors (age and social class), lifestyle factors (smoking, exercise, alcohol intake, and dietary nutrients), and intermediary factors (obesity, diabetes, serum lipids, coagulation, and rheological factors).

Hostile personality and risks of peripheral arterial disease in the general population.

The relationships between personality and risks of coronary heart disease have been studied widely, but little attention has been paid to other forms of atherosclerotic disease. The objective of this study was to determine relationships in the general population between hostile personality and Type A behavior pattern with asymptomatic and symptomatic chronic peripheral arterial disease. The Edinburgh Artery Study comprises a cross-sectional random sample survey of 1592 men and women aged 55 to 74 years sampled from age-sex registers of 10 general practices throughout the city.

Plasma essential fatty acids, cigarette smoking, and dietary antioxidants in peripheral arterial disease. A population-based case-control study.

The aim of this study was to determine the levels of plasma fatty acids in patients with peripheral arterial disease and in control subjects and to identify whether any risks of disease related to these differences were influenced by smoking and antioxidant intake. A random sample of 1592 men and women aged 55 to 74 years was selected from the general population (the Edinburgh Artery Study), from which 153 cases of peripheral arterial disease were identified by the presence of intermittent claudication and low ankle systolic pressures at rest and during reactive hyperemia; these were matched by age and sex to 153 control subjects with no evidence of cardiovascular disease. In 113 case and 122 control subjects, fatty acid levels were measured in three plasma fractions (triglyceride, cholesteryl ester, and phospholipid), and smoking habits and dietary antioxidant intake were determined by questionnaire.

Physical activity and risk of peripheral arterial disease in the general population: Edinburgh Artery Study.

Study Objective: To determine associations between physical activity at age 35-45 years with peripheral arterial disease and cardiovascular risk factors at age 55-74 years.

Design: Cross sectional survey of the general population--Edinburgh Artery Study. The presence of peripheral arterial disease was determined using the WHO/Rose questionnaire on intermittent claudication, and the ankle brachial pressure index at rest and during reactive hyperaemia.

Smoking, haemostatic factors and lipid peroxides in a population case control study of peripheral arterial disease.

The aim of this study was to determine differences between cases of peripheral arterial disease and healthy controls in levels of haemostatic factors and lipid peroxides and the influence of cigarette smoking. The study groups were selected from the Edinburgh Artery Study which is a random sample survey of men and women aged 55-74 years. Mean levels of plasma fibrinogen, von Willebrand factor, beta-thromboglobulin, plasminogen activator inhibitor (type I), cross-linked fibrin degradation products and lipid peroxides were markedly elevated in 121 study cases compared with 126 age- and sex-matched controls.

Quality of life following lower limb amputation for peripheral arterial disease.

Lower limb amputations for peripheral arterial disease are performed predominantly on an elderly population with poor social support and concomitant medical problems. The effect of amputations on the quality of life of this population has not been properly assessed. The quality of life of 149 amputees from one hospital was evaluated using the Nottingham Health Profile and compared to that of a control group matched for age and sex.

Blood viscosity, fibrinogen, and activation of coagulation and leukocytes in peripheral arterial disease and the normal population in the Edinburgh Artery Study.

Background: Increased blood and plasma viscosity, hematocrit, fibrinogen, and activation of coagulation and leukocytes have been reported in patients with claudication; however, their associations with symptomatic and asymptomatic peripheral arterial disease have not been reported in an epidemiological study.

Methods And Results: Blood and plasma viscosity, hematocrit, fibrinogen, urinary fibrinopeptide A, plasma leukocyte elastase, and uric acid were measured in a random sample of 1,581 men and women aged 55-74 years in Edinburgh, Scotland, and related to peripheral arterial stenosis (ankle-brachial systolic pressure index, ABPI) and to lower limb ischemia (intermittent claudication and reactive hyperemia test). Each variable (except fibrinopeptide A) was significantly related to prevalent symptomatic and asymptomatic peripheral arterial disease.

Diet as a risk factor for peripheral arterial disease in the general population: the Edinburgh Artery Study.

The Edinburgh Artery Study included a cross-sectional survey of 1592 men and women (aged 55-74 y). One aim was to examine relationships between an indicator of peripheral arterial disease, the ankle brachial pressure index (ABPI), and dietary factors. Nutrient intake was derived from a food-frequency questionnaire.

The relationship between blood viscosity and blood pressure in a random sample of the population aged 55 to 74 years.

Blood viscosity is elevated in hypertensive subjects, but the association of viscosity with arterial blood pressure in the general population, and the influence of social, lifestyle and disease characteristics on this association, are not established. In the Edinburgh Artery Study, 1592 men and women aged 55-74 years selected randomly from the general population attended a university clinic. A fasting blood sample was taken for the measurement of blood viscosity and its major determinants (haematocrit, plasma viscosity and fibrinogen).

Accuracy and reproducibility of duplex ultrasound imaging in a phantom model of femoral artery stenosis.

Purpose: The improvement of management strategies in patients with intermittent claudication might depend on a better understanding of the natural history of femoral atherosclerosis. The grading of stenoses, the monitoring of their progression, and the assessment of response to treatment are critically dependent on a method's accuracy and variability. Duplex ultrasound imaging provides a noninvasive way of measuring localized disease, but there has been relatively little objective evaluation of its accuracy and reproducibility.

Accuracy and reproducibility of duplex ultrasonography in grading femoropopliteal stenoses.

Purpose: The aim of this study was to determine the accuracy of Doppler waveform characteristics in grading femoropopliteal stenoses and to determine the interobserver and intraobserver reproducibility of measuring the same waveform characteristics.

Methods: Thirty patients with isolated areas of stenosis found by arteriography were evaluated by color duplex sonography. Each patient underwent scanning by two observers on two separate occasions.

Reactive hyperemia test in a random sample of the general population.

Purpose: The purpose of this article is to determine the performance of a reactive hyperemia test in the general population in terms of validity, increase in case identification, and test refusal; and to identify differences between the two major ways of expressing the results (the postocclusive ankle index and the percentage change in ankle systolic pressure).

Methods: Changes in ankle pressures were measured during reactive hyperemia in 1460 men and women aged 55 to 74 years, who were randomly sampled in the Edinburgh Artery Study. The validity of the test was determined in 91 cases identified by the presence of intermittent claudication and a low resting ankle pressure and in 91 controls matched by age and sex.

Oral cleanliness of dentally anxious schoolchildren and their need for periodontal treatment.

The aim of this study was to examine the relationship between self-reported dental anxiety and the oral cleanliness and periodontal treatment need in Scottish secondary schoolchildren. One thousand one hundred and three children participated in the study, mean age 14 years (sd 0.35 years), and the prevalence of high dental anxiety was 7.

Dental caries experience and prevalence of children afraid of dental treatment.

The aim of this study was to examine the clinical outcome with regard to dental caries of high self reported dental anxiety in a group of Scottish secondary schoolchildren. 1103 children participated in the study, mean age 14 yr (sd 0.35 yr), and the prevalence of high dental anxiety was 7.

Genetic variation at fibrinogen loci and plasma fibrinogen levels.

In view of the controversy regarding genetic variation at the fibrinogen loci and plasma fibrinogen levels, we have analysed DNA polymorphisms at the alpha (TaqI), beta (BclI and HaeIII), and gamma (KpnI/SacI) fibrinogen loci in 247 subjects whose plasma fibrinogen was determined by clotting and nephelometric assays. Strong linkage disequilibrium was found between the alpha/TaqI and gamma/KpnI/SacI markers and between the beta/BclI and beta/HaeIII markers. A lesser association was found between the alpha/TaqI and beta/BclI loci, beta/BclI and gamma/KpnI/SacI markers, alpha/TaqI and beta/HaeIII markers, and the gamma/KpnI/SacI and beta/HaeIII markers.

The prevalence of dental anxiety in a group of 13- and 14-year-old Scottish children.

The aim of this study was to determine the prevalence of dental anxiety reported by a group of 13- and 14-year-old children, and to explore the relationships between dental anxiety and general fear, social class, gender, size of family, length of time since the last dental appointment, and the number of people known by the child to be afraid of visiting the dentist. A group of 1103 children from eight schools took part in the study, which was completed in 1989. The children (mean age 14.

Fibrinogen genotype and risk of peripheral atherosclerosis.

There is conflicting evidence about the influence of fibrinogen genotype on plasma fibrinogen concentrations, and the relation between genotype and atherosclerotic disease has not been studied. In a population-based case-control study we aimed to find out whether certain fibrinogen genotypes are associated with an increased risk of peripheral atherosclerosis. 121 subjects with peripheral arterial disease and 126 healthy controls matched for age and sex were selected from a random population sample aged 55-74 years in the Edinburgh Artery Study.

Preventive oral health related behaviour of dentally anxious schoolchildren aged 13-14 years in Lothian, Scotland.

The aim of this study was to determine the self-reported preventive oral health related behaviours of dentally anxious schoolchildren. 1103 children participated in the study, mean age 14 years (SD 0.35 years), and the prevalence of high dental anxiety was 7.

Validity of duplex scanning in the detection of peripheral arterial disease in the general population.

Duplex scanning has the potential to identify asymptomatic atherosclerosis of the lower limbs in the general population. The aim of this study was to assess the validity of scanning in a group of men and women aged 55-74, sampled from a population survey. Disease was measured using the WHO questionnaire on claudication, the ankle brachial pressure index, and a reactive hyperaemia test.