Evaluating different physician's prescribing preference based instrumental variables in two primary care databases: a study of inhaled long-acting beta2-agonist use and the risk of myocardial infarction.

Purpose: Instrumental variable (IV) analysis with physician's prescribing preference (PPP) as IV is increasingly used in pharmacoepidemiology. However, it is unclear whether this IV performs consistently across databases. We aimed to evaluate the validity of different PPPs in a study of inhaled long-acting beta2-agonist (LABA) use and myocardial infarction (MI).

Time trends of period prevalence rates of patients with inhaled long-acting beta-2-agonists-containing prescriptions: a European comparative database study.

Background: Inhaled, long-acting beta-2-adrenoceptor agonists (LABA) have well-established roles in asthma and/or COPD treatment. Drug utilisation patterns for LABA have been described, but few studies have directly compared LABA use in different countries. We aimed to compare the prevalence of LABA-containing prescriptions in five European countries using a standardised methodology.

Methodological challenges in monitoring new treatments for rare diseases: lessons from the cryopyrin-associated periodic syndrome registry.

Background: The Cryopyrin-Associated Periodic Syndromes (CAPS) are a group of rare hereditary autoinflammatory diseases and encompass Familial Cold Autoinflammatory Syndrome (FCAS), Muckle-Wells Syndrome (MWS), and Neonatal Onset Multisystem Inflammatory Disease (NOMID). Canakinumab is a monoclonal antibody directed against IL-1 beta and approved for CAPS patients but requires post-approval monitoring due to low and short exposures during the licensing process. Creative approaches to observational methodology are needed, harnessing novel registry strategies to ensure Health Care Provider reporting and patient monitoring.

Sizable variations in circulatory disease mortality by region and country of birth in six European countries.

Background: Circulatory disease mortality inequalities by country of birth (COB) have been demonstrated for some EU countries but pan-European analyses are lacking. We examine inequalities in circulatory mortality by geographical region/COB for six EU countries.

Methods: We obtained national death and population data from Denmark, England and Wales, France, the Netherlands, Scotland and Sweden.

Relationship between inflammatory cytokines and uric acid levels with adverse cardiovascular outcomes in patients with stable coronary heart disease.

Background: So far it is unclear whether the association between serum uric acid (SUA), inflammatory cytokines and risk of atherosclerosis is causal or an epiphenomenon. The aim of the project is to investigate the independent prognostic relationship of inflammatory markers and SUA levels with adverse cardiovascular outcomes in a patient population with stable coronary heart disease (CHD).

Methods: SUA, C-reactive protein (CRP) and interleukin (IL)-6 were measured at baseline in a cohort of 1,056 patients aged 30-70 years with CHD.

Gout treatment and comorbidities: a retrospective cohort study in a large US managed care population.

Background: Gout prevalence increased in recent years to become one of the most common causes of inflammatory arthritis in most industrialised countries. Comorbidities may affect the disease severity and treatment patterns. We describe the main characteristics of gout patients, gout-related treatment patterns and prevalent comorbidities in a managed care population.

Frequency and risk factors of gout flares in a large population-based cohort of incident gout.

Objective: So far, few data are available to characterize the flare history of patients with gout. The objective of this study was to describe the frequency and risk factors of gout flares with special consideration of the comorbidity.

Methods: A cohort study was conducted in a U.

Cardiovascular surveys: manual of operations.

Cardiovascular disease (CVD) is the leading cause of death and hospitalization in both men and women in nearly all countries of Europe. The most frequent forms of CVD are those of an atherosclerotic origin, mainly ischaemic heart disease, stroke and heart failure. The magnitude of the problem contrasts with the usual paucity and poor quality of data available on incidence and prevalence of CVD, except for few rigorous but limited studies.

Self-reported never-drinkers in England 1994-2003: characteristics and trends in adults aged 18-54 years.

Aims: This paper describes prevalences, time-trends and characteristics of self-reported never-drinkers, during the period 1994-2003, focussing particularly on white adults aged 18-54.

Methods: Data on 122,809 adults (18 + ) were obtained from the Health Survey for England (HSfE). Logistic regressions were used to estimate time trends in self-reported never-drinking, and associations between never-drinking and living alone, and educational qualification.

Generalised and abdominal obesity and risk of diabetes, hypertension and hypertension-diabetes co-morbidity in England.

Objectives: To look at trends in generalised (body mass index (BMI) >or=30 kg m(-2)) and abdominal (waist circumference (WC) >102 cm in men, >88 cm in women) obesity among adults between 1993 and 2003, and to evaluate their association with diabetes, hypertension and hypertension-diabetes co-morbidity (HDC) in England.

Design: Analyses of nationally representative cross-sectional population surveys, the Health Survey for England (HSE).

Subjects: Non-institutionalised men and women aged >or=35 years.

Domestic physical activity in relationship to multiple CVD risk factors.

Background: Public health recommendations emphasize regular participation in moderate intensity physical activity (at least 5 days per week, 30 minutes or more per day), including domestic activities (e.g., heavy housework).

Improvement in hypertension management in England: results from the Health Survey for England 2003.

Objective: To evaluate the mean levels of blood pressure and hypertension (> or = 140 mmHg systolic or > or = 90 mmHg diastolic pressure or on treatment for hypertension) in the adult English population, and to evaluate any changes in the efficacy of hypertension management between 1994 and 2003.

Design/methods: Cross-sectional surveys. England, 2003.

Levels of dyslipidaemia and improvement in its management in England: results from the Health Survey for England 2003.

Objective: To evaluate blood lipid levels in the adult English population and to report changes in the use and efficacy of lipid-lowering treatment between 1998 and 2003.

Design: Cross-sectional surveys. Participants Nationally representative sample of 8,269 non-institutionalized adults (>or= 16 years) living in England, taking part in the Health Survey for England 2003.

Vitamin D concentrations among people aged 65 years and over living in private households and institutions in England: population survey.

Background: vitamin D deficiency among older people results in poor bone and muscle health and an increased risk of fractures. In the UK, government initiatives and the launch of the Osteoporosis Strategy have been in place since 1998, highlighting the importance of adequate levels of vitamin D for its prevention. The aim of this analysis is to assess vitamin D status and examine associations of deficiency with risk factors among older people in England.

An international comparative study of blood pressure in populations of European vs. African descent.

Background: The consistent finding of higher prevalence of hypertension in US blacks compared to whites has led to speculation that African-origin populations are particularly susceptible to this condition. Large surveys now provide new information on this issue.

Methods: Using a standardized analysis strategy we examined prevalence estimates for 8 white and 3 black populations (N = 85,000 participants).

Birth weight and blood pressure in childhood: results from the Health Survey for England.

Findings of previous reports relating low birth weight with raised blood pressure in childhood and adolescence have been inconsistent. The present study uses cross-sectional data from a series of nationally representative annual surveys--the Health Survey for England--between 1995 and 2002, totaling a sample of 15 629 children aged 5 to 15. A significant negative relationship between birth weight, in quartiles or dichotomized as low (<2.

Hypertension management and control among English adults aged 65 years and older in 2000 and 2001.

Objective: To describe blood pressures, and hypertension and its management among older people.

Design: Two combined annual cross-sectional surveys.

Setting: England 2000 and 2001.

Hypertension treatment and control in five European countries, Canada, and the United States.

Levels of hypertension treatment and control have been noted to vary between Europe and North America, although direct comparisons with similar methods have not been undertaken. In this study, we sought to estimate the relative impact of hypertension treatment strategies in Germany, Sweden, England, Spain, Italy, Canada, and the United States by using sample surveys conducted in the 1990s. Hypertension was defined as a blood pressure of 160/95 mm Hg or 140/90 mm Hg, plus persons taking antihypertensive medication.

Measuring nicotine intake in population surveys: comparability of saliva cotinine and plasma cotinine estimates.

Both plasma and saliva cotinine levels have been reported in surveys of smoking behavior, and it is of interest to know how closely these two measures correspond. Plasma and saliva specimens were gathered from a sample of 605 respondents in the 1998 Health Survey for England and assayed for cotinine by a well-proven gas chromatographic method. Plasma and saliva cotinine concentrations were highly correlated (r=.

Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States.

Context: Geographic variations in cardiovascular disease (CVD) and associated risk factors have been recognized worldwide. However, little attention has been directed to potential differences in hypertension between Europe and North America.

Objective: To determine whether higher blood pressure (BP) levels and hypertension are more prevalent in Europe than in the United States and Canada.

Influence of hormone replacement therapy on C-reactive protein: population-based data.

Background: Observational data, possibly resulting from confounding due to self-selection, show that use of hormone replacement therapy (HRT) is associated with reduced coronary risk, while randomized trial data do not. One possible explanation for the trial findings is that adverse effects of HRT-- such as an elevation of C-reactive protein (CRP)--might counterbalance other benefits of HRT.

Design: Women aged 40-74 years were identified from a cross-sectional, annual nationally representative study of the English population, the Health Survey for England 1998.