Ratio of cuff width/arm circumference as a determinant of arterial blood pressure measurements in adults.

Recommendations state that the optimum ratio of blood pressure cuff width/arm circumference (CW/AC) is about 0.4. In this study of middle-aged men (n = 940) and women (n = 1484), we analysed the effect of CW/AC on blood pressure measurement variability and its interaction with age, body mass index (BMI), pulse rate and room temperature.

The effect of the number of electrocardiograms analyzed on cardiovascular disease surveillance: the Minnesota Heart Survey (MHS).

One method used to control costs in community cardiovascular disease surveillance is to limit the number of electrocardiograms (ECGs) used to validate acute myocardial infarction (AMI). The Minnesota Heart Survey investigated the impact of decreasing the maximum number of ECGs analyzed on classification of ECG pattern and final AMI diagnosis (definite, probable, none). A 50% sample of all 1980 acute CHD hospital discharge records (ICD-9 code 410 or 411) from 30 of 31 Twin Cities hospitals were abstracted.

Association of incident carcinoma of the endometrium with body weight and fat distribution in older women: early findings of the Iowa Women's Health Study.

Previous epidemiological studies have demonstrated that obesity increases endometrial cancer risk two- to 10-fold. To test the hypothesis that abdominal adiposity further increases this relative risk, we conducted a nested case-control study of endometrial cancer incidence in a cohort of 41,873 women ages 55-69 years. Women were recruited by mail and asked to have a friend measure circumferences of several body parts using a tape measure and written instructions.

Associations of abdominal adiposity, fasting insulin, sex hormone binding globulin, and estrone with lipids and lipoproteins in post-menopausal women.

The associations of abdominal adiposity, fasting serum levels of insulin, and sex hormones with blood lipids, lipoproteins, and apolipoproteins A-I and B were studied cross-sectionally in 75 healthy, postmenopausal white women. In univariate analyses, abdominal adiposity (increased waist-to-hip girth ratio) and fasting insulin concentrations were negatively and significantly associated (P less than 0.05) with plasma high density lipoprotein cholesterol (r = -0.

A new epidemiologic classification system for interim myocardial infarction from serial electrocardiographic changes.

Many clinical trials or population studies have used change in Minnesota Q code, ST-segment depression code or T-wave inversion code as evidence of new myocardial infarction or new coronary heart disease event. Direct electrocardiogram (ECG) waveform comparison is a new standardized procedure for diagnosing interim myocardial infarction from ECGs classified according to the Minnesota code (serial Q-wave pattern change). This procedure was investigated for its application in epidemiologic studies.

Recruitment in the Hypertension Prevention trial. Hypertension Prevention Trial Research Group.

The Hypertension Prevention Trial (HPT) was a randomized, controlled, multicenter (four clinics, four resource centers) trial designed to test the feasibility of achieving and sustaining dietary changes in the intake of calories, sodium, and potassium and to assess the effect of those changes on blood pressure in a normotensive population. The trial involved 841 men and women (plus a test cohort of 78) who, at the first baseline (BL) examination were in the age range of 25-49 years and had diastolic blood pressure (DBP) greater than or equal to 76 but less than 100 mm Hg (average of two readings), and at the examination prior to randomization (BL 2), had DBP greater than or equal to 78 but less than 90 mm Hg (also averaged). Participants were randomly assigned to a control treatment group (no dietary counseling) or to one of four dietary treatment groups involving counseling designed to reduce calorie intake, reduce sodium intake, reduce sodium and calorie intake, and reduce sodium and increase potassium intake.

Body fat distribution and self-reported prevalence of hypertension, heart attack, and other heart disease in older women.

The associations of self-reported body mass and fat distribution with self-reported prevalence rates of hypertension, heart attack, and other heart disease were examined in a sample of 40,000 women, aged 55-69 years. Fat distribution was measured by the waist-to-hip circumference ratio (WHR), which had a mean +/- SD of 0.838 +/- 0.

Comparisons of cause of death verification methods and costs in the lipid research clinics program mortality follow-up study.

Classification of causes of death by a nosologist is standardized and relatively inexpensive, although the quality of the data recorded on death certificates has been subjected to criticism and the level of detail may not allow examination of specific circumstances of the death. A costly alternative is classification by a panel of physicians reviewing additional clinical information. The costs associated with both methods of classification as utilized by the Lipid Research Clinics Program Mortality Follow-up Study are presented along with their advantages and disadvantages.

Prevalence of "significant" hypertension in junior high school-aged children: the Children and Adolescent Blood Pressure Program.

Blood pressure (BP) data obtained during a BP screening program were analyzed to determine the prevalence of "significant" hypertension, defined by the Second National Heart, Lung, and Blood Institute Task Force on Blood Pressure Control in Children-1987 as the level of BP above which medical evaluation and intervention are recommended. In 14,686 black and white St. Paul and Minneapolis schoolchildren aged 10 to 15 years, BP was measured twice during an initial screening examination.

Cardiac status after four years in a trial on nutritional therapy for high blood pressure.

A randomized controlled trial demonstrated the ability of nutritional intervention in place of antihypertensive drugs to maintain blood pressure at normal levels for four years in 39% of less severely hypertensive patients whose blood pressure was previously well controlled by pharmacologic treatment. However, average blood pressures during the trial for patients in the intervention group were higher than those for a comparison group that continued to receive drug therapy throughout the study. Holter monitoring, echocardiography, roentgenography, and electrocardiography done at four years to determine whether blood pressure differences between groups were associated with differences in cardiac status did not indicate any differences in cardiac status favorable to one group compared with the other.

Electrocardiographic left ventricular hypertrophy and effects of antihypertensive drug therapy in hypertensive participants in the Multiple Risk Factor Intervention Trial.

Data are reported on electrocardiographic left ventricular hypertrophy (ECG LVH) among 8,012 men classified as hypertensive at baseline in the Multiple Risk Factor Intervention Trial. Compared with those allocated to the usual care (UC) control group, men allocated to the special intervention (SI) group experienced a mean reduction of 4 mm Hg in diastolic blood pressure and 7 mm Hg in systolic blood pressure, over 6 years of follow-up. There were 378 new cases of ECG LVH during follow-up; the incidence in the SI group was about 23% less than that in the UC group (4.

Effect of potassium supplementation combined with dietary sodium reduction on blood pressure in men taking antihypertensive medication.

It has long been suspected that sodium and potassium intake influence blood pressure. Since both these electrolytes can be modified by diet, attention has focused on decreasing sodium intake and increasing potassium intake as a potential way of treating and preventing hypertension. Several short-term controlled clinical trials have examined the effect of supplemental potassium intake on blood pressure, but with inconsistent results.

Accuracy and reliability of self-measurement of body girths.

Because body fat distribution has been recognized as a disease risk factor, practical methods for the measurement of body girths are needed. In two groups of postmenopausal women aged 55-69 years in the upper midwestern United States, the authors examined the reliability and accuracy of self-measurement by mail questionnaire of waist, hip, upper arm, wrist and calf girths. Intra-class correlations for waist girth were 0.

Discrepancies in racial designations of school children in Minneapolis.

To determine the frequency of inaccuracies in racial designations of school children in a health survey, racial designations were examined for a sample of 1,509 children in Minneapolis public schools who participated in the first home interview of the Minneapolis Children's Blood Pressure Study. The data were obtained from three sources: the school enrollment data based on parentally supplied information and teachers' visual judgments, school survey interviewers participating in a research project, and the parents themselves, at home interviews. Assuming the correctness of the information obtained from the parent in the home interview, cross tabulation comparisons were made of the accuracy of the information obtained from the other sources, and within sources.

Postural changes in blood pressure and pulse rate among black adolescents and white adolescents: the Minneapolis Children's Blood Pressure Study.

Because studies have suggested a possible relation between vascular responsiveness to postural changes and risk of subsequent myocardial infarction, the reactivity of blood pressure and pulse rate to change from supine to standing positions was examined in 158 black males, 144 black females, 342 white males, and 272 white females aged 14-16 years. The study was part of the Minneapolis Children's Blood Pressure Study and was conducted during October to December 1985. Two blood pressure readings and one pulse reading were taken after five minutes of supine rest, immediately upon standing, and five minutes after standing.

Persistent elevation of blood pressure among children with a family history of hypertension: the Minneapolis Children's Blood Pressure Study.

We examined the blood pressure of children with and without a family history of hypertension in a longitudinal study. Supine blood pressures were first measured in schoolchildren (mean age 8 years) in 1978 and then on nine more occasions until 1986. Blood pressures of parents were measured in the seated position and their medical histories were obtained in home interviews carried out between 1978 and 1979.

Coffee consumption and serum cholesterol in the hypertension detection and follow-up program.

The relation between coffee consumption and serum cholesterol level was investigated in a group of 9,043 hypertensive adults who were in the Hypertension Detection and Follow-up Program. In this study, men and women aged 30-69 years at baseline (1973-1974) had their serum cholesterol level measured at the two-year examination (1975-1976). Information about coffee, tea, and cola consumption was also obtained at that time from a food frequency questionnaire.

"Significant" diastolic hypertension in pre-high school black and white children. The children and adolescent blood pressure program.

The Second Task Force on Blood Pressure Control in Children defines "significant" hypertension as blood pressure persistently above the 95th percentile for age-sex specific distribution. In this report we present preliminary data on the prevalence of significant diastolic hypertension in pre-high school black and white children after repeated blood pressure measurements. Blood pressure was measured in 10,446 children two times at an initial screening in school and remeasured two times at a rescreening in 2,808 children from the upper 30 percentiles of the initial screening distribution.

Association of body fat distribution with plasma lipids, lipoproteins, apolipoproteins AI and B in postmenopausal women.

Associations between the distribution of body fat, measured by the waist/hip circumference ratio (WHR), and plasma lipid fractions were examined in 84 postmenopausal women. WHR was correlated r = 0.39 with body mass index (BMI).

Relation between ventricular premature complexes and sudden cardiac death in apparently healthy men.

The association between ventricular premature complexes (VPCs) detected on a rest 2-minute lead I electrocardiographic rhythm strip and sudden cardiac death (SCD), occurring within 1 hour of onset of symptoms, was evaluated in a prospective study of 15,637 apparently healthy white men, aged 35 to 57 years, at the first screening examination (1973 to 1975) to determine eligibility for the Multiple Risk Factor Intervention Trial in Minneapolis/St. Paul, Minnesota. The prevalence of any VPC was 4.

Trends in cardiovascular risk factors in an urban black population, 1973-74 to 1985: the Minnesota Heart Survey.

Cardiovascular disease mortality rates have fallen dramatically in blacks in the United States. To determine whether this may be due to a decline in cardiovascular risk factors, we compared risk factors in a 1985 urban black population, ages 35 to 69, with those obtained in blacks of the same area in 1973-74. Age-adjusted mean body mass and the prevalence of overweight increased significantly over the 12-year period in both men and women.

Prevalence and accuracy of home sphygmomanometers in an urban population.

The prevalence of ownership (7.5 per cent) and the accuracy of home sphygmomanometers were determined in a population-based survey in the Minneapolis-St. Paul metropolitan area.

The emerging prominence of computer electrocardiography in large population-based surveys.

The year 1987 marks the centennial of electrocardiography. As Beamish reminds us, it was the first and foremost technical aid to the cardiologist. During the history of cardiovascular epidemiology, which dates back roughly forty years, electrocardiography has played a central role as a relatively specific marker for coronary and hypertensive heart disease.

Natural variation in passive sodium permeability in human erythrocytes.

The rate of influx of 22Na+ into human erythrocytes (RBC) varies greatly depending upon the donor. A high rate of influx may be related to a congenital predisposition to essential hypertension. In Northern Europeans, we find a threefold difference in the rate of 22Na+ influx between those with the least (LP) and most highly permeable (HP) RBC (from less than 0.

Diuretics, serum potassium and ventricular arrhythmias in the Multiple Risk Factor Intervention Trial.

To examine the relation between diuretic use and ventricular premature complexes (VPCs) in the Multiple Risk Factor Intervention Trial, data derived from the baseline and annual rest electrocardiograms were analyzed for men in the special-intervention (SI) and usual-care (UC) groups. At baseline, age, diuretic use and presence of other rest electrocardiographic abnormalities were significantly associated with the prevalence of VPCs. Among diuretic users at baseline, those with lower serum potassium levels were most likely to have VPCs.