Harmful and beneficial relationships between alcohol consumption and subclinical atherosclerosis.

BACKGROUND AND AIMS: Arterial stiffness and increased intima-media wall thickness are two of the main predictors of cardiovascular disease (CVD). We evaluated whether brachial-ankle pulse wave velocity (baPWV) and common carotid artery intima-media wall thickness (CCA-IMT) are correlated with alcohol consumption in a cross-sectional study among Korean men and women aged 40 years and over. METHODS AND RESULTS: All 5539 subjects (2121 men and 3418 women) were participants in the Multi-Rural Communities cohort (MRcohort) study, a part of the Korean Genome Epidemiology Study (KoGES). The baPWV was positively correlated with alcohol consumption in men (p for trend <0.0001). Age (middle-aged versus elderly) modified the effect of alcohol consumption on PWV. On the other hand CCA-IMT decreased with alcohol consumption in men. There was no favorable zone of alcohol consumption in terms of baPWV and CCA-IMT. Adjustment for lipid profiles substantially attenuated the relationship between alcohol consumption and CCA-IMT. There was no clear relation between alcohol consumption and baPWV/CCA-IMT in women. CONCLUSIONS: Along with a linear harmful relationship between alcohol consumption and arterial stiffness in men there may also be a beneficial relationship between alcohol consumption and carotid intima-wall thickness. The effect of alcohol on arterial stiffness may be slightly stronger in elderly men, and the effect of alcohol on CCA-IMT may be mediated by lipid factors.

Prevalence and disease experience rates in Korean physicians.

This study aimed to find out the morbid status of Korean physicians living in Korea, as one part of a feasibility study on the Korean physician cohort. It was performed by mail survey using a self-administered questionnaire from Jan. 1, 1995 through Dec. 31, 1995. Study subjects were 21,552 including 17,877 (81.1%) males and 3,384 (15.5%) females. Person based prevalence rate of disease was 17.7% (18.3% for males and 13.8% for females) with the rate increasing with age. The disease group showing the highest prevalence rate was circulatory diseases (5.16%) for males, and respiratory disease (3.13%) for females. The individual disease showing the highest prevalence rates was hypertension (3.77%) for males and allergic rhinitis (2.25%) for females. The person based disease experience rate was 36.2% (36.9% for males, 32.7% for females) with the rate increasing with age. The disease group showing the highest disease experience rate was digestive disease for both sexes (10.05% for males, 7.42% for females). Individual disease showing the highest disease experience rate was hypertension (5.00%) for males and allergic rhinitis (4.08%) for females. There were different ranks of both prevalence and disease experience rate depending on age in both sexes.

The impact of diabetes on survival among patients with first myocardial infarction.

OBJECTIVE: The purpose of this paper is to estimate the impact of diabetes on survival among patients with first acute myocardial infarction, using data from the World Health Organization (WHO) Monitoring Trends and Determinants of Cardiovascular Disease (MONICA) Project in Newcastle, New South Wales, Australia. RESEARCH DESIGN AND METHODS: The WHO MONICA Project is a community-based surveillance system that monitors coronary heart disease morbidity and mortality. All patients with suspected coronary events were observed for 28 days after the onset of symptoms. RESULTS: Of 5,322 patients with acute myocardial infarction and no previous history of ischemic heart disease (3,643 men and 1,679 women), 333 men (9%) and 224 women (13%) had a history of diabetes. The age-adjusted 28-day case fatality for women with diabetes (25%) was significantly higher than for women without diabetes (16%); relative risk 1.56 (95% CI: 1.19-2.04). The difference for men was also significant (25% with diabetes and 20% without diabetes); relative risk 1.25 (95% CI: 1.02-1.53). Age-specific case fatality increased significantly with age in both men and women without diabetes, but systematic age effects were not so apparent in patients with diabetes. Case fatality significantly decreased over the study period in patients without diabetes, but not among the diabetic patients. CONCLUSIONS: The increased risk of death in the diabetic patients remained after accounting for their poorer risk factor profiles; even if they reached the hospital alive, diabetic patients were also less likely to survive than nondiabetic patients. The relative impact of diabetes on survival is greater in women than in men.

Illness associated with contamination of drinking water supplies with phenol.

An accidental spill of phenol (100%) into the Nakdong river with subsequent contamination of the tap water for about two million consumers in Teagu city of Korea occurred in March 1991. A historical cohort study of 6,913 individuals was undertaken to determine association with illness. Population subjects were divided into two groups of exposed and unexposed. Exposed subjects were reported to have significantly more phenol associated symptoms than those in a nearby unexposed area (39.6% vs. 9.4%, p < 0.01). Especially, in the related symptoms, highly significant differences were noted in the number of subjects reporting gastrointestinal illness such as nausea, vomiting, diarrhea, or abdominal pain. During the accident, study subjects who experienced peculiar taste or odor in the tap water were significantly more in the exposed areas (92% vs. 34.3%).

Smoking and the incidence of coronary heart disease in an Australian population.

OBJECTIVE: To estimate the impact of smoking on the incidence of coronary heart disease in Australia. Data collected for the WHO MONICA Project were used. DESIGN: Combined data from a community-based register of all suspected coronary events and a survey of risk factor prevalence in a random sample of the same population. SETTING AND PARTICIPANTS: All residents of the Hunter Region of New South Wales aged 35-69 years who had a first acute myocardial infarction or fatal heart attack (without a history of coronary heart disease) between 1 January 1986 and 31 December 1990. MAIN OUTCOME MEASURES: Acute myocardial infarction or coronary death, as defined by the WHO MONICA Project. RESULTS: Men who are current smokers are 2.9 times (95% CI, 2.7-3.1) more likely than non-smokers to have a first myocardial infarction or fatal heart attack, and for women the equivalent figure is 3.5 times (95% CI, 3.2-3.8), after adjusting for age. Current male smokers with a history of hypertension are 4.5 times more likely to have a coronary event (7.9 times in women) than are non-smokers without a history of hypertension. The age-adjusted excess rate was 566 per 100,000 per year in men and 373 per 100,000 per year in women. Smoking is a stronger predictor of coronary heart disease incidence than a history of hypertension (relative risk [RR] = 1.6 for men and 1.9 for women) or a known history of hypercholesterolaemia (RR not significantly different from 1). CONCLUSIONS: Cigarette smoking plays a more important role in the causation of a first myocardial infarction or fatal heart attack and appears to have more influence on the incidence of coronary heart disease in Australia than hypertension.