摘要:

AbstractStroke mortality is declining fast in many countries (this decline being due, in part, to treatment), with implications for medical care and for coronary disease incidence, but in some European countries rates are rising. Coronary mortality is decreasing fast in some countries, probably because of a fall in incidence; dietary and other life‐style changes are likely to be involved, but lack of systematic monitoring inhibits firm conclusions. In other countries with comparable medical care the rates have not declined, and in eastern Europe and sections of developing populations they are rising fast. Some implications are discusse

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03599.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

AbstractTrends in mortality from Ischemic Heart Disease (IHD) and other principal causes of death, and in hospital admission rates for Acute Myocardial Infarction (AMI) have been studied in residents aged 35–64 years of the Perth Statistical Division for the period 1968–1982. Death rates were based on data abstracted from official statistics or computer tapes of unit death records. Hospital admission rates were derived from the computer tapes of the Western Australian Hospital Inpatient Survey, 1968–1982.Since 1968, mortality from IHD has fallen in the Perth Statistical Division in both males and females by 30% and 33%, respectively. This fall has occurred principally in deaths occurring out‐of‐hospital and has been accompanied by similar fails in mortality from other vascular diseases and in total mortality. Hospital admission rates for Acute Myocardial Infarction (AMI) in the Perth Statistical Division have fallen since 1971 by 17% in males and 27% in females. These findings taken together suggest that the improvement in IHD mortality in Western Australia has been due mainly to a fall in the incidence of acute manifestations of IHD (sudden death and AMI), rather than improvements in case fatality. The possible underlying mechanisms responsible for this are

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03600.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:Ischemic heart disease is the major cause of death in Australia. Australian attack and mortality rates from this disease are high compared with most other countries. Over the last thirty years there have been remarkable changes in heart disease death rates which rose from the 1950's until around 1965–7 and then declined by about 40% over the period 1965–7 to 1980–81. Although the pattern of this decline was similar for most age groups and both sexes it varied among subgroups of the population defined by country of birth, geographic region and occupation. For example, Australian‐born men initially had higher death rates than immigrants and they experienced relatively greater declines; Perth and Adelaide (with low initial rates) had similar declines to Sydney and Brisbane (with high rates); professionals (with the lowest rates) had the greatest decline among occupational groups.While the decline in mortality is encouraging the cause is still unclear so control programmes must proceed, to some extent, by guesswork. If the subpopulations with high mortality can achieve rates comparable with subpopulations with low rates further substantial decline in heart disease mortality is p

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03601.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:The National Heart Foundation's Risk Factor Prevalence Survey in 1980 is described. Results for the prevalence of hypertension, smoking, hyperlipidemia, obesity and inactivity from the 1980 survey are presented. A second study was conducted in 1983 and a third is planned for 1986 or later. These surveys provide unique data on risk factors in Australians, and hold the prospect of determining trends which may be relevant to overall mortality trends in cardiovascular disease.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03602.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:Vegetarian diets produce moderate but appreciable changes in serum lipid levels. A six‐weeg intervention study in which other aspects of life‐style were kept constant showed that levels of total cholesterol, LDL‐cholesterol and HDL‐cholesterol fell 0.22, 0.19 and 0.07 mmol/l, respectively, while triglyceride levels increased non‐significantly 0.12 mmol/l. The ratio of total cholesterol to HDL‐cholesterol did not change. A comparison of grous of habitual vegetarians and omnivores matched for other aspects of lifestyle showed rather larger differences in atherogenic lipid levels: 0.71 and 0.67 mmol/l for total— and LDL—cholesterol; the difference in HDL‐C levels was 0.04 mmol/l; triglyceride was 0.19 mmol/l greater in vegetarians. 92% of the variation in intakes of major nutrients was accounted for by three derived factors; changes in levels of most of the lipids were associated in each case with one of the factors. The resultant falls in the levels of total‐and LDL‐cholesterol in people adopting a vegetarian diet probably contribute to a reduction i

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03603.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:Historical trends are presented showing an increase in total cigarette consumption but a fall in the number of adult male smokers. The prevalence of smoking among children appears to have increased. The role of tobacco advertising and reduced cigarette prices are discussed. The need to prevent children from taking up smoking is emphasised, and recent data show that the earlier a child begins to smoke, the higher will be the subsequent daily cigarette consumption.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03604.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:Sixty‐four subjects Who participated in a smoking withdrawal programme were analysed with respect to the relative usefulness of biochemical and hematological indices ofsmoking exposure. Plasma thiocyanate was foundto be the best biochemical correlate of baseline cigarette consumption when compared to salivary thiocyanate or expiredair carbon monoxide. Both plasma and salivary thiocyanate also correlated significantly with depth of inhalation per cigarette but not with any other questionnaire index of smoking exposure. After six weeks of successful smoking cessation all three indices fell significantly. Plasma thiocyanate proved the most sensitive biochemical index for monitoring ultimate outcome, accurately dichotomizing 90% of subjects as successful or unsuccessful in their attempts to stop smoking. The use of all three variables allowed accurate classification of 96% of subjects. White cell count, red cell count and hemoglobin also correlated significantly with baseline cigarette consumption and a significant decrease in these hematological indices occurred consequent to successful smoking cessation. However, these hematological changes were not as sensitive as biochemical indices in monitoring successful outcom

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03605.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:This paper describes multiple risk factor intervention, its rationale and the form it takes, referring to recent intervention trials and the issues arising from their approaches and outcomes. Some questions relevant to intervention are raised and some guesses made as to future directions and opportunities.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03606.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:The efficacy of the Sydney ambulance paramedic service in dealing with out‐of‐hospital cardiac and other emergencies was examined. The outcome of 182 cases (from a total of 1,799 casualty calls) treated by a paramedic service was compared with the outcome of 104 similar cases (from a total of 2,376 calls) treated by a general duties service. There were 33 cases of cardiac arrest in the general duties group; resuscitation was attempted in 12 and none survived. There were 49 cases of cardiac arrest in the paramedic group; resuscitation was attempted in 21 cases and 4 survived. There were 35 cases of suspected myocardial infarction in the general duties group; 7 died compared with 58 cases and 4 deaths, in the paramedic group (mortality 20%,cf. 7%; difference not significant). The increased cost of a paramedic call, less than half of an entire hospital day, appears justified by better resu

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03607.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Abstract:Death rates over a nine year period were studied in 1,232 survivors of myocardial infarction. From 1973 to 1981, the 29 to 365 day case fatality rate in 28 day survivors dropped from 13.3% to 3.2%. This down‐trend in case fatality was highly significant, averaging 14.3% in each year. After adjustment for changes in age and severity of infarction, using a prognostic score derived from the Perth Coronary Register (the PCR score), the estimated decline was still 12.2% in each year. During the nine years, the rate of coronary surgery in the post‐infarction year rose from 1.5% to 12.0%. Overall, the surgically treated cases had a lower case fatality rate (1.6%) than the medically treated cases (7.7%). However, the surgical cases had a better prognosis at the time of infarction than the medical cases. When the severity of infarction (PCR score) and year of admission were considered, coronary surgery in the post‐infarction year had no independent effect on ou

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1984.tb03608.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY