摘要:

Purpose and Patients and Methods:The purpose of this study was to determine the relationship between diabetes and the development of some peripheral arterial findings— carotid and femoral bruits and nonpalpable pedal pulse—and acute cardiovascular events in 1,196 men and 1,582 women based on 20-year follow-up data in the Framingham Study.Results:For both men and women without diabetes, the incidence of carotid bruits and noapalpable pedal pulses increased significantly with age (p<0.05) without any apparent male predominance. In contrast, diabetic men and women were at an elevated risk of each peripheral arterial condition that was not appreciably different aoross age groups. Compared with women without diabetes, those with diabetes experienced nearly a twofold excess of femoral bruits (p<0.05) and a 50% excess of nonpalpable pedal pulses (p<0.01). Among men, diabetes nearly doubled the risk of carotid bruits (p<0.05). Those who had both diabetes and symptoms of peripheral arterial disease were at especially high risk of incident cardiovascular events. In particular, nonpalpable pedal pulses were associated with more than a twofold excess of coronary heart disease (p<0.05) and stroke (p<0.01) in diabetic women and more than a twofold excess of coronary heart disease and cardiac failure in diabetio men (p <0.01). Femoral bruits doubled the risk of coronary heart disease in diabetic men (p<0.05).Conclusion:We conclude that while diabetes predisposes to various forms and locations of peripheral arterial disease, the enhanced risk of aoute cardiovascular events experienced by diabetic patients is increased further when diabetes is accompanied by indications of a peripheral arterial condition. Since signs of peripheral arterial disease may suggest an impending or coexistent atherosclerotic process, careful examination of arterial circulation by evaluating peripheral pulses and assessing whether bruits are present is important.

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Using data from the 1986 Adult Use of Tobacco Survey, we analyzed smoking-cessation methods used by adult smokers in the United States who tried to quit. About 90% of successful quitters and 80% of unsuccessful quitters used individual methods of smoking cessation rather than organized programs. Most of these smokers who quit on their own used a “cold turkey” approach. Multivariate analysis showed that women, middle-aged persons, more educated persons, persons who had made more quit-smoking attempts, and particularly, heavier smokers were most likely to use a cessation program. Daily cigarette consumption, however, did not predict whether persons would succeed or fail during their attempts to quit smoking. Rather, the cessation method used was the strongest predictor of success. Among smokers who had attempted cessation within the previous 10 years, 47.5% of persons who tried to quit on their own were successful whereas only 23.6% of persons who used cessation programs succeeded. We conclude that cessation programs serve a small, but important, population of smokers that includes heavier smokers, those most at risk for tobacco-related morbidity and mortality.

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1991

数据来源: OVID