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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

96.3%, i.e., 7746 people, of the male personnel of a large French firm were surveyed to study the effects of smoking on the cardiovascular system. All males were between 43-54, and were regularly followed-up for 6 years after an initial, thorough visit. There were 399 deaths, of which only 23 were nonsmokers. The average yearly mortality rate was calcualted to be 3/1000 among nonsmokers, and 8.9/1000 among smokers, an incidence 3 times higher. Excess mortality of smokers was found among those with lung cancer or with coronary heart disease. The number of cigarettes smoked and inhaled had a great influence on the incidence of leg atherosclerosis and of coronary disease. Risk of ischemic cardiopathy was multiplied by 1.7 in people who smoked 20 cigarettes a day, and by 2.9 in people who smoked 40 cigarettes a day. A well organized campaign of health education conducted at national level would be highly advisable.
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PMID:[Tobacco, mortality and morbidity of atherosclerotic cardiovascular diseases--a prospective study in Paris]. 45 93

From 1951 to 1971 male doctors reduced their cigarette smoking more than did men in social classes I and II combined. In 1970-2, 665 male doctors died aged under 65. Had they shown the same improvements in cause-specific death rates over the 20 years as men in classes I and II, 699 deaths would have been expected. This "saving" of 34 deaths in the doctors comprised savings from coronary heart disease (83), stroke (16), and lung cancer (8) balanced by 60 "losses" from three stress-related causes--namely, accident, poisonings, etc (30); suicide (26); and cirrhosis of the liver (4)--plus 13 from other causes. As a relative reduction in mortality from heart disease in doctors (as compared with that in social classes I and II) also occurred during 1931-51--that is, before they began to give up smoking--some of the saving in heart-disease deaths in 1951-71 was probably not related to changes in smoking habits. The relative worsening in mortality from stress-related diseases may have been due partly to a possible adverse effect of giving up smoking if smoking had acted to reduce stress. From these findings, the benefits of giving up smoking may not be so great as has commonly been assumed.
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PMID:Has the mortality of male doctors improved with the reductions in their cigarette smoking? 53 59

Analysis of the clinical and post-mortem assessment of the underlying cause of death in 742 autopsies showed that over- and underdiagnosis cancelled each other out in the majority of the main diagnostic groups, so there was little difference in the total number of cases recorded in the different groups after clinical and post-mortem investigation. However, in the individual case the reliability of the clinical diagnosis varied greatly with the nature of the diagnosis and its degree of certainty. Reliability was for example high with clinically certain arteriosclerotic heart disease and low with cerebrovascular disease. Underdiagnosis of lung cancer is still a problem. Lack of interest in autopsy investigation may be reflection of lack of clinical involvement or therapeutic frustration rather than the use of sophisticated diagnostic procedures, as has been assumed by previous authors. It is suggested that the idea of selection of cases for autopsy should be replaced by selection of autopsies for microscopic investigation on the basis of the macroscopic post-mortem findings. It is suggested also that clinicians might profitably attend autopsies on patients in their sphere of interest that were not admitted under their care.
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PMID:Clinical and post-mortem assessment of the cause of death. 59 24

During a period of 28 months, all patients (79) who presented with bilateral bundle-branch block were selected for study from a private practice outpatient population. They were followed prospectively from the date of entry into the study and their charts were reviewed retrospectively. The average age of the participants was 73-3 years and they were observed clinically for a cumulative period of 4237 months (353-08 years). A high incidence of severe heart disease and death was noted among the study group. Twenty-four (30-3%) had a New York Heart Association functional classification of 3 or 4. Eight (10-1%) died. Only one patient died suddenly and he had had a stable electrocardiographic pattern of bilateral bundle-branch block for a period of 118 months (9 years 10 months). Seven patients required permanent pacemakers. In 6 instances death resulted from pump failure; in one it was the result of lung cancer. In none of these 7 individuals did rhythm disturbances contribute to death. In most cases vertigo was not of cardiac origin (88-2%). Eight patients had 11 major surgical procedures with no significant cardiac sequelae. Our observations suggest that elderly patients with chronic bilateral bundle-branch block should be managed conservatively. The prognosis in these patients appears primarily to be related to the degree of myocardial disease rather than to the conduction disorder.
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PMID:Chronic bilateral bundle-branch block. Long-term observations in ambulatory patients. 83 36

In 1951 the British Medical Association forwarded to all British doctors a questionnaire about their smoking habits, and 34440 men replied. With few exceptions, all men who replied in 1951 have been followed for 20 years. The certified causes of all 10 072 deaths and subsequent changes in smoking habits were recorded. The ratio of the death rate among cigarette smokers to that among lifelong non-smokers of comparable age was, for men under 70 years, about 2:1, while for men over 70 years it was about 1-5:1. These ratios suggest that between a half and a third of all cigarette smokers will die because of their smoking, if the excess death rates are actually caused by smoking. To investigate whether this is the case, the relation of many different causes of death to age and tobacco consumption were examined, as were the effects of giving up smoking. Smoking caused death chiefly by heart disease among middle-aged men (and, with a less extreme relative risk, among old men,) lung cancer, chronic obstructive lung disease, and various vascular diseases. The distinctive features of this study were the completeness of follow-up, the accuracy of death certification, and the fact that the study population as a whole reduced its cigarette consumption substantially during the period of observation. As a result lung cancer grew relatively less common as the study progressed, but other cancers did not, thus illustrating in an unusual way the causal nature of the association between smoking and lung cancer.
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PMID:Mortality in relation to smoking: 20 years' observations on male British doctors. 100 86

In the contemporary United States, males have 60 percent higher mortality than females. In Part I, published in the previous issue, we showed that 40 percent of this sex differential in mortality is due to a twofold elevation of arteriosclerotic heart disease among men. Major causes of higher rates of arteriosclerotic heart disease in men include greater cigarette smoking among men; probably a greater prevalence of the competitive, aggressive Coronary Prone Behavior Pattern among men; and possibly a protective role of female hormones. In addition, men have higher death rates for lung cancer and emphysema, primarily because more men smoke cigarettes. In Part II we analyze the other major causes of men's higher death rates: accidents, suicide, and cirrhosis of the liver. Each of these is related to behaviors which are encouraged or accepted more in men than in women in our society--for example, using guns, being adventurous and acting unafraid, working at hazardous jobs and drinking alcohol. We conclude with suggestions for reducing male mortality; for example, by changing the social conditions which foster in men the behaviors that elevate their mortality.
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PMID:Why do women live longer than men? 101 15

Emergency pericardiocentesis, guided by a two-dimensional echocardiography, was performed on twenty patients with symptomatic pericardial effusion of various types and causes. There were fourteen men and six women. The underlying causes were: primary lung cancer (6 cases), metastatic cardiac tumors (3 cases), tuberculosis (4 cases), complicated interventional procedures with cardiac chamber or vessel perforations (2 cases), dissecting aortic aneurysm (1 case), systemic lupus erythematous (1 case), idiopathic pericarditis (1 case), bacterial pericarditis (1 case), and myxedema heart disease (1 case). Seventeen cases were performed through the left xipho-sternal approach and 3 cases through the apical approach. None of the patients died as a result of these procedures. A two-dimensional echocardiogram is useful in diagnosing cardiac tamponade as well as in guiding pericardiocentesis, and obtaines highly positive results (20/20). The positive rate of pericardial fluid cytology for malignant cells was 89% (8/9), however, pericardial fluid cultures or direct smear for tuberculosis were negative (0/4). In cancer patients, the mean survival time following pericardiocentesis was 4.2 months (range, 1-7.8 months). We concluded that neoplastic involvement of the pericardium is the most frequent cause of symptomatic pericardial effusion. Pericardiocentesis assisted by a two-dimensional echocardiogram is safe and easy. In addition, pericarditis caused by TB is still significant and must be considered in every case in our nation.
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PMID:Pericardiocentesis: a 20 patients study. 133 Feb 47

This is the second update of a study of 3,444 taconite miners and millers who were first exposed to taconite, with associated exposures to silica and nonasbestiform amphiboles, in the period 1947 through 1958. Previous analyses of deaths through 1977, and again through 1983, showed no significant excess deaths from any specific causes. The present study continues the follow-up through 1988, adding 14,748 person-years of observation and 261 death certificates for analysis. The population, reduced to 3,431 because of the detection of 13 earlier duplications, has now been observed for 101,055 person-years, with 1,058 deaths and 1,039 death certificates. Death certificates were obtained for 98.2% of those known to be dead. The total number of deaths was significantly fewer than expected. Based on US rates, the standardized mortality ratio (SMR) was 83 (ie, 83% of expected). Based on Minnesota death rates, it was 91. With both US and Minnesota death rates, the SMRs for malignant neoplasms, cancer of the respiratory tract, cancer of the digestive system, heart disease, nonmalignant respiratory disease, and cirrhosis of the liver were all below 100. Slightly elevated SMRs were found for cancer of the colon, cancer of the kidney, and lymphopoietic cancer. These elevations were not statistically significant. Separate analyses were made of total deaths, lung cancer deaths, and kidney cancer deaths in men who had worked with taconite for time periods of less than 1 year, 1-5 years, 5-10 years, and over 10 years, during observation periods less than 10 years, 10-20 years, and over 20 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An updated study of taconite miners and millers exposed to silica and non-asbestiform amphiboles. 133 7

Over one quarter of the risk of death due to the sudden infant death syndrome (cot death) is attributable to maternal smoking. Maternal smoking during pregnancy and infancy is one of the most important avoidable risk factors for infant death. Nicotine is a drug of addiction. Many young smokers are addicted to nicotine and develop withdrawal symptoms on stopping. Smoking is an important marker for other types of drug abuse, e.g. alcohol, cannabis and cocaine. The earlier children start smoking, the greater the risk of lung cancer and heart disease. Smoking affects immunity and has been associated with an increased risk of acquiring human immunodeficiency virus-1 infection.
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PMID:Smoking and the young. 146 39

To assess sociodemographic differences in beliefs about the health effects of cigarette smoking and passive smoke exposure, we recently surveyed 2092 adults in St. Louis and Kansas City, Mo. The percentages of respondents who knew that smoking causes lung cancer, emphysema, and heart disease were 76.7, 74.1, and 67.2, respectively. After multivariate adjustment, knowledge about smoking's health effects was generally lower among women, older respondents, those of lower education level, and current smokers. Blacks were generally less likely to appreciate the health effects of active smoking, but were more likely to acknowledge the health effects of passive smoking.
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PMID:Demographic and socioeconomic differences in beliefs about the health effects of smoking. 153 45


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