Mass examination in organized populations at industrial enterprises made it possible to bring to light a statistically significant different effect of the level of productive labor and sport activity on the prevalence of frequent alcohol consumption as one of CHD risk factors. A sufficient degree of regular physical training made a considerable effect on a decrease in CHD prevalence.
In the cross-sectional population study of 411 subjects aged 35-64 years and longitudinal 5.5-year follow-up of 157 aged 20-54 years, a relationship was examined between pulse blood flow to the cerebral vessels, their tone as assessed by rheoencephalography and resistance to arterial hypertension, coronary heart disease, and brain vascular lesions. The proportion of healthy persons (without the above-mentioned diseases) was shown to be larger if the pulse blood flow to the cerebral vessels was higher and their tone was lower. In the longitudinal study, the probability to remain healthy was demonstrated to be increased with elevated pulse flow to the cerebral vessels.
This is the first paper in a four-part series that presents an updated protocol for selective longitudinal health maintenance of asymptomatic adults. Five conditions related to atherosclerotic diseases are reviewed with reference to six generally accepted screening criteria. A recommendation is made for each condition and is compared, when appropriate, with the recommendations of the Canadian Task Force on the Periodic Health Examination. In the fourth paper, the recommendations will be combined into a practical health maintenance flow sheet for use by primary care physicians.
We have developed a targeted approach to identification of high-risk patients in British Columbia, Canada, as an initial strategy for the prevention of coronary disease. Patients with the diagnosis of familial hypercholesterolemia have been identified through the Lipid Clinic. First degree relatives of these persons and subsequently identified individuals will be screened for the presence of hypercholesterolemia. Using this approach, the likelihood of identifying persons at high risk is high, close to 50%. The program will also allow collection of data on factors affecting the expression of hyperlipidemia and atherosclerosis and their response to therapy. In an effort to establish the infrastructure that would be necessary for identification and management of such patients throughout the province, a Lipid Clinic Outreach Program has been developed. The objective is to provide each community in the province with expertise to manage hyperlipidemia without traveling to a major urban area. With this infrastructure in place, this will serve patients who have premature atherosclerosis due to other causes and will also form the framework for dissemination of heart health policies and programs by different levels of government, voluntary and professional organizations, as well as the private sector. From a targeted family centered pilot program, a broad approach to the prevention of coronary artery disease in this community will be possible.
BACKGROUND: Familial hypercholesterolemia (FH) is one of the most common genetic metabolic disorders and is associated with a high risk of premature coronary heart disease. Primary prevention directed at lifestyle changes, combined with preventive medical treatment, is the most important way to reduce the risk of coronary heart disease in individuals with FH. Knowledge about the condition and adherence to drug treatment may facilitate reaching treatment goals. OBJECTIVE: The purpose of this study was to describe disease knowledge and adherence to treatment in patients with FH. SUBJECTS AND METHODS: Seventy-four patients, more than 18 years of age, with FH were asked to participate. A questionnaire on disease knowledge about FH and adherence to drug treatment was sent to the patients. Response rate was 92% (n = 68). Drug treatment, laboratory results, blood pressure, and smoking were also documented. RESULTS: Most patients knew about cholesterol, prevention, and the reason for drug treatment but were less informed about the risk of genetic transmission and family history. No significant correlation was found between knowledge and low-density lipoprotein cholesterol level. A significant, negative correlation between adherence and low-density lipoprotein cholesterol level was found (r = -.354, P
To evaluate the ability of doctors in primary care to assess risk patients' risk of coronary heart disease.
Continuing medical education meetings, Ontario and Quebec, Canada.
Community based doctors who agreed to enroll in the coronary health assessment study.
Ratings of coronary risk factors and estimates by doctors of relative and absolute coronary risk of two hypothetical patients and the "average" 40 year old Canadian man and 70 year old Canadian woman.
253 doctors answered the questionnaire. For 30 year olds the doctors rated cigarette smoking as the most important risk factor and raised serum triglyceride concentrations as the least important; for 70 year old patients they rated diabetes as the most important risk factor and raised serum triglyceride concentrations as the least important. They rated each individual risk factor as significantly less important for 70 year olds than for 30 year olds (all risk factors, P
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