Abstract:
OBJECTIVE:To assess the efficacy of high serum cholesterol concentration, raised blood pressure, and smoking as predictors of coronary heart disease. DESIGN:Prospective cohort study of middle aged men conducted over 25 years. SETTING:Finish components of an ongoing international study (seven countries study). PARTICIPANTS:1520 Men who at age 40-59 in 1959 were free of clinically evident heart disease. INTERVENTIONS:At each follow up visit a detailed medical examination including resting electrocardiography was performed, blood pressure and serum total cholesterol concentration were measured, and smoking was assessed. MEASUREMENTS AND MAIN RESULTS:825 Deaths (54% of participants) occurred during follow up, of which 335 were due to coronary heart disease. The hazard ratio for death from coronary heart disease with respect to risk factors at entry were: for serum cholesterol concentrations above 8.4 mmol/l v below 5.2 mmol/l, 2.68 (95% confidence interval 1.62 to 4.42); for systolic blood pressure in the highest quintile v that in the lowest quintile, 2.46 (1.72 to 3.50); and for smoking 10 or more cigarettes daily v never smoking, 1.95 (1.36 to 2.79). The hazard ratios with respect to cholesterol concentrations and blood pressure remained constant during follow up but the ratio with respect to smoking diminished, mainly owing to men giving up the habit. The estimated conditional probability of a 50 year old man dying of coronary heart disease in the next 25 years ranged from 12% among those with the most favourable risk factor profile to 75% among those with the least favourable profile. CONCLUSIONS:High risk factor levels (as determined in this study) in middle aged men may greatly increase the absolute probability of death from coronary heart disease when the period of study is relevant to the human life span.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Pekkanen J,Nissinen A,Puska P,Punsar S,Karvonen MJdoi
10.1136/bmj.299.6691.81subject
Has Abstractpub_date
1989-07-08 00:00:00pages
81-5issue
6691eissn
0959-8138issn
1756-1833journal_volume
299pub_type
杂志文章abstract:OBJECTIVE:To assess whether sleep apnoea syndrome is an independent risk factor for hypertension. DESIGN:Population study. SETTING:Sleep clinic in Toronto. PARTICIPANTS:2,677 adults, aged 20-85 years, referred to the sleep clinic with suspected sleep apnoea syndrome. OUTCOME MEASURES:Medical history, demographic da...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.320.7233.479
更新日期:2000-02-19 00:00:00
abstract:OBJECTIVES:(a) To investigate defensive medical practices among general practitioners; (b) to compare any such practices with general practitioners' understanding of certain aspects of the terms of service and medical negligence and practitioners' concerns about the risk of being sued or having a complaint lodged. DES...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6971.27
更新日期:1995-01-07 00:00:00
abstract::For the past 18 years there has been a proliferation of European committees, boards, associations, colleges, and working groups set up to promote the harmonisation of specialist training in Europe. It has been taken as read that this objective is desirable. The fact that these bodies have achieved remarkably little is...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7000.297
更新日期:1995-07-29 00:00:00
abstract:OBJECTIVE:To compare patient outcomes of restrictive versus liberal blood transfusion strategies in patients with cardiovascular disease not undergoing cardiac surgery. DESIGN:Systematic review and meta-analysis. DATA SOURCES:Randomised controlled trials involving a threshold for red blood cell transfusion in hospita...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.i1351
更新日期:2016-03-29 00:00:00
abstract:OBJECTIVES:To identify risk factors predisposing to the development of flucloxacillin associated jaundice. DESIGN:Case-control study. Medical records of cases and controls were reviewed and information recorded on standard data collection forms. SETTING:Alfred Hospital recruiting subjects from Melbourne, Sydney, and ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6872.233
更新日期:1993-01-23 00:00:00
abstract::Hepatitis B virus (HBV) is a global health problem that can lead to cirrhosis and hepatocellular carcinoma (HCC). Although HBV vaccination has reduced the prevalence Of HBV infection, the burden of disease remains high. Treatment with antiviral drugs reduces the risk of liver disease and the development of HCC, and it...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.h4263
更新日期:2015-10-21 00:00:00
abstract:OBJECTIVES:To investigate the possible influence of attendance at cultural events, reading books or periodicals, making music or singing in a choir as determinants for survival. DESIGN:A simple random sample was drawn of 15,198 individuals aged 16-74 years. Of these, 85% (12,982) were interviewed by trained non-medica...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7072.1577
更新日期:1996-12-21 00:00:00
abstract:OBJECTIVES:To audit services for prenatal diagnosis for haemoglobin disorders in the United Kingdom. DESIGN:Comparison of the annual number of cases recorded in a United Kingdom register of prenatal diagnoses for haemoglobin disorders, with the annual number of pregnancies at risk of these disorders, by ethnic group a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.315.7111.779
更新日期:1997-09-27 00:00:00
abstract:OBJECTIVES:To investigate potential determinants of severe hypoglycaemia, including baseline characteristics, in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the association of severe hypoglycaemia with levels of glycated haemoglobin (haemoglobin A(1C)) achieved during therapy. DESIGN:Post ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.b5444
更新日期:2010-01-08 00:00:00
abstract:CLINICAL QUESTION:Do adults with atraumatic shoulder pain for more than 3 months diagnosed as subacromial pain syndrome (SAPS), also labelled as rotator cuff disease, benefit from subacromial decompression surgery? This guideline builds on to two recent high quality trials of shoulder surgery. CURRENT PRACTICE:SAPS is...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l294
更新日期:2019-02-06 00:00:00
abstract:OBJECTIVE:To determine whether the increased iron demands of pregnancy could be met by increased absorption from dietary sources. DESIGN AND SETTING:Longitudinal prospective study in the research unit of a maternity hospital. SUBJECTS:12 normal pregnant women. INTERVENTIONS:At 12, 24, and 36 weeks' gestation (within...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6947.79
更新日期:1994-07-09 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy in the treatment of patients with fever and neutropenia. DATA SOURCES:Medline, Embase, Lilacs, the Cochrane Library, and conference proceedings to 2002. References of included studies and contact wit...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.326.7399.1111
更新日期:2003-05-24 00:00:00
abstract:OBJECTIVE:To examine the association between warfarin treatment and longitudinal outcomes after ischemic stroke in patients with atrial fibrillation in community practice. DESIGN:Observational study. SETTING:Hospitals (n = 1487) participating in the Get With The Guidelines (GWTG)-Stroke program in the United States, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h3786
更新日期:2015-07-31 00:00:00
abstract:OBJECTIVE:To evaluate participants' perceptions of the impact on them of an additional six months' training beyond the standard 12 month general practice vocational training scheme. DESIGN:Qualitative study using focus groups. SETTING:General practice vocational training in Northern Ireland. PARTICIPANTS:13 general ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.327.7421.971
更新日期:2003-10-25 00:00:00
abstract:OBJECTIVES: To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself. DEIGN: Observational cohort study. SETTING: US Health and Retirement Study. PARTICIPANTS: 960 patients aged ≥65 (1998-2010) with fee-for-service Medicare coverage w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.i2375
更新日期:2016-05-17 00:00:00
abstract::London's health care problems, particularly underfunding, are mirrored in other major cities in the United Kingdom and abroad. None has found the perfect solution, but the debates on the Tomlinson report provide an opportunity to review how to manage the three major areas of service provision, medical education, and r...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6871.199
更新日期:1993-01-16 00:00:00
abstract:OBJECTIVE:To estimate the comparative clinical efficacy and acceptability of non-surgical brain stimulation for the acute treatment of major depressive episodes in adults. DESIGN:Systematic review with pairwise and network meta-analysis. DATA SOURCES:Electronic search of Embase, PubMed/Medline, and PsycINFO up to 8 M...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.l1079
更新日期:2019-03-27 00:00:00
abstract::In the existing WHO guidelines, complementary feeding at 4-6 months is advocated. However, many nutrition specialists believe that these guidelines lead to complementary foods being offered from the age of 3 months, or even earlier, subsequently suggesting that the WHO should change its recommendations to about 6 mon...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:
更新日期:2000-09-09 00:00:00
abstract:OBJECTIVE:To investigate the impact of patients' preferences for the treatment of atrial fibrillation, by using individualised decision analysis combining probability and utility assessments into a decision tree. DESIGN:Observational study based on interviews with patients. SETTING:Eight general practices in Avon. P...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.320.7246.1380
更新日期:2000-05-20 00:00:00
abstract:PROBLEM:Deep infection after joint arthroplasty can be catastrophic, leading to further surgery, loss of the prosthesis, disability, and risk of mortality. Twenty nine new cases of methicillin resistant Staphylococcus aureus occurred in the first year after elective orthopaedic surgery was centralised to a district gen...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.329.7458.149
更新日期:2004-07-17 00:00:00
abstract:OBJECTIVE:To determine whether short-term, oral low dose prednisolone (< or = 15 mg daily) is superior to placebo and non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis. DESIGN:Meta-analysis of randomised trials of oral corticosteroids compared with placebo or a non-steroidal anti-inflammatory...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.316.7134.811
更新日期:1998-03-14 00:00:00
abstract:OBJECTIVE:To examine associations between varenicline and the incidence of a range of adverse outcomes. DESIGN:Population based cohort study using within person analyses to control for confounding by indication. SETTING:Whole population of Sweden. PARTICIPANTS:7,917,436 people aged 15 and over, of whom 69,757 were t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h2388
更新日期:2015-06-02 00:00:00
abstract:OBJECTIVE:To evaluate the outcome of liver transplantation in patients with alcoholic cirrhosis with respect to selection criteria, survival, and evidence suggesting a return to harmful drinking. DESIGN:Nine year retrospective study. SETTING:Cambridge and King's College Hospital liver transplant programme. SUBJECTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6742.15
更新日期:1990-07-07 00:00:00
abstract::The recent growth in the numbers of published systematic reviews reflects growing recognition of their importance for improving knowledge about the effects of health care. In Britain the NHS R&D Programme has established two centres to prepare systematic reviews of existing information, and the Cochrane Collaboration-...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.309.6958.862
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:To assess the impact of a theoretically based sex education programme (SHARE) delivered by teachers compared with conventional education in terms of conceptions and terminations registered by the NHS. DESIGN:Follow-up of cluster randomised trial 4.5 years after intervention. SETTING:NHS records of women who...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.39014.503692.55
更新日期:2007-01-20 00:00:00
abstract:OBJECTIVE:To investigate whether users of oral contraceptives and in [corrected] carriers of a hereditary prothrombotic condition (factor V Leiden mutation, protein C, S, or antithrombin deficiency) have an increased risk of cerebral sinus thrombosis. DESIGN:Comparison of a prospective series of cases of cerebral sinu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7131.589
更新日期:1998-02-21 00:00:00
abstract:OBJECTIVES:To measure the prevalence of domestic violence among women attending general practice; test the association between experience of domestic violence and demographic factors; evaluate the extent of recording of domestic violence in records held by general practices; and assess acceptability to women of screeni...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.324.7332.274
更新日期:2002-02-02 00:00:00
abstract::South African Health Minister Dr. Manto Tshabalala-Msimang was accused of human rights abuse for refusing to supply zidovudine to all HIV-positive pregnant women. The accusations were laid by Dr. Costa Gazi, a South African doctor employed in the state health system with the Human Rights Commission. Dr. Gazi believe...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:
更新日期:2000-01-29 00:00:00
abstract:OBJECTIVE:To examine the effects of involving patients in the planning and development of health care. DATA SOURCES:Published and grey literature. STUDY SELECTION:Systematic search for worldwide reports written in English between January 1966 and October 2000. DATA EXTRACTION:Qualitative review of papers describing ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.325.7375.1263
更新日期:2002-11-30 00:00:00
abstract:OBJECTIVE:To evaluate the effect on general practitioners' prescribing of feedback on their levels of prescribing. DESIGN:Randomised controlled trial. SETTING:General practice in rural Australia. PARTICIPANTS:2440 full time recognised general practitioners practising in non-urban areas. INTERVENTION:Two sets of gra...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.318.7182.507
更新日期:1999-02-20 00:00:00