Posted by James
BACKGROUND
Approximately 80% of the world’s smokers live in developing countries. While the prevalence of cigarette smoking has declined over the past two decades in developed countries, smoking prevalence continues to rise in the majority of developing countries. Tobacco is fast becoming the single leading cause of death worldwide and is estimated to kill nearly 10 million people per year by 2030. If current trends continue, an estimated one billion people worldwide will die from tobacco use in the 21st century. Approximately 70% of these tobacco-related deaths will occur among smokers in developing countries.
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Posted by James
An urban hospital setting, the prevalence of first-degree AV block is slightly less in African-American patients compared with Caucasian patients. The greatest contrast of the prevalence of first-degree AV block between the two ethnic groups occurs in the 10th decade of life when the prevalence of first-degree AV block rises to a level of 23.3% (n=10 of 43) in African-American patients compared with only 12.2% (n=22 of 181) in Caucasian patients in the same age group; p=0.06. The cause of the reduced prevalence of first-degree AV block in Caucasian patients in the 10th decade of life is not known. Although the sample size is relatively small for analysis, and the statistical relationship approaches—but does not achieve—traditional criteria of significance, one can speculate that the presence of various disease states involving the AV node could lead to complete AV block, death, or the implantation of an electronic pacemaker. Such a series of events would result in a decreased prevalence of first-degree AV block in Caucasian patients in the 10th decade of life. A similar observation was reported in an earlier study of intraventricular block in which there was a dramatic reduction in the prevalence of left ventricular conduction block in both ethnic groups in the 10th decade of life. This suggested failure of left ventricular conduction with advancing age due to increasing sclerosis of the left ventricular conduction system.
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Posted by James
Figure and Table 1 demonstrate the gradual rising prevalence of first-degree AV block with advancing age in both ethnic groups. In the study group (Table 1), 6.9% (n=64 of 922) African-American patients had first-degree AV block, compared with 7.0% (n=84 of 1,201) Caucasian patients. For African-American patients, there is a gradual rise in the prevalence of first-degree AV block beginning at age 50 years and peaking in the 10th decade of life at 23.3% (n=10 of 43) patients. For Caucasian patients there is a gradual rise in the prevalence of first-degree AV block beginning at age 50 years with peaking in the ninth decade of life at 14.6% (n=26 of 178) patients, followed by a decline in the 10th decade of life to 12.2% (n=22 of 181) patients. First-degree AV block is more prevalent in African-American patients compared with Caucasian patients in all age groups of the study except for those patients in the eighth decade of life.
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Posted by James
The study group consisted of 2,123 patients— 1,201 Caucasian patients and 922 African-American patients—attending the hospital as both inpatients, outpatients, and the emergency department. These patients had an ECG recorded as part of their examination, and they were divided according to patient age into 10-year groups beginning at the third decade of life and extending through the 10th decade of life. ECGs recorded between October 28, 1996 and June 30, 1998 were retrieved from the files of the Carter Smith, Sr. ECG Laboratory of the hospital in groups of 95 to 250 ECGs for each age group of both African-American and Caucasian patients. The number of patients in each age group varied because of differing numbers of patients in the study groups attending the hospital but averaged 115 for African-American patients (range: 43-167) and 150 for Caucasian patients (range: 104-181). Each group of ECGs was studied in a consecutive manner. When a series of ECGs were recorded on a patient, the earliest ECG was chosen as the one of study. All ECGs were recorded with the patient supine using the computer programs of the Marquette Electronic MAC8 Resting ECG Analysis system at a paper speed of 25 mm/s, and the author reviewed all ECG interpretations. Correlation of the patient’s ECG and hospital diagnosis was not within the scope of this study. All calculations of the prevalence of first-degree AV block were rounded off to the nearest 10th of a percent.
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Posted by James
It is the purpose of this study to present data on the prevalence of first-degree atrioventricular (AV) conduction block in African-American and Caucasian patients attending an urban hospital. In earlier studies of racial differences of the electrocardiogram (ECG), African-American patients attending an urban hospital had atrial fibrillation and intraventricular block significantly less frequently than Caucasian patients. Piedmont Hospital in Atlanta, GA is a 500-bed tertiary care facility offering a wide variety of medical, surgical, and diagnostic services (including invasive cardiovascular treatment, and cardiovascular surgery). The hospital serves a metropolitan area with 4.1 million people.
Posted by James
Findings resulted from our study of the relation of nutritional status and pulmonary function in rural Fulani males as compared to urban males. First, there was a significant difference in the nutritional status of the two study populations as assessed by weight, BMI, mid-arm circumference, and triceps skin-fold thickness measurements. Although the mean heights of both groups were identical (1.70 m), the Fulani men weighed, on average, about 9 kg less than their urban counterparts, which translated into a mean difference in BMI between the two study populations of 3.1 kg/m2. In light of the observed difference in BMI, it was not unexpected, therefore, to find that mid-arm circumference and triceps skinfold thickness were also decreased in the Fulani men, since mid-arm circumference and triceps skin-fold thickness are indices of muscle mass and subcutaneous fat, respectively. The anthropometric variations we observed between these two groups of subjects corresponded with observations made in previous studies of these same populations.
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Posted by James
Comments on the Study Population
The study subjects were well-matched with respect to age: the mean ages of the urban subjects (Jos) and rural Fulani were 39.6 ± 11.7 and 35.0 ± 14.8 years, respectively, with no significant difference between the mean ages of the two groups. The mean heights of the men in the two groups were identical at 1.70 m (Table 1). However, on average, the Fulani men weighed about 9 kg less than the males in Jos (58.5 ± 9.4 versus 67.4 ±11.3 kg, respectively, pO.001). Consequently, the BMI was lower in the Fulani men (20.3 ± 2.5 versus 23.4 ± 3.5 kg/m2, respectively, p<0.001). To obtain information about body composition, the mid-arm circumference, which is proportional to lean body mass, and triceps skin-fold thickness, which is proportional to body fat, were measured. Both parameters were significantly lower in the Fulani subjects compared with the urban males: the mean mid-arm circumference and triceps skin-fold thickness in the rural Fulani and Jos subjects were 25.0 ± 2.2, 27.6 ± 3.5 cm (p<0.001); and 5.23 ± 1.4, 7.60 ± 3.6 mm (p<0.001), respectively.
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