Coffee and cardiovascular risk: epidemiological findings in Austria.

The results of studies on the connection between the consumption of coffee and cardiovascular risk factors have been conflicting, particularly concerning serum lipids. We examined several associations in a representative sample of 1203 men and women between 25 and 64 years of age in the state of Vorarlberg, Austria. Coffee consumption correlated significantly (p less than 0.001) with the number of cigarettes smoked per day (men: r = 0.30; women: r = 0.26) and the prevalence of smokers (men: r = 0.27; women: r = 0.25). We found no adverse effect of coffee on blood lipids or lipoproteins. The lack of evidence was independent of smoking habits in both sexes. We suggest that the lack of evidence is due to the usual method of preparing coffee in Vorarlberg, ie percolated or as 'Espresso'.

Recent trends and sociodemographic distribution of cardiovascular risk factors: results from two population surveys in the Austrian WHO CINDI demonstration area.

OBJECTIVE: The major risk factors for cardiovascular diseases are well established; however, only a few studies report on recent trends in risk factor profiles. This study analyses the sociodemographic distribution of risk factors and gives an account of their changes from 1991 to 1999. METHODS: Two cross-sectional population surveys as part of the CINDI (Countrywide Integrated Noncommunicable Diseases Intervention) program of the World Health Organization were performed in 1991 and 1999 in the province of Vorarlberg (Austria). The surveys included a standardized interview and a medical examination. 1863 persons aged 25 to 64 years in 1991 and 1550 persons in 1999 participated in the interview section of the surveys. From these, 1446 in 1991 and 841 persons in 1999 underwent medical examination. Prevalence of overweight and obesity, mild and severe hypertension, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, regular smoking and lack of physical activity were estimated. Framingham risk functions were calculated to compare overall risk for coronary heart disease. RESULTS: In women, prevalence of overweight including obesity increased from 34% in 1991 to 41% in 1999. Almost 50% of the male population were estimated to be overweight or obese in 1991 and 1999. Hypertension showed a favorable trend and decreased substantially in both genders. Hypercholesterolemia decreased only in men, from 27% to 21%. In 1999, women aged 55-64 showed a prevalence of over 50% in highly elevated cholesterol. Hypertriglyceridemia decreased in men from 21% to 18%, in women it remained almost unchanged. Total prevalence of smoking did not change from 1991 to 1999. 34% of the men and 24% of the women reported to smoke more than one cigarette daily. In women under 45 years of age, regular smoking increased slightly and reached a prevalence of over 30%. Less educated people and people of non-national origin had significantly higher risk factor levels. The risk functions did not reveal a significant difference in 10 year risk for coronary heart disease between the two surveys. CONCLUSIONS: Decreasing levels in hypertension and in male hypercholesterolemia showed favorable developments in risk factor prevalence. Preventive measures should concentrate on reducing overweight in older people and smoking in young women as well as on intensifying the care for less educated people and people of non-national origin.

[Follow-up studies of routine health screening in Vorarlberg 1986-1994]. / Verlaufsbeobachtungen bei Gesundenuntersuchungen in Vorarlberg 1986 bis 1994.

In this longitudinal study we observed a sample of people who participated in the general health screening program in Vorarlberg between 1986 and 1994. The aim was to analyse the changes in the parameters, body-mass index, diastolic and systolic blood pressure, blood glucose, cholesterol, gamma-GT and triglycerides of 1205 women and 718 men over this period. Using the baseline values recorded in 1986 as reference the sample was divided into groups with normal, slightly increased and highly increased values for the parameters. On average, the risk factors of people with highly increased baseline values decreased on both a short-term (1986-1988), and a long-term basis (1986-1994). The only exception was the body-mass index, which showed a slight reduction in the first two years and a slight increase in the long run. The normal baseline values rose in all the variables within the period of observation. Sex differences must be considered with regard to body-mass index, cholesterol and triglycerides, age differences are significant with regard to body-mass index, systolic blood pressure and cholesterol. The results of the study point to the usefulness of regular participation in general health screening programs. They show, in particular, that the risk factors for civilization-induced diseases diminish visibly in the group of highly endangered people.

[Total cholesterol findings in Austria--an overview of epidemiologic studies]. / Gesamtcholesterinbefunde in Osterreich--ein Uberblick epidemiologischer Studien.

Hyperlipoproteinaemia is the most important public health risk factor for ischaemic heart disease. This publication gives a review of six Austrian epidemiological studies covering more than 87,000 people in all. The results are not representative for Austria, but give a picture of the epidemiology in Austria. Mean values were calculated age-standardized (age-adjusted when ten-year age groups are registered) to the Austrian population of 1985, for the age group 20 to 79 years. This age range covers 99.77% of the adult male population aged 20 or more, and 95.70% of the women. Mean total cholesterol level for the six studies is 224.2 mg/dl in men and 227.3 mg/dl in women. These results are similar to those of a representative study in the province of Vorarlberg in western Austria (220.0 mg/dl, and 227.4 mg/dl respectively). Variation range is 20.4 mg/dl in men, and 22.5 mg/dl in women; the coefficient of variation is 3.9% in both, men and women.

Overweight and coronary risk factors results from a western Austrian survey.

Objectives of the study are to estimate prevalence of weight categories in a western Austrian population and to determine differences in primary coronary risk factors between weight categories in adults. The study population consists of 635 males and 693 females aged 25 to 64 years from the state Vorarlberg in western Austria. Age-standardized prevalence of body-mass-index 25.0 to 29.9 kg/m2 is 42.8% in men and 23.0% in women. The prevalence of a body-mass-index of 30.0 kg/m2 or more is 8.6% in men and 13.3% in women. Categories of relative weight correlated in both sexes significantly with all investigated risk factors, i.e. total cholesterol, HDL cholesterol, triglycerides, fasting blood glucose and systolic blood pressure. Significance remained in multivariate regression analysis in all parameters for both sexes, when controlling for age. Thus, the survey clearly shows the importance of relative weight as an indicator of elevated coronary risk and the importance of overweight for public health.

[Drug induced esophageal ulcers]. / Das medikamentös bedingte Osophagusulkus.

Drug induced esophageal ulcers are more frequent than supposed. Four ulcerative lesions of the esophagus, two after ingestion of doxycycline-hydrochloride, one after metacycline-hydrochloride, and one after emeproniumbromide were detected at the department of Internal Medicine of a medium-sized standard-hospital during the last six years. Symptoms develop suddenly after taking the drug with minimum fluid, usually before going to bed. Retrosternal burning, odynophagia and dysphagia are pathognomonic features. The cause of ulceration is discussed to be a matter of the drug remaining in the esophagus and of its local cytolytic and corrosive effect. Cytomegalo and herpes-simplex-infections can be excluded as etiologic factor of such ulcers. The clinical diagnosis is verified by endoscopy only.

Hyperglycemia and coronary risk factors results from western Austria.

We investigated mean levels and prevalences of total cholesterol, HDL cholesterol, triglycerides, fasting blood glucose, systolic blood pressure and body mass index in adults aged 25 to 64 years participating in the WHO Country-wide Integrated Noncommunicable Diseases Intervention (CINDI) Programme in Vorarlberg, western Austria. According to the Austrian expert panel and based upon the above age standardized risk factors 50.9% of the male and 29.3% of the female population were at high risk for developing coronary heart disease. Risk factor levels were further compared between euglycemic and hyperglycemic participants. After adjusting for age hyperglycemia was associated with higher body mass index in men (p = 0.026) and women (p less than 0.001), higher systolic blood pressure in men (p less than 0.001) and women (p = 0.003), and higher levels of triglycerides in women (p = 0.008). No significant differences were observed in total and HDL cholesterol in either sex. When controlling for age and body mass index, fasting blood glucose levels had significant associations only with systolic blood pressure in men (p = 0.001). But, with respect to all risk factors, hyperglycemic participants had an age-adjusted adverse coronary risk profile both in men (p = 0.002) and in women (p less than 0.001).

Coffee, tea, and lifestyle.

BACKGROUND: Previous reports have indicated that coffee drinking is associated with an unhealthy lifestyle, compared with tea drinking, which may confound the effect in relation to coronary risk factors. METHODS: In a population sample of 2,400 25- to 64-year-old men and women, associations of lifestyle factors with coffee and tea consumption were analyzed. Lifestyle factors were related to four realms of behavior: smoking, eating, drinking, and physical activity. RESULTS: Overall response rate exceeded 77%. Twenty-two behavioral factors were included in the analysis and controlled for age and sex. Mean daily cigarette consumption, the consumption of main fat sources (meat and sausages) and lemonade drinking increased with coffee and decreased with tea consumption. Conversely, intake of fresh fruits, drinking of juice or mineral water, and physical activity on the way to work decreased with coffee and increased with tea. The strongest associations were between coffee, than tea, and cigarette smoking. Controlling smoking (and physical activity) changed trends mainly with respect to alcoholic drinks. CONCLUSIONS: We conclude that drinking coffee is positively associated with factors that promote coronary heart disease, while drinking tea is associated with a preventive lifestyle. Factors supporting these results were found located in all realms of lifestyle for both for coffee and tea. Therefore, investigations on the health effects of coffee and tea must be carefully controlled for confounding behavioral parameters.

[Menopausal bone density in healthy females of Voralberg. Lack of relation to anamnesis]. / Menopausale Knochendichte bei gesunden Voralbergerinnen. Fehlende Beziehung zur Anamnese.

Bone density was evaluated in 182 healthy climacteric women. Women were recruted from a general prevention program. The results show deviation from 58.2 to 218.6--mean value 128.28, SD 30.91 mg/ccm K2HPO4. 28% of bone density values are under the fracture risk level citated in literature. No statistical relationship was found between bone density and anamnestic data--only the age at hysterectomy shows statistical correlation. The follow up after one year shows no predictive value of anamnestic data to the lost of bone mineral density.