Preventive medicine
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Preventive medicine · Sep 1997
ReviewThe nocebo phenomenon: concept, evidence, and implications for public health.
The nocebo hypothesis proposes that expectations of sickness and the affective states associated with such expectations cause sickness in the expectant. The nocebo phenomenon is a little-recognized facet of culture that may be responsible for a substantial variety of pathology throughout the world. However, the extent of the phenomenon is not yet known, and evidence is piecemeal and ambiguous. This paper reviews the concept of nocebo and its association with the placebo phenomenon, gives examples of evidence for the nocebo phenomenon, and suggests public health implications.
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Preventive medicine · Sep 1997
Comparative StudyValidity of self-reported hypertension in the National Health and Nutrition Examination Survey III, 1988-1991.
The National Health and Nutrition Examination Survey (NHANES) is the main data source for hypertension surveillance. However, because of a gap of almost 10 years between each NHANES, self-reported data from annual surveys need to be examined as an alternative data source. This study analyzes the validity of self-reported hypertension in a national sample of non-Hispanic whites, non-Hispanic blacks, and Mexican-Americans. ⋯ Self-reported hypertension may be used for surveillance of hypertension trends, in the absence of measured blood pressure, among non-Hispanic whites and non-Hispanic black women and persons with a medical visit in the past year. Validation should be repeated with each NHANES.
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Preventive medicine · Jul 1997
ReviewThe role of nicotine in smoking-related cardiovascular disease.
Nicotine activates the sympathetic nervous system and in this way could contribute to cardiovascular disease. Animal studies and mechanistic studies indicate that nicotine could play a role in accelerating atherosclerosis, but evidence among humans is too inadequate to be definitive about such an effect. ⋯ Clinical studies of pipe smokers and people using transdermal nicotine support the idea that toxins other than nicotine are the most important causes of acute cardiovascular events. Finally, the dose response for cardiovascular events of nicotine appears to be flat, suggesting that if nicotine is involved, adverse effects might be seen with relatively low-level cigarette exposures.
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Epidemiologic surveys have revealed accelerated increases in adenocarcinoma but less rapid increases in squamous cell carcinoma of the lung among cigarette smokers in recent decades. Changes in the makeup of cigarettes and corresponding changes in smoke composition along with nicotine-compensating smoking patterns, such as the frequency of puff drawing and depth of inhalation, are suggested to have contributed to the observed epidemiologic profiles of these major histologic types of lung cancers. ⋯ The product changes, the smokers' dependence on nicotine which governs their smoking patterns, and the modified smoke chemistry support the hypothesis that differences in PAH and TSNA exposure may be linked to the observed different incidences of squamous cell cancer and adenocarcinoma of the lung.
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Preventive medicine · Jul 1997
Intake of nutrients related to cardiovascular disease risk among three groups of American Indians: the Strong Heart Dietary Study.
Although diet is implicated in the elevated rate of cardiovascular disease among some American Indian tribes, the dietary intakes of these individuals have not been described. The Strong Heart Dietary Study compared diets of 10 tribes in Arizona, Oklahoma, and the Dakotas to examine the possible contribution of diet to cardiovascular and other chronic diseases. ⋯ Area differences in nutrient intake were observed, but most participants consumed diets associated with increased risk of heart disease and other chronic diseases. Women and older participants in general reported healthier nutrient intakes. Dietary intervention programs should educate American Indians about dietary modifications to reduce the risk of cardiovascular and other nutrition-related disorders.