British Regional Heart Study: geographic variations in cardiovascular mortality, and the role of water quality

Pocock, Stuart J.; Shaper, A. G.; Cook, Derek G; Packham, R. F.; Lacey, R F; Powell, Pippa; Russell, Paul F.

doi:10.1136/bmj.280.6226.1243

Cited by 128 publications

(45 citation statements)

References 14 publications

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“…2). The towns with higher IH,D mortality tend to have slightly higher blood lead concentrations, perhaps because blood lead levels are higher in soft water areas (13), which are known to have higher IHD mortality (14,15). Therefore, analysis of covariance has been used to obtain an Figure 6 shows that the odds (or risk) of IHD is somewhat greater at higher blood lead concentrations, particularly at 1.2 imole/L or more.…”

Section: Separate Analyses Within Each Townmentioning

confidence: 99%

The relationship between blood lead, blood pressure, stroke, and heart attacks in middle-aged British men.

Pocock

Shaper

Ashby

et al. 1988

Environ Health Perspect

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The relationship between blood lead concentration and blood pressure is examined in a survey of 7371 men aged 40 to 59 from 24 British towns. After allowance for relevant confounding variables, including town of residence and alcohol consumption, there exists a very weak but statistically significant positive association between blood lead and both systolic and diastolic blood pressure. These cross-sectional data indicate that an estimated mean increase of 1.45 mm Hg in systolic blood pressure occurs for every doubling of blood lead concentration with a 95% confidence interval of 0.47 to 2.43 mm Hg.After 6 years of follow-up, 316 of these men had major ischemic heart disease, and 66 had a stroke. After allowance for the confounding effects of cigarette smoking and town of residence there is no evidence that blood lead is a risk factor for these cardiovascular events. However, as the blood lead-blood pressure association is so weak, it is unlikely that any consequent association between lead and cardiovascular disease could be demonstrated from prospective epidemiological studies.An overview of data from this and other large epidemiological surveys provides reasonably consistent evidence on lead and blood pressure. While NHANES II data on 2254 U.S. men indicate a slighdy stronger association between blood lead and systolic blood pressure, data from two Welsh studies on over 2000 men did not show a statistically significant association. However, the overlapping confidence limits for all these studies suggest that there may be a weak positive statistical association whereby systolic blood pressure is increased by about 1 mm Hg for every doubling of blood lead concentration. Nevertheless, such statistical association cannot be taken as establishing a causal effect of low-level lead exposure on blood pressure, particularly since there are important confounders, e.g., alcohol consumption, which are much more strongly related to blood pressure.

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Section: Separate Analyses Within Each Townmentioning

confidence: 99%

The relationship between blood lead, blood pressure, stroke, and heart attacks in middle-aged British men.

Pocock

Shaper

Ashby

et al. 1988

Environ Health Perspect

Self Cite

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“…This maintenance of public health is tied to the living environment: Varied environments result in different health status [20][21][22]. In the United Kingdom, different areas have different mortality rates [23][24][25]. Intuitively, an unhealthy environment, including perverse effects of climate change, also shows negative influences on not only people's health [26][27][28], but their perception of health care quality, as well [29].…”

Section: Introductionmentioning

confidence: 99%

Psychological and Socio-Economic Factors Affecting Social Sustainability through Impacts on Perceived Health Care Quality and Public Health: The Case of Vietnam

Vuong

et al. 2017

Sustainability

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A study on over 2000 patients has been conducted in Hanoi, Vietnam, to explore the influences of psychological and socio-economic factors on the evaluation of healthcare quality and public health by patients. The findings suggest effective health communication and the status of being married are two elements that have the strongest impact on people's positive perceptions about healthcare quality (β HealthCom = 0.210, β otherMaritalstt = −0.386, p < 0.001). Young unmarried people and the insured tend to be more critical of healthcare quality (β Age = −0.005, p < 0.05; β yesHealthIns = −0.208, p < 0.001). At the same time, a higher BMI and better view of health care quality are linked to negative opinions about community health. These outcomes suggest that in order to maintain collective health as part of social sustainability, the Vietnamese government should pay attention to infrastructure improvement, insurance system reforms, and communication of personal health care knowledge.

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“…A negative association between silica concentration and the incidence of ischemic heart disease (IHD) has been reported (39,40) and is associated with the lower incidence of IHD in hard-water areas (41,42). Silicon is associated negatively with IHD mortality (correlation coefficient r = 0.66) and positively (r = +0.68) with water hardness (42).…”

Section: Silicic Acid: Geochemistry and Healthmentioning

confidence: 94%

Silicon—Aluminum Interactions and Biology

Birchall

1994

Advances in Chemistry

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Silicon is listed as an essential element. Its removal from the diet of experimental animals has been shown to result in reduced growth rate (reversed on silicon supplementation) and changes to bone formation and the synthesis of collagenous connective tissue. However, in spite of much effort, no organic binding (e.g., to proteins) of silicon has been convincingly demonstrated under physiological conditions in which silicon exists as silicic acid, Si (OH)4, and no biochemical rationale has been proposed to account for the effects of silicon deficiency. However, recent research indicates that a major role for silicon (as silicic acid) is to reduce the bioavailability of aluminum, which is toxic when it gains entry into biological systems, but which is normally largely excluded. The formation of subcolloidal hydroxyaluminosilicate species is shown to prevent the absorption of aluminum in fish via gill epithelia. The generality of this effect is discussed. The symptoms of silicon deficiency in experimental animals seem likely to result from aluminum toxicity, so that the environmental balance for the two elements may be critical. This chapter reviews the present position.

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British Regional Heart Study: geographic variations in cardiovascular mortality, and the role of water quality

Cited by 128 publications

References 14 publications

The relationship between blood lead, blood pressure, stroke, and heart attacks in middle-aged British men.

The relationship between blood lead, blood pressure, stroke, and heart attacks in middle-aged British men.

Psychological and Socio-Economic Factors Affecting Social Sustainability through Impacts on Perceived Health Care Quality and Public Health: The Case of Vietnam

Silicon—Aluminum Interactions and Biology

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