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. CVD EPIDEMIOLOGY NEWSLETTER . t I Number 43 Winter 1988 Milton Z. Nichaman, M.D.., Sc.D. Editor f=in-Day International Teaching Seminar on Cardiovascular Ulsease Epi'de+eiotogy and Prevention Report 1 FourteentK Ten-Day Seminar on the Epidemiology and Prevention of Cardiovascular Diseases Announcement 3 2nd International Conference on Preventive Cardiology and the Annual Meeting of the AHA Council on Epidemiology Announcement 4 1988 Council for High Blood Pressure Research Fall Scientific Sessions 5 Announcement Cardiovascular Behavioral Medicine, Epide+ai'ology, and Biostatistics Research Training Session Announcement 6 Program 7 Submitted Abstracts 9 2Btti Annual Conference on Cardiovascular Disease Epidemiology Submitted Abstracts 13 Index of Correspondents 51 AMA Council on Epidemiology Membership Application 61

Abstracts Sub.itted for the 28th COrtference on P.ardiovasailar Disease Epi6e.*i'ology Sartta Fe, New Mexico March U-19, 1981 Abstracts of a1l papers sub.i'tted to the Prograa Cosittee of the Council on Epidemioloqy for the 28th Annual Conference on Cardiovascular Disease Epidemioloqy are reprinted below in the order they were received, except for those deleted at the request of the author. For additi~onal inforsation about any of the abstracts see the index of author correspondents i.,ediately following the last abstract. lLCKEISi 2'g DKI17CcQ O/ IIYTDQ'0S10p 1 C /O7 ffi iAC C010LARY l7lIYVIlSOn ".IAl. (C,TlR) C. a.lund; RP Mdf.hen, Pi Whaley, OI Casiar, S+l+er»t.ia, m. Uel.arsity of Oerth 4eolim t thapel gll1, K. ien (!IS!) is afLen aaseci,aL.d with high latarol l.sla. we sts+di.d 2395 norsoi.nsin (systolic pr.asvrs (tit) }r0 and diastolic yr+ssur. (Dlr)s.o soft) in tae vrt to ..t.:.lna il lw.ring -G d.cr.ass the ri.at af gYT ( tah 1&0 er DHt»G r 3P sadiutim). fas.litr aaatinatiees laclai.d a treae.i11 test ard assaaaot of riaa faetarr and r. rap.at.d arewlly. IIr incid.nu ef 9" alter S years of fe11w-vo w 11.A (lSd/1297) is the P Tac.so traup coWarM ta 9. 2't (111 / 12N ) is tAe cholestn^sai:+. lsvuy. Tbls ditfsranca wrs sigili- eae+t, r0.007, t.sti+g rita a lagistia rigressien .od.l iaeludie4 stadard R7 riat faetors as eo- wariataa. Purtbrr anal'rsr r..aalM that d.cre•se in U)C-C was tEr factor eqla.i" t!r tsvtarnt •ff.ct. ar r.latiw rist ef MT1 (RR-RTP) .s sig- nificantly Oro.o1) rseciatad with tha t+.auctiee in tA-C emtrolliig fer eo.ariataa. A &0 q/tl and a a0 e;ld1 d.cr.asa im lVL-C corr.spondad te a qt-KYT ef 0.71 ard 0.52 s.ap+etiwly. Ye eaneluM 'triat ebel.stTrsi+r *n`-r' lew." of La.-C ia aas,ocsst.d wita a d.er.a.. In tlr risk of NYT, raisirs tAa possibility of lDf.-{ psir4 a.odifiabl• t E 1-9-FF1dt DECLINE OF COROHARY HEAZT DISEASE AND STRO'EE IN TidE HONCLUI:U HEART PROG'1CA?S Dvsyne Reed and Charles MacLean. Honolulu H:art Pro=raa, Nonolu3u, HI Since 1966, th..Honolulu Heart Prograa has sionitored the lncid'ence and mortality rates for coronary heart disease (C8D), and stroke asonj a cohort of 6006 sen of Japanese ancestry living in Rawaii. During 19 years of follow-up there w re )02 cases of total definite CfID of vhich 458 were fataL. and 643 cases of stroke of which 193 were fatal. There was a 182 decrease In age-adjusted CHD sortality rata and a 203 decrease in the incidence of definite CHD. The decrease In srortality rates was less than that for US white sales, and was not statistically significant. During the sasr time period, there was a 64: decrease In stroke eiortality races and a 651 decrease in the incidence of total stroke. The decrease In srortality rates was greater than that for US vhite males and was statistically signiYieant. The eiortality rates of these vascular diseases appear to reflect the changes in total incidence for this cohort. 13

,/cH„~'. Ne...rlehitr ~j..,....L.... `+. PASSIVE S2i0KING AND MYOCARDIAL INFARCTION IN WO?SEN.Ju1Se R. Palmer, 83 Lpnn Rosenberg, Samuel Shapiro. Slone Epidemiology Utiit, Brookline, MA In a hospital-based case-control study of past oral contraceptive use an&myocar- dial infarction (MI) in womemaged 20 to 64, information is being obtained on the 'smokSng habits of subjects' husbands in order to evaluate the effect of passive exposure to sidescream cigarette smoke on, risk of MI. We conducted an interim analysis of data from 336 married cases and 799 married, controls. With a refer- ence category of nonsmoking women marrie to nonsmoking men, the relative risk es- timate for nonsmoking women whose hus- band's smoked was 1.2; for women who smoked less than 25 cigarettes per day the estimates were 2.9 (nonsmoking hus- bands) and 3.9 (husbands smoked); and fo women who were heavy smokers, the esti- mates were 6.3 and 8.3,respeccively. The observed crend'was not accounted for by. Ithe known risk factors for lfl. These re- sults, which lend support to the hypo- thesls that exposure to spouses' smoking increases the risk of MI, are unlikely t be explained by selection or information bias. ~ T 2-~ r m _ ORAL CONTRACEPTIVE USE AND~PfYOCAR- DIAL INFARCTION. Lynn Rosenberg, Julie R, Palmer, Samuel Shapiro, Slo Epidemiology Unit. Brookline, MA A case-control study is being condv1Eted primarily to assess vhether the lo g-ter use of oral~ contraceptives(OCs),a t:er discontinuation, increases the r sk of m}iocardlal infarction(MI).In an/interim analysis of data from 675 wome under ag. 65 vith~ first MIs and 1274 coroY women of similar ages,the estimate relative risks of MI for women who h d used OCs 'for 1-4,5-9, and~10+ years ere 1,2(95x confidence interval 0.8-1 ),1.2(0.8-1.9) ,and 1.3(0.7-2.4),respect ely. These re- sults do:not confirm~a evious finding of a doubling in risk ng vomen who ha used the older OCs for at least 5 years; possibly the newer lo,er-dose OCs have less adverse effeets on serum lipids and other cardiovascula ri'sk factors than the older pills. F current OC users,th relative risk esti te vas 2.6(1.0-7.1); although this poi c estimace is compati- b1e with the 4-f! l~d' increase inm risk associated vithAhe older pills, it is also compatible/vith a smaller increase, or with no inc/ease at a11. INTERCORRELATIONS OF LIPOPROTEINS ANDT LOW DENSITY LIPOPROTEIN (LDL) SUBCLASS 86 PATTERNS IN'RELATION'TO RISK AF MTOCARDIAL INFARCTION. Melissa A Austin, Charles H Hennekens, JamL Breslov„ Julie E Buring, Walter C Willett, Karen M/Vranizan, Ronald M Krauss. Univ. of Caldf'., Berkeley, CA In 230'subjects fro e Boston Area Health Study, a case-c ntroll study of styo- eardial infarction O survivors, ve have shovn that a predosi ance of small, densc LDL particles (LDL ubclass pattern B by gradient gel elec ophoresi's) is associ- ated with increa d1risk of MI with an odds ratio (OR) f 3.0 (95X CI 1.7-5.3), independent of ge, sex, relative veight, LDL-cholester and intermediate density lipoprotei'n a(ss (IDL). Adjustment for high densit~1ipoprotein cholesterol l(HDL-C) and triglyceride (TG) reduced the OR to 2.2 95X CI 1.2-4.1) and 1.6 (95Z CI 0.8-3.2) respectively. Because of colli'- nearity n these models, intercorrelations of lip roteins and pattern s were inves- tigat . BDL-C, IDL and TG were aLl found to W independently related to LDL sub- clasi pattern B, after adjustment for age, sex/ relative weight, and case-control' stttus. Biological echanisss aay sisiulta- n}rously influence ulti'ple lipoprouin vriabLes, including LDL subclass pat- erns, and result in increased risk of KI.1 EXERTIONAL CHEST PAIN AND RISK OF FATAL AND NON-FATAL CORONARY HEART DISEASE IN THREE OLDER POPULATIONS ,y. Andrea Z. LaCrob;. Jack M. Guralnik;, Charles H. HennNcens, Robert B. 1Mallrce. Adrian M. Osttad. J. Davfd Curb. NatkxaallrtstRtute on Aptnp, Bethesda, MD % Among older people, the proQnOsfk: slpntflcance of ' setf-tsportnd'chest pain for future myocardial Intarctk7n (MI) and' coronary heart' dllease (CHD) death Is unknown. Cohorts aged 65 and older In three i communltfes (East Boston. MA; fVew Hrven, CT: rural I lowa)' wlchout hWory of heart aisack (3067 men, 5291 women) w.re fofl'awedfor 3 years for CHDdeath and'annuatly (seN or proxy) ~ raported~hosptialtzatkm for MI. At baselane, Chest paln on,ixertkxswas found In fi-7% of rnen~(79J1195;,531936;,54(936) and 6-10% of women (197/2046: 131/1435, )'15/1a11) In each communfty, respecttvely: Fatalar)d non-fatal CHD.vents occurred k+ a total of 213 men and 250 wornen. In East Boston, , and Iowa, exertlonal chest pain was slpnl}Icantly associated wlth 14sk of fataf and non.faal I CHD .verrts combined In t~oth men and women: AQe-sd)usted Msk ratbs hx ranged from 2.0 (95% confidence lntervar (Gt)~t J.S)~ In East Bostoni to 5.1 (p5% C! I 2.8-9.E) In..4ovra, with men's rtsk ratlos Intermediate In these cohorts. In New Haven, the association was posltfve1n both sexy butwe.kerand'non•s/pnlhcant! These 'flndlnps suggest that axertlbnal chest paln reported by order p.ople wlthout txevlous heart sttack can be an Itnportant fhdlcator of future CHD everns. 29