P2-311 Consistency between the measurements of chronic morbidity in a health interview survey and a population census

J. Van der Heyden, D. De Bacquer, K. Van Herck, H. Van Oyen, J. Tafforeau
2011 Journal of Epidemiology and Community Health  
Elevated blood pressure and excess weight are established major risk factors for cardiovascular disease (CVD). Previous studies have suggested that hypertension is a greater cardiovascular hazard among obese compared with lean individuals, but the epidemiological evidence is conflicting. Methods and Results The interaction between systolic blood pressure (SBP) and BMI on fatal or non-fatal coronary heart disease (CHD), ischaemic stroke and hemorrhagic stroke was examined using pooled data from
more » ... he Asia Pacific Cohort Studies Collaboration. Participants of the study were 419 448 men and women aged >30 years at baseline. BMI was categorised into five groups (12.0e18.4, 18.5e22.9, 23.0e24.9, 25.0e29.9 and 30.0e60.0 kg/m 2 ). Cox proportional hazard models, stratified by sex and study, were used to estimate HRs adjusting for age and smoking status, and the interaction between SBP and BMI was assessed by likelihood ratio test. During 2 619 241 person-years of follow-up, there were 10 877 CVD events (59% in Asia, 34% women, 71% fatal). For all forms of CVD except haemorrhagic stroke, there was evidence of an antagonistic interaction between SBP and BMI such that the risks of subsequent CHD (p¼0.01), ischaemic stroke (p¼0.03) and CVD (p¼0.001) associated with increases in SBP were higher in normal-weight individuals compared with obese individuals. Conclusion Increased SBP is an important determinant of subsequent cardiovascular risk irrespective of body size and, in relative terms, lean individuals were shown to have a poorer prognosis for CHD and ischaemic stroke. Background Alcohol consumption, metabolic factors and oxidative stress have consistently been linked to cancer development. Gamma-glutamyltransferase (GGT) is a biomarker for adverse alcohol consumption and oxidative stress. It is highly related to metabolic factors such as hyperglycaemia, dislipidaemia and obesity. We therefore hypothesise that GGT is associated with cancer incidence at different sites. Methods First visit measurements in 94 628 adult women and 80 224 men screened for metabolic risk factors as part of the Vorarlberg Health Monitoring & Promotion Programme (VHM&PP). During a median follow-up of 13 years, a total of 5136 incident cancers were diagnosed in men and 4665 in women. Sexspecific Cox proportional hazards models, adjusted for age, bodymass index and smoking were performed to estimate HRs and 95% CI per quintiles of GGT. Results In males, there were associations (highest vs lowest quintiles) of GGT with liver cancer (HR¼16.50, 4.00e68.19), cancers of the lip, oral cavity, pharynx and larynx (HR¼3.80, 2.33e6.20), oesophageal cancer (HR¼2.39, 1.01e5.72), pancreatic cancer (HR¼2.13, 1.01e4.56), lung cancer (HR¼2.04, 1.55e2.70), bladder cancer (HR¼1.76, 1.11e2.77), kidney cancer (HR¼1.61, 0.92e2.82, p for trend¼0.009) and colorectal cancer (HR¼1.36, 1.01e1.83). In females, the association was most pronounced in cervical cancer (HR¼3.77, 1.94e7.32), followed by lung cancer (HR¼1.63, 1.02e2.60), endometrial cancer (HR¼1.42, 0.98e2.05, p for trend¼0.013) and breast cancer (HR¼1.19, 1.02e1.39).
doi:10.1136/jech.2011.142976k.44 fatcat:qw4g3ict3rfj3hzhbzennbd4gq