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Background: Despite the widespread prevalence and serious clinical sequelae of infection with Helicobacter pylori, there have been few large population-based studies, using randomly selected subjects, examining the epidemiology of this infection.Aim: To examine the distribution and determinants of H. pylori infection in a developed country.Subjects and Setting: Overall 4742 subjects, aged 12-64, from Northern Ireland were randomly selected.Methods: Helicobacter pylori specific IgG antibodies were measured by enzyme linked immunosorbent assay, using an acid-glycine extract antigen, in stored serum from subjects who had participated in three linked population-based surveys of cardiovascular risk factors performed in 1986 and 1987.Results: The overall prevalence of H. pylori infection was 50.5%. Prevalence increased with age from 23.4% in 12-14 year olds to 72.7% in 60-64 year olds: chi 2 for trend 518, P < 10(-4). In subjects aged > or = 25, infection was more common in males (60.9%) than females (55.2%): chi 2 = 9.53, P < 0.01. This relation remained significant after adjusting for age, and measures of socioeconomic class: odds ratio (OR) for infection, male versus female was 1.19 (95% confidence interval [CI]: 1.02-1.40). Infection was associated with social class: the adjusted OR of infection in subjects from manual social classes relative to those from non-manual classes was 1.7 (95% CI: 1.47-1.98). Infection was significantly more common in current smokers and ex-smokers than in subjects who had never smoked: adjusted OR for infection, ex-smokers versus never smoked was 1.22 (95% CI: 1.01-1.49); for smokers of > or = 20/day versus never smoked OR = 1.33 (95% CI: 1.05-1.67). Infection was not associated with height in adult males but mean height in infected women was lower than in uninfected women after adjusting for age and socioeconomic status: difference in mean height (SE), -0.85 cm (0.32), P < 0.01. There was no demonstrable relationship between H. pylori infection and current alcohol intake.Conclusions: This study demonstrated a high prevalence of infection in a population from a developed country. Previously reported associations between H. pylori infection, age, sex, social class, and reduced height in females were confirmed and smoking was identified as a possible risk factor for H. pylori infection. [ABSTRACT FROM AUTHOR]

The Framingham Type A behaviour pattern (TABP), a risk factor for cardiovascular disease mortality, was examined in a cross-cultural study involving three countries known to differ in cardiovascular disease mortality, namely Germany, Lithuania and Northern Ireland. The factorial structure of the Framingham TABP scale was strikingly similar in the three countries, with three factors (work pressure, hard driving, and impatience) identified; evidence for the cross-cultural validity of the scale. Scores on all three factors showed considerable variation between the three populations for both men (multivariate P < 0.0001) and women (multivariate P < 0.0001). Of particular note, on the two factors, hard driving and impatience, thought to be core pathogenic elements in the TABP complex, Lithuanian and Northern Irish males and females scored substantially higher than their German counterparts. These cross-cultural variations in levels of risk are discussed in the context of the different ischaemic heart disease mortality rates in the three countries.

All death certificates over a one-year period (20 July 1981 to 19 July 1982) for residents of Belfast were examined in order to ascertain those due to ischaemic heart disease. Some 1654 were included for further investigation of which 1288 (78%) were coded by ICD Nos 410-414 (9th revision). Additional data were obtained from hospital records, ECGs, cardiac enzyme measurements, post mortems, general practitioners and from relatives of the deceased. Some 108 deaths coded by 410-414 and 223 deaths coded by other rubrics were eventually excluded. For people aged less than 70 years the net effect of excluding these deaths and including some coded under rubrics other than 410-414 was very small representing a change from 498 to 496 deaths (-0.4%). For people aged 70 years and above the net effect also was small, namely an increase from 790 to 827 (+4.4%). We conclude that the total number of deaths recorded as being due to IHD in Belfast was reasonably accurate. While 76% of deaths registered under ICD Nos 410-414 had been coded by ICD No 410 (acute myocardial infarction) only 19% of all deaths due to IHD could be classified as definite myocardial infarction using World Health Organization criteria.