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-EQ&J$ /J/i& I ‘- ‘i Public Use DataTapa Documentation Cardiovascular Data I Tape Number 1004 Utbn8l Hmtth Examination Suwq, 1M

IL. DEPARTMENT OF HEALTH AND HUMAN SERVICES 0 Pubhc Hdth Swvlcr . Dike of Hdth Remarch. Sotrbcr, end Technology . WionaI C.nt.r foe Huith Sutrtu

PublicUseDataTapeDocumentationCardiovascular DataI Tape Number 1004MkMl Health Examination Survey, 1SS62

5, DEPARTMENT OF HEALTH AND HUMAN SERVICESblic Health %wce

Off me of Health Rrmarch, S[mistics. md TechnologyNmioml Center for Health Statmtics

Hyattsville. MarylmdMW 19S1

..-. .-. .— - ----- ---— -—-— —--- —. --- -. —- , --—- —-- .---—. ----- ----

(~ntmducticn

The overalT plan of the Heal tn Exafiination Survey (!iES) wzs co conduct- ..

succcssivc;se:ara:e Cycles of examinations in specific seqmfl:s of the

natimai population. ~ne data in this report refers. tc tl:ewwey for

qfcle 1.

It was directed tcward the cal]cction of statistics on the fiedicaiiy defined

prevaicnccof ccrt.ainchronic disc3ses afid ofa particular set OF demal

sazzpTecmsis-d Gf7,~Cl aFaTT mn-institutional civilign ●dults in the

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TITLE:

coiiT-Ein-:

CASE COLH:

REcoi!DCoLi::T:

RECOR3i~G MCC:

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DENSITY:

CHAW2:

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CKmEIl BY:

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IU!3S?(5) :

CO~ENTS:

FILE CHARACTE2!S?ICS.

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User Oata Set,*4 - Cardiovasku!er

Cardiovascular Ddta by Fi lC Sequ-s Number

5672

6672

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10 Records

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File kcrip:ion

~cscripcicn of Cat3 I:er..s

Special Case Codimj Corrections -

Glossary of Selectca ?ems

Hedical HisUry il~cstiens Related tsCardiovascular-Gisease

Fores used in FinSingsExamination Relatad ‘w

5CG CGdC Simet

Cardiovascular Disease

ElectrocardicSe2phic Criteria

Interpretation bf -Chest X-Ray

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Antcriw or posterlor~ocardialinfdrctl~n out61dc crttoriaIlight outs devtdtton Inside orout$ldq criterialoft ventricular hyf&trophy In$ldW outside Crite~i4 or right -ventricular hypcrtrophy outstd~criteriaSub-~qche:ola, sub-lscllcmla/dlgltalor current of injwy Inside oroqtsido criteriaIlon-specific T+lave Inside or out-sldo criteria or left ventricularischemia outside criteriaIncomplete right “bundle branchblock w 1-V blockVcntrtcu]ar tachycardia, llur., Nodor supra-vent tachycard{a abnormalventricular rhytlm or abnormalnodal rhythmHi SCCI laneous H(G rcadlngs

Left axis dtiviatl~n aqd one Or ~~e

of the following;

10 chest pain historyb heart pain history

1c high blood rcssure hls}ory

!d heart t~ouh 6 history’First degree AV block fnslde or out-stde crlterta and one wmore of th~follol’lillg: —

Ia rheumattc fever historyb phorea historyc high blood pressure history ,’d heart trouble historyOne ormorc of tha follwing:

I

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P..- File Se~uenc= lhxbc~——

This five digit wde reprcsen:s two identiFying .

is the number’chre.’ which is given to evc~ record. This m:$cr identi~ies.

the tapa as bein~

nwier all of “Je

a cardiovascular tape. The last four disits s+entially

rec~rts ( fmm 0001 to IS072)on the tape.

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sawJlcd person to Me MU selecticn technique md to the past-stratification

by agc and sex fur the finaT natiaml estimates. in addittan “dis tw~her

biasing effect of non-response”wuTd be minimized..

.

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abtained iii a siagk sessicm.

*

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,“

Questions 21 and 22 (Appendix C), dealing with

c,“pain, were of i:mrU,nce for the diagnasis-uf heart

. ..

cimt pain sfic hurt

discas~. It was on the

basis & ‘he rcspanse to tneseqmtions and associat~d :=bes W: a

diagnosis af an~ina ?ectoris was made. Response ta the ~thsrcar=iovascular

questi9ns on :!e mdicd hista~ fomwere alsc ofassis:ance i~, a7’Wugh-

not sufficien: in themselves for,

.

●

.

heart disease diagrwsis.

.-

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,- . .,, .

. .

Time of examination is the time the examinee beqan his examination..

POSSibie values inct~de ‘01’ -’24’ such that ’01’ reg;esents 1 A.ti.and ’24’

.

.

..-

?

.

.

.

.

.-,.. . .

.--’ ,.

..—, ..— .. —.--— .- -.... .— . —— —---- --.—- ---- --- - -. ----.’— - ----- --

..

.

n Detail Notes :48 -#51

The averasa sy:tolic anti dfastalic blood pressure readings were cG=wted.

mcasur~.ent was tihn just after the physician met L?a sxa.nines. The second

was taken ,mic!my in t!!c=~amifiation, a:ter completing tis auscultation 0?. .the heart in the si::in~ position. The third measurement was ~aken at ~’w

GbelT ofhfs stct!!as:a:c. the physician noted

.

the prcssurs when the sound

and when it disapoea-. ATT

atwhich Lk KomtWf sounds

disappeared ‘was ~aken as the dias’taiic pressur=. If Me 5011nCkdid no:

wdisappear, the paint af muffTinqz iF distinctly hedrd.,k.=s used. since

.

.-

.-

---- .. -. . ..— .-

.- .. -...-. --- ------ —----- —-----. .. . .— -—- — .—. — - —=— -..—-- - --- -----

.

Oetail Iiotes:53 - #64

exist:

.

.

.

.

.

tight refle’x

nam-th+ ar.crioles

tafious arteri~tes

AV co~ression

.

.

I

,

-...

.-

..-

. .

.

. ..-, *

.

..-. — -.— --. -.. .— ---—- —.-, -.—- - -—. ---..—- -- —. —..-—- -,- —----- ---- -.——-----.“

. ..

●

.

.Octail Notes +83 -499n.

(~d’ -.”

These data its::sare t!:eresults of the standardized cardiac examination..

on the ~hysical Exmimtion

The exafiineedid m: exercise

- The prccordim::as Palga’trk for thrills with the~xamirtee first sitting

Code ‘4’ re~rcscncs Grades T znd 2..

.-. .----- .—— ., . .. ..— -..—- ..— ., --. ——-. -. . -- -,, ---- -- - - — .--..—- -----

.-

.

,-1.

Detail Rotes *104 - #15Z

-.The elc’xacardiogram was rezd independently by thres ~ardioiGTjists

.

accordifi~ ‘tocsrtain criteria L!at they developed. Tha criteria a?d classi-

fications used al~d the E(G Code Sheet (HZS-N2), the fom an which the

fimiings ware entergd, appear fn Appendix E.

For all r~jar findings allowance was made for designating-any electro-

cardiographic

criteria for

ahom!lity obs”erved by the reader even %$ouqh the speci$ied

S!at almomality were” not satisfied. These abnoma!itjes

criteria” in ‘tiecoded item. .

the event t!!zt there ws my tifsagreermt, the tire= reders met w!t!! aQ.

coortina’dr and cme ‘a a finaT decision.

.,

.

. .

.

—- .—

.. . ._. . .. —-- —:- .. — -- . --—.—— ----—-— -

—— -- --— .- — ‘--,--- .--— -.-—

.

.. OcQil M3tes 3153 - 4161e,.1

‘~.> --These tlirccsets a: da:a item are derived from the interpretation

.

OF X-ray fit=s b; ‘Jree radiologists with a special intarcst in ?ulmnary

disease. in 2L2ition :U mtinq cvidcncc Qf pul=nary disease- =~e readers.

wcr~ requestrl M record evidmcc of distinct cardiovascular abmmel ity.

F.

as ‘Z’ repressntinqdefinite GCE. If the enTargemrit was not ~ens?aTized.

r

.

.

-,“ .

.... ---- .

k. “.. . .,. .. —- -. . ..— — —-. . .- ., ., .. . . . . . . . . ..-_ .— -_ ______ —. -.— -—, - -

●

Octail Mtc $162 .--,

Ti~cFinal cvaluatfnn code af heart enlarg=.ent yas detemi ned Sy the.. .

fal Towifig procsdurc. A finding of general ca~iac erila}-gm.ent or 1e$:

. ventricul~r hypertmphy, defini?s or borderl ine, was considered “pm~tive”.

Alt film were read by two pulmnary readers and ane cardiovascular reader.

The de:cminaticn cf the two Ful=nary readers provided. a preliminary● .

svatution. If :O-ti considered the film “positive” a decision OF enlargement

.

was maae Aateve= L5e findinss af the cardiovase~lar r=adw. If they disagreed -

and tk cardiovascular rCader caf?sidered the fi~~ pOSitiV@r :~e cIacfsfGt?

was that enlar$eme~: wzs presen:. Othemise, ● second e3rd!sv2sc=iz- r5a&3r

ATt

. was

independently and no recancfl iatiom of differences

The coczbinatianaf beTow.

-:z3

NegativePnsitivcPositiveNe?at~vePositiveRc~3tivc-P3stt~Yc)ieqativcRcgative?ositivc?4eqxi’J?

Neqati VePositive

- NegativePositive

—...--..--

4

.-,.” .!! .-, .,.

. ...- .-

..

—.. — —.-..--———. .

.

——. : - ..: - - ---—--—- - - --—- ——. —- —’- --

m

(- Oetail Note H163‘>

This it-= is included because serum clwlesteral levels ars associated

wit!!‘de devcTa7ent af coronary hea~ disease. It ?l?S bc?fl ~X’JW? that

patients wi“h aR@IM pec”arfs and cammry disease have 1evels aF te”dl

blood chales:erol subs*~ntiaTTy greater then those af qam~l contmis.

A blood speciuen was collected fmm each exaraineein a 15 CC.

Shep;ard-!hiaelLbe. The tu~e was kept at mca t~gera&re Far a minimm

af one haur faTTawi~~gvenipunctura then refrigemted for a tiini=~ of six

hours u assure-~ gaactclat. The

Wbe and tie We was centrifuged

Oetemina:ian of tataT sarune

blood elat was freed gentTy fmn the

far ttienty fiinut=.

cholesterol concentration wer= :atiehy a

IMdified fcmic chTaride procedure.” The vaTues were t!!encawerted taI ..

‘cnmp~mbTeAbell -“WAIT &Tues..-

G . . .

.

.

..

. .-.

. .

.

—,

‘-’J

,.

.—-— .

. . ., ,-..

- -. - L.- ——--.1------ - - ---- -. -- --- -- -—-— --- - —- —--- ----- . .,------- --.-—— .—---

,.. .

●

I~

Oetail Notes 3164 - ?170 .-..

*During the Household Interfiew, the individualsuere asked if anyone

fn their fwily has any af a nwher af chronic conditiotx. These chronic.

conditions were 1istcd on Cbndi:ion Can! 3. The answers were ~<d

according to the InternationalDisease Cdes.. The condicians reiating

to cardiovascular disease app=r in data items #164 - H70. ”

1

c)

●

.

.

.,-

-.

. . ..

.

“.. .. .

. . .-.

.

... .

.

-..,-1.”. ‘a”

. ..—

.-.-. -..— . —---- .— --- -- —...— -. -. —...- ... . _ . ,-.--. — -...—. ------ .

. .

.

C.-

Thesc heart 4iscase

9.

Oetail Kates #172 -3179--“

. .

cardiavasculm ~=i ~acian. These it~.s weF. used ta catain the P@l i shed.

sUtis:ic&T tibles cn tie prcvztsncc af heart disease in the United S’Qtes.

To pmgrcss from examination findings ~ heart disease diasrtasas,

cirst, the chest X-ray film and e?ectra-several steps were involved... ,

cardiaSraphie tracicg were i nterpretcd. Then> a set ~f diagnostic criteria

was cans”nctg~. FfnaT?Y, a.pracedure was devc?cped for translating L?e -

findinss frm theex@naLian a~d the itis~rstatian af=+e X-my and

electmcardiqrm intt sgedfic diagnoses.

The ffrst-stsg in arrivin~ at adiagnasiswu q suppTy a sat c~wtas

s@tile for cmputerdiagnasis. The rules wuuTdcanvert thE coded

o . ....-.. hfamatian f- tkmedica~ reco”ti andf%m ‘de in:srpretat~on af +&e X-my.

fiturwtd tice7~’mcar&aqm inta adiagnastic desisian.

speciFie heart

decisions were

2) cases with a dfagnasis af angina pectaris. -.

‘3) cases k.here thedia~.osis dependcdon a historj of“or a histcry of myocmd.ial infarction..

They include:-

hygertcnsian .

——. -

This omi::d from ‘Ae review were those cases with amclcar and deffnite..

diagnosis sf h~art disease on the available evidcnc~ and “AOSQ cases where.

there was no possibility of diagnosing heati disease fro!?the availabls

evidence.

Irtmast cases wherathe cmputer diagnosis was reviewed, ttiedia~nostic.

decision uude by the cmputerw asunaltered.. In a few insUmces, hawever,

there was a diagmstic change’an the basis af review.

theUnitestS’Ates.

,.

. .. ..:--- - - .. . —...— —- *---.——— -- .- —-— -.-. . ---— — --------- ----

. .

.

f-J

Oetait ::a:es31Z0 - 4199 .

.

These data itexs ar~ based on:

t. Oiagmsis of heart disc.ase by the Health Lamination Survey.

Z. ~i~smsis afhcart disease by the gersonaT physicians oFa-leaf HES examiners..

Inqufrigswere sent to tje persmal physicians of a subsample of the

HES exminees: 4.98usable repTics were msived.

. h tt~:ua- <T83r the 48S cases ars coded as ‘l’s ‘2’, ‘3’ or

,~#- 8oth thcuminatimand physician diagnasis are availahTe For these

cases.

ltemsr184 -#189, show theperwnaT physfcia~’s diayos~saf heart

dtseaseforL!488 cases..“

. . . . ..,... .. ..,-

...-

. ,.

.,,..

. . . ... . -. . .-...: . . .-. ..,-. .

.

.-.

..

●

✌✎✎✎

“..-.

-.-’

.

——

-.,.‘G.. -

-.. ,... ?

— ..— .— — L.- . .-. -—- --- -.-.’-—--- - _- —---- .--— . .. ---- ...—. —._ —

... ..

.. m

Appendix A --

SPcciaT Case Codinn Corrections”.

.

In item 91, the de was changed from ‘3’” W ‘2’ for file sequence

changed from ‘ ‘ b ‘Z’. Thismher 32190 &tso, in itm 92. the code was

w done b mkc these two itens consistent with. the other itezs on.

Heart

Sounds (Itans 93-37}. The other item specify that 5118 cases have all “ -

:!is. ‘nmnal heart sounds. It=s 9T and 92 have been recoded ta indica:e

.’

A

o...’ .

., ., .:..

.“-. . .

,.. ,

-. . . . ....-

. .“ ..:

..-. . . .

. . ‘,’.,

w

.-,, . .. -.,.. . -., -. -. .,-..-:. - .. . ,.. -

. ..,- -... .

.

..

.

..

.-..

.— - - -—--—- .- ——— - .. . . . .— ----- ., ---- ..” -— — .-—.-- —- .

.

c’-- Amendix E-.

Hy~crtension - aanomally high blood pressure, especially, atisrial 5101xI

pressure.

M~ocardiaT inf~r-ctibn - the dca’h of the @“ssue in ‘thgmiddle cuswlar layeror the hcdrc wail resulting from abstmction.of the local circulation bya thrombus or dalus. ~

%bolus - an abnonraT patiicle (as an air bubble) circulating in L9e blood.

Thmtius - a cTotofbToad Fo=ed withfn a blmcivessel and r~ainifig~ to its place of ari~in.

Aotiic stenosis - a namawing or constriction af t!!e diameter af 2?= aorta.

0-.

. . .

●

.

. .“

. . . .

.:,, . ,-., . . .. ..,. .”.-,.. .-.

.

, .

.

.

,.-1

‘b”’

*k. -. .

-— . . . . . . . . . . .. ----- .. . —.— -——- .— —— .— --- .:-— ---- ,--— --— .-.”— --

9

APPENDIX C.

MEDl~L HISTORY QUES~ONS RELATED TO OiRDIOVAS~MR DISEASE

.

If-‘KS b. Hu= Oftsn?.. .. . .

●

Q,....m

d. &ss there tnytiw in your lif~ uha you hed I “10t of bld sors

thrssts? . . Emm*WSS of 5W-th -en c1;-i=16. a. ksve m -r km bdwre4 by

Stai”ki?”

I F YES h & aften?

G k it bother you

.

I ( -

-----,

,! :...

-’

.

,-

. . . . -. -------------- .---— — --. ——- — . ——. - A--- . . ... .

.

u. ●.

U. ●.

20. ●.

.

?ram.

Izmml

P*

. .

.

,..-Q

,.. . .. —- .

----- ------ .-. ..— -. ------ . . . ,--- .-— . ..- --- -—-..— .— - . ,,.

. ----—.- ----- .-, -.. -. -—---- --- . . .

,.—.—- - -—.._.-. . .--— - -----

u L In the mst fe Ysers. have You -r had sny rein, discdofi.

or tmuhle in or sround your hear. ? EzImzl

.

IT. be itus~lly came *V Y:u we uoset or

Saew’: t~is .mske ●y :i f:erems Ij. b you tlws ~ oill S or mi:ins for it? EIEIEI

?mBes A.3i

C..i

El “m24+ L

Probes A,3

e k this bother

Are yor mk]es ecr mu}len It bedti-? EEIElm25. *.

If ~ 5, !S themlTiq gme by mmiq?

26. R.

PRDe A

MS ● dater *er hid you tid rtmmstic fewer [inflmtory

*timl mm

b. kte YaI hsd it im the oestQ mths?IfY5

IfYEs

~~u

C. A= you takirq any sills or~icine far it? mm——

$. ~zt is i:?

.

,-- -

.. ------ —------ - .- —- ..-. — .-. .-. . ...---- -.. .

. ..-

..-. —.— —--- -- .—— - ———--. .... ____ ,---- -— -- --. . ..- ------

?mbe c

57. a. Haw y- mer hsd am msm to t~ink yau my Swe Seart

—uu~—

. ...---- . .

......- --=. --- —-------- -—.—--—-

.— . .—. — . . ---- . . —.—- .- -.

,

‘c

r

FINDINGS ON

. RELATED

Ca6A9diW

APPENDIX D

THE ?HYSICAL 5XXHINATION

TO CARD1OVASCULAR DISEASE

Saihcbiaz:?R IM7

●

MD P!EMILE - UFT Mm

71Q I anTsl.le I SIMTOLIC 1 f EIM7DLIC 2

. .4. II I tLms 54C i! ias

. .

7. Irilis ti1

.- .

-.

,——. - .--. —. - _ —.. .- ----. —---. . .

I - I I27. All mtalu

EIUET SIDE I~MAL Scutarlc nRT3alu #m Bo9f- : 90C

2S. SUOtEr?fC;aT ?emoanl I1 I I .I t t I

3r. sumrf:ciar :emsorat I 1- 1 I I32. 3raC5ia I } I “t

..

. ,“

---- ...---- .. ...-. —----

---- -.

-.—

.- . -,, ..— -.

F

.-.— - — ,-- . ..— .. ..- ---

(-””

.

.

-.

-... ..-

-. .—-1

. ..—. — -- ...—- —-- ---- . ..—.

—-. —

HEART .

s6. Tbrlllo n OneCl

/ -.

Timing II

L7. ADleml Imsulsma

-.—— Eat r@l:

[I

Di*stolic -cm. c18

. :

.----

.,-x,.. ,

.—.—.. --- - -—-— - - - -----------

Ewunlma EITSICIAHW IMRESSIOR

Card lewascuiir ~lscasac -.”. UC4TIYE POSITIVE SUSPECT

Hy*rtens ion ......................................... ...... ............... @ c o*rip&ml ●rtSri SClerOSi S._ H..m._...H—_-.. .--- . . . . . . a. n c1

Organic Ream 5is8asc . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . ❑ n c1

An; in= mc:ar: s___ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . n o 0Ir Bsitiwe or susps-ct.

Etiology

Am Lomy.

P’lwsialqy

Cmnts

8

Da ●mhrt?is G

Qwstiamaale :mu; ain!a

4.:.

.-.

?+*-—-u. —

..— —

.—. .— —-. — --.. . .. . . . .

.- .- —- .— -

APPENDIX E

(-. .“PI ELECTROCAIDIOGR-4?~IC CRITERIA

-_ssx:=. s

.-.

.-

“L

*2

s.

r

.4.

1, =, 7:.7’ (e)

AYL

=

A77

r

1

.—., -, i?-, AT,.1.-Y- [=YJ i-.

---- .—. —- ------. ... . . ..- -—.-

.●

(-’

I

.

I,- :=. ;.

-7

:, =, = :4)

.--, -, = :41:, A-~k, 7=, 75 [4!

&-r

>.

e.

d.

7.

?-

9

d

“,-

.

------ - --—- ,- —--- ,— ,-- ——- —- ....,.--.—-——. .

r - .,.- ..

=Y

*

.- =

,-

. .

ECG Code Shmot,

UuLVH Rw

‘A1v-rn

b- QES Ubr -

U&=

41 u

.

. .

—ccc—-.

APPENDIX F.

,.

lNTEl?PRHAT10t4 OF CHEST X-RAY

Form Used in Pulmonary Rmding

?H%5739 NATYOWL !lEALiH SURVEY CHEST X-RAT IHT ERPRETATION&l .

X.FL4Y wnEl

.

-EQ&J$ /J/i& I ‘- ‘i

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