Discharge diagnosis of CVD, hypertension, diabetes, chronic bronchitis or emphysema, acholoism, liver cirrhosis, upper GI bleed, RA, systemic lupus erythematosus and use of high-dose aspirin, platelet inhibitors, insulin or oral hypoglycemic drugs, antihypertensive drugs, lipid-lowering drugs, oral anticoagulants, hormone therapy, nitrates, penicillamine, gold and glucocorticocoids before date of admission. This evidence concerns the gene INS and pulmonary emphysema.