| 1. |
- Blom, M, et al.
(författare)
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Social relations in women with coronary heart disease : the effects of work and marital stress
- 2003
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Ingår i: Journal of Cardiovascular Risk. - Karolinska Hosp, Karolinska Inst, Dept Publ Hlth Sci, S-17176 Stockholm, Sweden. Semmelweis Univ, Inst Behav Sci, H-1085 Budapest, Hungary. Swedish Natl Inst Publ Hlth, Stockholm, Sweden. : LIPPINCOTT WILLIAMS & WILKINS. - 1350-6277 .- 1473-5652. ; 10:3, s. 201-206
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Tidskriftsartikel (refereegranskat)abstract
- Background Studies have previously shown that psychosocial stress, related to both work and family, is associated with the increased risk of coronary heart disease (CHD) morbidity and mortality. The objective of this study was to examine how social relations are affected by marital stress and work stress in a population-based sample of Swedish women with CHD. Method Data was obtained from the Stockholm Female Coronary Risk Study, comprising 292 women aged 65 years or younger, with a mean age of 56 (SD = 7) years admitted for an acute event of CHD and examined 3-6 months after hospitalization. Marital and work stress was assessed using the Stockholm Marital Stress Scale and the Swedish version of the Karasek demand-control questionnaire, respectively. Condensed versions of the Interview Schedule for Social Interaction (ISSI) and of Interpersonal Support Evaluation List (ISEL) were used to assess social relations and social support. Results Marital stress was associated with less social integration (P< 0.001), less appraisal support (P< 0.001), a lower sense of belonging (P<0.01) and less tangible support (P< 0.01) even after controlling for work stress. Adjustment for age, socioeconomic status (education and occupational status) did not alter these results significantly. Work stress did not show statistically significant effects on any of the measured social relations. Conclusion The present study showed that marital stress influenced women's social relations. These results suggest that marital stress needs to be further investigated not only as an independent but also as an interactive risk factor for women with CHD. J Cardiovasc Risk 10:201-206 (C) 2003 Lippincott Williams Wilkins.
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| 2. |
- Hallman, T, et al.
(författare)
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Psychosocial risk factors for coronary heart disease (CHD), their importance compared with other risk factors and gender differences in sensitivity
- 2001
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Ingår i: Journal of Cardiovascular Risk. - 1350-6277 .- 1473-5652. ; 8:1, s. 39-49
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Few studies have focused on risk factors in women's lives concerning psychosocial factors and coronary heart disease (CHD). The present study is one of a series in which a wide range of psychosocial factors will be analysed with a focus on women. Women and men have been compared with respect to sensitivity to psychosocial risk factors regarding CHD. The importance of psychosocial risk factors for women, compared with biomedical risk factors has also been studied. METHODS: A questionnaire (The Stress Profile) was answered by 538 rehabilitation participants (97 women, 441 men) and a reference group (5308 women, 5177 men), aged 40-65 years. Psychosocial factors were investigated using means and b-coefficients. Comparisons between psychosocial and biomedical risk factors were made, with respect to the product of the beta-coefficient and the standard deviation for each compared risk factor. RESULTS: Significant differences appeared concerning five areas: work content, workload and control, physical stress reactions, emotional stress reactions and burnout. All showed that the relative sensitivity was larger for women than for men. Predictive psychosocial risk factors for women with respect to CHD were physical stress reactions, emotional stress reactions, burnout, family relationships and daily hassles/satisfactions, and they were on approximately the same level as biomedical risk factors. CONCLUSIONS: Women appear to be more sensitive than men with respect to psychosocial risk factors for CHD, and the predictive ability of psychosocial risk factors shows great importance. Actions against unhealthy psychosocial conditions are recommended. Both presumptive CHD patients and others might benefit from preventive actions, and since women are more sensitive they will probably gain more than men.
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| 3. |
- Hedbäck, Bo, 1944-, et al.
(författare)
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Cardiac rehabilitation after coronary artery bypass surgery : 10-Year results on mortality, morbidity and readmissions to hospital
- 2001
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Ingår i: Journal of Cardiovascular Risk. - : Ovid Technologies (Wolters Kluwer Health). - 1350-6277 .- 1473-5652. ; 8:3, s. 153-158
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the long-term secondary preventive effect of a comprehensive rehabilitation programme after coronary artery bypass grafting (CABG). Methods: The study group included 49 consecutive patients who underwent bypass surgery and were then offered a rehabilitation programme consisting of education in risk-factor control, a physical training programme and regular follow-up at a post-CABG clinic. The control group (n = 98), consisting of two well-matched CABG patients for each study patient, was offered the usual care with no access to a cardiac rehabilitation programme. The two groups were followed for 10 years and the results regarding cardiovascular mortality, morbidity, total cardiac events and readmissions to hospital were compared. Results: The total mortality (study group 8.2%, control group 20.4%) and cardiovascular mortality (8.2 versus 15.3%) after 10 years did not differ significantly between the groups. In the study group, nine patients (18.4%) had 10 cardiac events (four cardiovascular deaths, five non-fatal myocardial infarctions and one CABG) compared to 34 patients (34.7%, P < 0.05) suffering 46 (P < 0.01) cardiac events (15 cardiovascular deaths, 18 non-fatal myocardial infarctions, eight CABG, five coronary angioplasties) in the control group. The number of readmissions to hospital (2.1 versus 3.5 per patient) and length of admissions (11 versus 26 days per patient) was significantly lower in the study group (P < 0.01). Conclusion: A comprehensive cardiac rehabilitation programme offered to patients after coronary artery bypass surgery will improve the long-term prognosis and reduce the need for hospital care.
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| 4. |
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| 5. |
- Horsten, M, et al.
(författare)
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Social relations and the metabolic syndrome in middle-aged Swedish women
- 1999
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Ingår i: Journal of Cardiovascular Risk. - Karolinska Inst, Novum, Div Prevent Med, Dept Publ Hlth Sci, S-14157 Huddinge, Sweden. Beth Israel Deaconess Med Ctr, Div Cardiovasc, Boston, MA USA. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. Karolinska Hosp, Dept Cardiol, S-10401 Stockholm, Sweden. : LIPPINCOTT WILLIAMS & WILKINS. - 1350-6277 .- 1473-5652 .- 1741-8267 .- 1741-8275. ; 6:6, s. 391-397
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Tidskriftsartikel (refereegranskat)abstract
- Background Both social isolation and the metabolic syndrome are independently associated with greater than normal cardiovascular risk. Design A population-based cross-sectional study of middle-aged Swedish women. Methods The study group consisted of 300 healthy women (aged 31-65 years) who were representative of women living in the greater Stockholm area. Social isolation was measured by using a condensed Version of the Interpersonal Support Evaluation List. Health behaviours were assessed and a full serum-lipid-level and haemostatic profile was obtained by standardized methods, The metabolic syndrome was defined as the presence of two or more of these components: fasting serum level of glucose greater than or equal to 7.0 mmol/l, arterial blood pressure greater than or equal to 160/90 mmHg, fasting serum level of triglycerides greater than or equal to 1.7 mmol/l or high-density lipoprotein < 1.0 mmol/l, or both, and central obesity (waist:hip ratio > 0.85 or body mass index > 30 kg/m(2), or both), Results After adjustment for age, menopausal status, educational level, smoking, exercise habits and consumption of alcohol, the risk ratio for the metabolic syndrome for women in the lower compared with women in the upper social-support quartile was 3.5 (95% confidence interval 1.1-11.4), whereas that of women in the two middle quartiles was 2.2 (95% confidence interval 0.67-7.2; P for trend 0.02). Conclusions Social isolation was associated with the metabolic syndrome for these middle-aged women. The findings suggest that the metabolic syndrome and its components may be mediators of the reported association between social isolation and cardiovascular disease, (C) 1999 Lippincott Williams & Wilkins.
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| 6. |
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| 7. |
- Lind, Lars, et al.
(författare)
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Endothelium-dependent vasodilation is impaired in apparently healthy subjects with a family history of myocardial infarction
- 2002
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Ingår i: Journal of Cardiovascular Risk. - : Oxford University Press (OUP). - 1350-6277 .- 1473-5652. ; 9:1, s. 53-57
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate whether endothelial-dependent vasodilation is altered in healthy subjects with a family history of myocardial infarction. SETTING: Tertiary University Hospital SUBJECTS AND DESIGN: Fifty apparently healthy subjects selected from the general population were subjected to an evaluation of endothelial-dependent vasodilation (EDV) and endothelial-independent vasodilation (EIDV) by means of local infusion of methacholine (MCh, 2 and 4 microg/min) and sodium nitroprusside (SNP, 5 and 10 microg/min) with measurements of forearm blood flow with venous occlusion plethysmography. The occurrence of plaque and the intima-media thickness of the carotid arteries were determined by ultrasonography. RESULTS: Subjects reporting at least one parent suffering from myocardial infarction (n = 11) showed a significantly lower EDV than subjects without such a family history (21 +/- 3.7 vs. 26 +/- 6.7 ml/min/100 ml tissue at MCh 4 microg/min, P<0.05). EIDV was not significantly different between the groups (21 +/- 6.8 vs. 18 +/- 5.4 ml/min/100 ml tissue at SNP 10 microg/min). Age, sex distribution, body mass index, waist to hip ratio, blood pressure, lipids, fasting blood glucose, smoking habits and status of the carotid arteries were not significantly different between the groups. CONCLUSION: A family history of myocardial infarction was found to be associated with an impaired endothelial-dependent vasodilation in the forearm of apparently healthy subjects. The risk factor profile was not different from the control group, suggesting that genetic factors are responsible for the impaired endothelial-dependent vasodilation.
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| 8. |
- Luepker, RV, et al.
(författare)
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Differences in the treatment of acute myocardial infarction between regions of countries and the impact on prognosis
- 1999
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Ingår i: Journal of Cardiovascular Risk. - : Sage Publications Ltd.. - 1350-6277 .- 1473-5652. ; 6:2, s. 77-98
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Tidskriftsartikel (refereegranskat)abstract
- Differences in the incidence, prevalence of and mortality from coronary heart disease (CHD) are observed between and within countries. These differences are believed to be related to differing levels of CHD risk factors and medical care. Medical care for acute myocardial infarction has changed significantly in the past decades, with the development of new methods for diagnosis and treatment. Although widely known, these technologies are not consistently applied for reasons of availability and cost, as well as local medical cultures and traditions. The outcomes of medical care for acute myocardial infarction are best measured by case fatality of those hospitalized. Since the early 1960s, case fatality has fallen to less than half that observed previously. This has occurred in the context of widespread use of coronary care unit monitoring, innovative pharmacologic agents and invasive reperfusion treatments. A common debate compares aggressive invasive management with more conservative pharmacologic methods. In this context, studies have produced mixed results with no clear advantage to one approach when both methods are available and effectively applied to appropriately selected patients.
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