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Träfflista för sökning "AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems) ;lar1:(ki)"

Sökning: AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems) > Karolinska Institutet

  • Resultat 1-10 av 1779
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1.
  • Taddei, C, et al. (författare)
  • Repositioning of the global epicentre of non-optimal cholesterol
  • 2020
  • Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 582:7810, s. 73-
  • Tidskriftsartikel (refereegranskat)abstract
    • High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
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3.
  • Ruiz, Jonatan R., et al. (författare)
  • High cardiovascular fitness is associated with low metabolic risk score in children : the European Youth Heart Study
  • 2007
  • Ingår i: Pediatric Research. - Baltimore, Md : Williams and Wilkins Co. - 0031-3998 .- 1530-0447. ; 61:3, s. 350-355
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present study was to examine the associations of cardiovascular fitness (CVF) with a clustering of metabolic risk factors in children, and to examine whether there is a CVF level associated with a low metabolic risk. CVF was estimated by a maximal ergometer bike test on 873 randomly selected children from Sweden and Estonia. Additional measured outcomes included fasting insulin, glucose, triglycerides, HDLC, blood pressure, and the sum of five skinfolds. A metabolic risk score was computed as the mean of the standardized outcomes scores. A risk score <75th percentile was considered to indicate a low metabolic risk. CVF was negatively associated with clustering of metabolic risk factors in children. Receiver operating characteristic curve analysis showed a significant discriminatory accuracy of CVF in identifying the low/high metabolic risk in girls and boys (p < 0.001). The CVF level for a low metabolic risk was 37.0 and 42.1 mL/kg/min in girls and boys, respectively. These levels are similar to the health-related threshold values of CVF suggested by worldwide recognized organizations. In conclusion, the results suggest a hypothetical CVF level for having a low metabolic risk, which should be further tested in longitudinal and/or intervention studies. Abbreviations: AUC, area under the curve CVF, cardiovascular fitness ROC, receiver operating characteristic
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5.
  • Mälstam, Emelie, et al. (författare)
  • 'Weaving lifestyle habits' : Complex pathways to health for persons at risk for stroke.
  • 2022
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 29:2, s. 152-164
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: It is important to understand how healthy lifestyle habits can be developed as they are essential in cardiovascular disease (CVD) prevention. There is limited knowledge regarding whether, and how, engaging occupations (things that people do and occupy themselves with) can promote and help sustain healthy lifestyle habits for persons at risk for CVDs, including stroke.AIM: The aim was to develop knowledge of how engaging in occupations can contribute to changes in lifestyle habits among persons at risk for stroke.METHODS: Six adults presenting with stroke risk factors were interviewed on several occasions after participating in an occupation-focused stroke prevention programme. Grounded theory was utilised, and constant comparative methods guided the analysis.FINDINGS: Changing lifestyle habits was perceived as a complex process, much like weaving a fabric with many parallel and interlacing threads. Literacy of both health and occupations and participation in engaging occupations were important facilitators for promoting healthy lifestyle habits, yet engagement in health-promoting occupations was described as conditioned behaviour.CONCLUSIONS: CVD prevention programmes can benefit from incorporating engaging occupations to promote healthy lifestyle habits and literacy of health and occupations. However, contextual factors conditioning health and occupations should be considered when developing and implementing sustainable interventions.
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6.
  • Osika, Walter, et al. (författare)
  • Sex differences in peripheral artery intima, media and intima media thickness in children and adolescents
  • 2009
  • Ingår i: Atherosclerosis. - Amsterdam : Elsevier. - 0021-9150 .- 1879-1484. ; 203:1, s. 172-177
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective Males have higher coronary heart disease (CHD) lifetime risk and increased magnitude of atherosclerosis, compared with women. Using very high-resolution ultrasound, we have shown that the intima thickness (IT) of radial and dorsal pedal arteries, measured separately from the media thickness (MT), increases with age. We wanted to test whether there is already a difference between the sexes in childhood for IT, MT and intima media thickness (IMT) in the radial and dorsal pedal arteries. Methods and results A total of 252 children (age 14.5 years S.D. ± 1.0 girls/boys 139/113) from two schools in Gothenburg, Sweden, participated in the study. The high-resolution (55 MHz) ultrasound measurements showed that boys had larger values than girls for the radial IT (0.057 ± 0.010 mm vs. 0.054 ± 0.008 mm, P = 0.007), MT (0.176 ± 0.033 vs. 0.153 ± 0.025, P = 0.031), IMT (0.232 ± 0.035 vs. 0.207 ± 0.026, P = 0.000), and for dorsal pedal artery MT (0.160 ± 0.039 vs. 0.149 ± 0.034, P = 0.022) and IMT (0.222 ± 0.041 vs. 0.209 ± 0.037, P = 0.016). Conclusion With this new very high-resolution ultrasound technique, we demonstrated in a large study population of children, that both intimal and medial arterial wall layers were thicker in boys than in girls. These findings may constitute an “early background” explaining why CHD starts sooner in men compared with women.
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7.
  • Jonsson, M., et al. (författare)
  • Survival after out-of-hospital cardiac arrest is associated with area-level socioeconomic status
  • 2019
  • Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 105:8, s. 632-638
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective Out-of-hospital cardiac arrest (OHCA) is a major cause of death in the Western world. In this study we aimed to investigate the relationship between area-level socioeconomic status (SES) and 30-day survival after OHCA. We hypothesised that high SES at an area level is associated with an improved chance of 30-day survival. Methods Patients with OHCA in Stockholm County between 1 January 2006 and 31 December 2015 were analysed retrospectively. To quantify area-level SES, we linked the patient's home address to 250 x 250/1000 x 1000 meter grids with aggregated information about income and education. We constructed multivariable logistic regression models in which area-level SES measures were adjusted for age, sex, emergency medical services response time, witnessed status, initial rhythm, aetiology, location and year of cardiac arrest. Results We included 7431 OHCAs. There was significantly greater 30-day survival (p=0.003) in areas with a high proportion of university-educated people. No statistically significant association was seen between median disposable income and 30-day survival. The adjusted OR for 30-day survival among patients in the highest educational quintile was 1.70 (95% CI 1.15 to 2.51) compared with patients in the lowest educational quintile. We found no significant interaction for sex. Positive trend with increasing area-level education was seen in both men and women but the trend was only statistically significant among men (p=0.012) Conclusions Survival to 30 days after OHCA is positively associated with the average educational level of the residential area. Area-level income does not independently predict 30-day survival after OHCA.
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8.
  • Heshmati, Amy Frances, et al. (författare)
  • Childhood and adulthood socio-economic position and hypertensive disorders in pregnancy: the Uppsala Birth Cohort Multigenerational Study
  • 2013
  • Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 67:11, s. 939-946
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Childhood and adulthood socio-economic position (SEP) is associated with cardiovascular disease in later life, but associations with hypertensive disorders in pregnancy are not well established.                                 Objective The aim of this study was to investigate the association of childhood and adulthood SEP with hypertensive disorders in pregnancy (chronic hypertension, gestational hypertension and pre-eclampsia/eclampsia).                                 Method Study participants were Swedish women (n=9507) from generation 3 of the Uppsala Birth Cohort Multigenerational Study (UBCoS Multigen) who delivered a live singleton offspring between 1982 and 2008. Social and health data were obtained from routine Swedish registers. Associations of own education (adulthood SEP), and parental education and social class (childhood SEP) with hypertensive disorders were studied using logistic regression with adjustments for age, calendar period, parity, smoking and body mass index.                                 Results Low own education was associated with chronic hypertension, but not with gestational hypertension or pre-eclampsia/eclampsia. Increased risk of chronic hypertension was seen in women whose mothers had medium education compared with women whose mothers had high education (OR 2.18, 95% CI 1.03 to 4.62). Women from a manual social class during childhood had twice the risk of chronic hypertension compared with those from non-manual backgrounds (OR 2.19, 95% CI 1.28 to 3.75). Childhood SEP was not associated with gestational hypertension or pre-eclampsia/eclampsia.                                 Conclusions Childhood and adulthood SEP was associated with chronic hypertension in pregnancy. In contrast, no association with childhood or adulthood SEP was seen for gestational hypertension or pre-eclampsia/eclampsia.
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9.
  • Di Gennaro, A., et al. (författare)
  • Cysteinyl leukotriene receptor 1 antagonism prevents experimental abdominal aortic aneurysm
  • 2018
  • Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 115:8, s. 1907-1912
  • Tidskriftsartikel (refereegranskat)abstract
    • Cysteinyl-leukotrienes (cys-LTs) are 5-lipoxygenase-derived lipid mediators involved in the pathogenesis and progression of inflammatory disorders, in particular asthma. We have previously found evidence linking these mediators to increased levels of proteolytic enzymes in tissue specimens of human abdominal aortic aneurysm (AAA). Here we show that antagonism of the CysLT1 receptor by montelukast, an established antiasthma drug, protects against a strong aorta dilatation (>50% increase = aneurysm) in a mouse model of CaCl2-induced AAA at a dose comparable to human medical practice. Analysis of tissue extracts revealed that montelukast reduces the levels of matrix metalloproteinase-9 (MMP-9) and macrophage inflammatory protein-1 alpha (MIP-1 alpha) in the aortic wall. Furthermore, aneurysm progression was specifically mediated through CysLT1 signaling since a selective CysLT2 antagonist was without effect. A significantly reduced vessel dilatation is also observed when treatment with montelukast is started days after aneurysm induction, suggesting that the drug not only prevents but also stops and possibly reverts an already ongoing degenerative process. Moreover, montelukast reduced the incidence of aortic rupture and attenuated the AAA development in two additional independent models, i.e., angiotensin II- and porcine pancreatic elastase-induced AAA, respectively. Our results indicate that cys-LTs are involved in the pathogenesis of AAA and that antagonism of the CysLT1 receptor is a promising strategy for preventive and therapeutic treatment of this clinically silent and highly lethal disease.
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10.
  • Matilla-Santander, Nuria, et al. (författare)
  • Trajectories of precarious employment and the risk of myocardial infarction and stroke among middle-aged workers in Sweden : A register-based cohort study
  • 2022
  • Ingår i: The Lancet Regional Health. - : Elsevier BV. - 2666-7762. ; 15
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The aim is to identify trajectories of precarious employment (PE) over time in Sweden to examine associations of these with the subsequent risk of myocardial infarction (MI) and stroke.Methods This is a nation-wide register-based cohort study of 1,583,957 individuals aged 40 to 61 years old residing in Sweden between 2003-2007. Trajectories of PE as a multidimensional construct and single PE components (contractual employment relationship, temporariness, income levels, multiple job holding, probability of coverage by collective agreements) were identified for 2003-2007 by means of group-based model trajectories. Risk Ratios (RR) for MI and stroke according to PE trajectories were calculated by means of generalized linear models with binomial family.Findings Adjusted estimates showed that constant PE and borderline PE trajectories increased the risk of MI (RR: 1.08, CI95%:1.05-1.11 and RR:1.13, CI95%: 1.07-1.20 respectively) and stroke (RR:1.14, CI95%: 1.10-1.18 and HR:1.24, CI95%: 1.16-1.33 respectively) among men. A higher risk of stroke in men was found for the following unidimensional trajectories: former agency employees (RR:1.32, CI95%:1.04-1.68); moving from high to a low probability of having collective agreements (RR: 1.10, CI95%:1.01-1.20). Having constant low or very low income was associated to an increased risk of MI and Stroke for both men and women.Interpretation The study findings provide evidence that PE increases the risk of stroke and possibly MI. It highlights the importance of being covered by collective bargaining agreements, being directly employed and having sufficient income levels over time.
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