| 1. |
- Akrawi, Delshad Saleh, et al.
(författare)
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Familial risks of glomerulonephritis : a nationwide family study in Sweden
- 2016
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Ingår i: Annals of Medicine. - : Informa UK Limited. - 0785-3890 .- 1365-2060. ; 48:5, s. 313-322
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Familial risks of glomerulonephritis (acute, chronic and unspecified glomerulonephritis) have not been studied. This study aims to determine the familial risks of glomerulonephritis. Methods: Individuals born from1932 onwards diagnosed with glomerulonephritis (acute [n = 7011], chronic [n = 10,242] and unspecified glomerulonephritis [n = 5762]) were included. The familial risk (Standardized incidence ratio = SIR) was calculated for individuals whose parents/full-siblings were diagnosed with glomerulonephritis compared to those whose parents/full-siblings were not. The procedure was repeated for spouses. Familial concordant risk (same disease in proband and exposed relative) and discordant risk (different disease in proband and exposed relative) of glomerulonephritis were determined. Results: Familial concordant risks (parents/full-sibling history) were: SIR = 3.57 (95% confidence interval, 2.77–4.53) for acute glomerulonephritis, SIR = 3.84 (3.37–4.36) for chronic glomerulonephritis and SIR = 3.75 (2.85–4.83) for unspecified glomerulonephritis. High familial risks were observed if two or more relatives were affected; the SIR was 209.83 (150.51–284.87) in individuals with at least one affected parent as well as one full-sibling. The spouse risk was only moderately increased (SIR = 1.53, 1.33–1.75). Conclusions: Family history of glomerulonephritis is a strong predictor for glomerulonephritis, and is a potentially useful tool in clinical risk assessment. Our data emphasize the contribution of familial factors to the glomerulonephritis burden in the community.Key messagesThe familial risks (full-sibling/parent history) of glomerulonephritis (acute, chronic and unspecified glomerulonephritis) have not been determined previously.The familial risks of glomerulonephritis were increased among individuals with family history of acute, chronic or unspecified glomerulonephritis.The familial risks of glomerulonephritis were slightly increased among spouses indicating a modest non-genetic contribution.Very high familial risks were observed in multiplex families, i.e. with one or more affected first-degree relatives.
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| 2. |
- Hemminki, Kari, et al.
(författare)
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Risk of asthma and autoimmune diseases and related conditions in patients hospitalized for obesity
- 2012
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Ingår i: Annals of Medicine. - : Informa UK Limited. - 1365-2060 .- 0785-3890. ; 44:3, s. 289-295
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Tidskriftsartikel (refereegranskat)abstract
- Background. Although there are putative mechanistic links between obesity and autoimmune diseases, obesity is not considered a risk factor for most autoimmune diseases. Methods. Using the nation-wide Hospital Discharge Register we defined a cohort of 29,665 patients hospitalized for obesity since year 1964. The patients were followed for hospitalization for any of 34 autoimmune or related conditions through year 2007. Standardized incidence ratios (SIRs) were calculated for autoimmune diseases in obese individuals compared to those who had not been hospitalized for obesity. Results. Among 22 immune diseases diagnosed after hospitalization for obesity and in at least 5 patients, the overall SIR was 2.05. Of the individual diseases studied, the risk of 16 was significantly increased; none displayed a decreased risk. Psoriasis (4.54) and Behcet's disease (4.49) exhibited the highest risks, followed by Hashimoto's disease/hypothyroidism (4.12) and asthma (3.39). Small but significant increases in SIRs were also noted for the common autoimmune diseases Graves' sdisease/hyperthyroidism (1.28) and rheumatoid arthritis (1.37). Conclusions. The present population of obese individuals, subsequently diagnosed with a number of autoimmune diseases and related conditions, was hospitalized at a relatively young age. Further studies are needed to describe the morbidity in the obese population at large.
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| 3. |
- Rosengren, Per, et al.
(författare)
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Hospitalization rate of paroxysmal supraventricular tachycardia in Sweden
- 2018
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Ingår i: Annals of Medicine. - : Informa UK Limited. - 0785-3890 .- 1365-2060. ; 50:7, s. 556-564
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The hospitalization rate of paroxysmal supraventricular tachycardia (PSVT) in a nationwide study is not established. We determined age- and sex-specific hospitalization rates and time trends for hospitalized PSVT in the Swedish population between 1987 and 2010. Methods: This nationwide study is based on the Swedish Hospital Discharge Register. The patients with first PSVT diagnoses between January 1987 and December 2010 were identified. Results: A total of 42,765 individuals with PSVT were diagnosed (mean age 60 years; 44% males). The overall age- and sex-adjusted hospitalization rate was 20 per 100,000 person-years. The hospitalization rate increased with advancing age with highest hospitalization rates in individuals aged 80–84 years (67.12 per 100,000 person-years) and did not change significantly over time. A total of 20,011 (46.8%) patients had “lone” PSVT without any comorbidities. Lone PSVT patients were younger than PSVT patients with comorbidities (mean age 54 vs. 67 years, p =.0002). Conclusions: This study showed a slight preponderance for females and stable hospitalization rate of PSVT over time; the hospitalization rate increased with age. A high proportion of PSVT patients had no comorbidities. They were affected at a younger age than patients with comorbidities, which suggests an inherent predisposition.Key messages This study represents the first extensive and nationwide hospitalization study of PSVT. Hospitalization is highest in old age but a bimodal pattern was observed with a small peak in the first years of life. Patients with lone PSVT are younger than those with comorbidities; which suggests an inherent predisposition.
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| 4. |
- Wandell, Per, et al.
(författare)
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Depression or anxiety and all-cause mortality in adults with atrial fibrillation : A cohort study in Swedish primary care
- 2016
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Ingår i: Annals of Medicine. - : Informa UK Limited. - 0785-3890 .- 1365-2060. ; 48:1-2, s. 59-66
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Tidskriftsartikel (refereegranskat)abstract
- Objective Our aim was to study depression and anxiety in atrial fibrillation (AF) patients as risk factors for all-cause mortality in a primary care setting.Methods The study population included adults (n=12283) of 45 years and older diagnosed with AF in 75 primary care centres in Sweden. The association between depression or anxiety and all-cause mortality was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). Analyses were conducted in men and women, adjusted for age, educational level, marital status, neighborhood socio-economic status (SES), change of neighborhood status and anxiety or depression, respectively, and cardiovascular co-morbidities. As a secondary analysis, background factors and their association with depression or anxiety were explored.Results The risk of all-cause mortality was higher among men with depression compared to their counterparts without depression even after full adjustment (HR=1.28, 95% CI 1.08-1.53). For anxiety among men and anxiety or depression among women with AF, no associations were found. Cerebrovascular disease was more common among depressed AF patients.Conclusions Increased awareness of the higher mortality among men with AF and subsequent depression is called for. We suggest a tight follow-up and treatment of both ailments in clinical practice.
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| 5. |
- Wändell, Per, et al.
(författare)
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Mortality in patients with atrial fibrillation and common co-morbidities - a cohort study in primary care
- 2018
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Ingår i: Annals of Medicine. - : Informa UK Limited. - 0785-3890 .- 1365-2060. ; 50:2, s. 156-163
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the association between cardiovascular co-morbidities and mortality risk in primary care patients with atrial fibrillation.METHODS: The study population included all adults (n = 12,283) ≥ 45 years diagnosed with AF at 75 primary care centres in Sweden between 2001 and 2007. The outcome was mortality (until 2010) and data were explored for co-morbidities using Cox regression with hazard ratios (HRs). Analyses were performed stratified by sex and by age-group (45-64, 65-74 and ≥75 years of age) with adjustment for age, socio-economic factors and relevant co-morbidities.RESULTS: During a mean of 5.8 years (standard deviation 2.4) of follow-up, 3954 (32%) patients died (1971 (35%) women, and 1983 (30%) men). High HRs were found for congestive heart disease (CHF) and cerebrovascular diseases for all age-groups among men and women (except for the 45-64 year old women); for coronary heart disease among the oldest men; for diabetes among the 65-74 year old men and the 45-64 year old women. Low HRs were found for hypertension among women ≥75 years of age.CONCLUSIONS: In this clinical setting, CHF and cerebrovascular diseases were consistently associated with mortality in all age-groups. The possible protective effect by hypertension among elderly women should be interpreted with caution. KEY MESSAGES We found congestive heart failure and cerebrovascular diseases to be consistently associated with mortality in both women and men. We found hypertension to be associated with lower mortality risk among women ≥75 years of age, although this finding must be interpreted with caution. Depression was found to be associated with increased mortality risk among men and women aged 65-74 years of age.
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| 6. |
- Zöller, Bengt, et al.
(författare)
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Cardiovascular fitness in young males and risk of unprovoked venous thromboembolism in adulthood
- 2017
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Ingår i: Annals of Medicine. - : Informa UK Limited. - 0785-3890 .- 1365-2060. ; 49:2, s. 176-184
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Tidskriftsartikel (refereegranskat)abstract
- Background: Whether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown. The present study aims to determine whether high cardiovascular fitness reduces the risk of VTE. Methods: A Swedish cohort of male conscripts (n = 773,925) born in 1954–1970 with no history of previous VTE were followed from enlistment (1972–1990) until 2010. Data on cardiovascular fitness using a cycle ergonometric test (maximal aerobic workload in Watt [Wmax]) at conscription were linked with national hospital register data and the Multi-Generation Register. We identified all full-siblings and first-cousin pairs discordant for maximal aerobic workload. This co-relative design allows for adjustment for familial resemblance. Results: In total, 3005 (0.39%) males were affected by VTE. Cardiovascular fitness estimated with Wmax was not associated with VTE risk when adjusted for body mass index (BMI). However, cardiovascular fitness estimated with Wmax/kg and adjusted for BMI was associated with reduced risk for VTE (Hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.78–0.85 per standard deviation compared with mean Wmax/kg). The association was weaker over time and also when examining discordant first cousins and full-sibling pairs. Conclusions: These results suggest that there is a relationship between cardiovascular fitness and weight that is important for future VTE risk.Key messagesWhether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown.A Swedish cohort of male conscripts (n = 773,925) tested with a cycle ergometric test with no history of previous VTE were followed from enlistment (1972–1990) until 2010.Cardiovascular fitness estimated with Wmax/kg and adjusted for BMI was associated with reduced risk for VTE (HR 0.81, 95% CI 0.78–0.85).These results suggest that there is a relationship between cardiovascular fitness and weight that is important for future VTE risk.
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