| 1. |
- Calling, Susanna, et al.
(författare)
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Effects of body fatness and physical activity on cardiovascular risk: risk prediction using the bioelectrical impedance method.
- 2006
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 34:6, s. 568-575
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To explore the effects of body fat percentage (BF%) on incidence of and mortality from cardiovascular disease (CVD) and to study the cardio-protective effect of physical activity in relation to BF%. Methods: A total of 26,942 men and women, aged 45-73 years, without history of CVD were followed up for incidence of coronary events (CE), ischaemic stroke, and CVD mortality over seven years in relation to sex-specific quartiles (Q1-Q4) of BF%. The cardio-protective effect of leisure-time physical activity was studied in relation to BF%. Results: In men, the relative risk (RR) for CE and CVD mortality increased progressively with BF%. RR for CE in Q4 was 1.37 (95% confidence interval: 1.07-1.74), adjusted for age, height, smoking, high alcohol intake, and physical activity, compared with Q1. In women, BF% was significantly associated with incidence of CE and stroke. BF% was more strongly correlated to body mass index (BMI) (r=50.83) and waist circumference (r=0.76) in women than in men (r=0.59 and r=50.66, respectively). BF% was a stronger risk factor than BMI in women, and equally strong as waist circumference. A significant interaction (p=0.013 for incidence of CE, p=0.026 for ischaemic stroke) was found between BF% and sex. The raised cardiovascular risk was reduced by physical activity in subjects with high BF%. Conclusions: BF% is a risk factor for CE, ischaemic stroke, and CVD mortality. An interaction between BF% and sex suggests that BF% is a stronger CVD risk factor in women. The raised cardiovascular risk associated with high BF% is reduced by physical activity.
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| 2. |
- Hedblad, Bo, et al.
(författare)
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COHb% as a marker of cardiovascular risk in never smokers: results from a population-based cohort study.
- 2006
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 34:6, s. 609-615
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Carbon monoxide (CO) in blood as assessed by the COHb% is a marker of the cardiovascular ( CV) risk in smokers. Non-smokers exposed to tobacco smoke similarly inhale and absorb CO. The objective in this population-based cohort study has been to describe inter-individual differences in COHb% in never smokers and to estimate the associated cardiovascular risk. Methods: Of the 8,333 men, aged 34-49 years, from the city of Malmo, Sweden, 4,111 were smokers, 1,229 ex-smokers, and 2,893 were never smokers. Incidence of CV disease was monitored over 19 years of follow up. Results: COHb% in never smokers ranged from 0.13% to 5.47%. Never smokers with COHb% in the top quartile (above 0.67%) had a significantly higher incidence of cardiac events and deaths; relative risk 3.7 (95% CI 2.0-7.0) and 2.2 (1.4-3.5), respectively, compared with those with COHb% in the lowest quartile (below 0.50%). This risk remained after adjustment for confounding factors. Conclusion: COHb% varied widely between never-smoking men in this urban population. Incidence of CV disease and death in non-smokers was related to COHb%. It is suggested that measurement of COHb% could be part of the risk assessment in non-smoking patients considered at risk of cardiac disease. In random samples from the general population COHb% could be used to assess the size of the population exposed to second-hand smoke.
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| 3. |
- Hedblad, Bo, et al.
(författare)
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Incidence of cardiovascular disease, cancer and death in postmenopausal women affirming use of hormone replacement therapy.
- 2002
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 30:1, s. 12-19
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The goal of this study was to evaluate the incidence of myocardial infarction, cancer and death in relation to use of hormone replacement therapy (HRT). METHODS: Nine years' follow up of an urban cohort of peri-/postmenopausal women was undertaken. Local and national registers were used for retrieval of events. RESULTS: The incidence of myocardial infarction per 1.000 person-years in users and non-users was 0.61 (5/962) and 2.20 (92/4759) respectively, adjusted relative risk (RR) 0.37; 95% confidence interval 0.15-0.90. Rates of mortality from cardiovascular disease and cancer were 0.36 and 1.10, p= 0.058, and 2.60 and 2.09, p=0.360 respectively. In terms of all-cause mortality the adjusted RR was 1.02; 0.69-1.52, incidence of cancer 1.28; 1.01-1.64, breast cancer 1.52; 1.01-2.28 and endometrial cancer 3.61; 1.54-8.46. CONCLUSIONS: Women affirming use of HRT had a lower incidence of myocardial infarction. Further studies are needed to assess whether the absence of effect on total mortality may be accounted for by an increased cancer risk.
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| 4. |
- Janzon, Ellis, et al.
(författare)
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Smoking as a determinant of the geographical pattern of cardiac events among women in an urban population
- 2007
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 35:3, s. 272-277
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To assess to what extent geographical differences of the female incidence of myocardial infarction in the city of Malmö in Sweden can be accounted for by smoking and to what extent intra-urban variances of smoking are related to socio-economic circumstances. Method. Area specific prevalence’s of smokers is based on a sample of 17319 women, aged 45-73 years. A comprehensive score was used to rank the 17 residential areas in terms of socioeconomic circumstances. Incidence of myocardial infarction and death is based on official statistics 1989-97. Results. The area-specific prevalence of female smokers, which ranged from 17.5 to 32.5% was inversely related to the socio-economic score in 45-54 and 55-64 years old, r = -0.65 (p<0.05) and -0.59 (p<0.05). No correlation was found for women above 65 years of age. The annual age-adjusted incidence of cardiac events in the residential areas which ranged from 151 to 414 per 100 000 person years, was strongly related to the prevalence of smokers, r = 0.75 (p < 0.001). Conclusion. Between 50-60% of the intra-urban variance of the female incidence of myocardial infarction was accounted for by smoking in this urban population. The geographical pattern of smoking was strongly related to inferior socio-economic circumstances. Key words: cardiac events, smoking women, risks and prevention
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| 5. |
- Janzon, Ellis, et al.
(författare)
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Who are the "quitters"? a cross-sectional study of circumstances associated with women giving up smoking.
- 2005
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 33:3, s. 175-182
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Tidskriftsartikel (refereegranskat)abstract
- Background: Smoking is an important preventable risk factor for cardiovascular disease, cancer, and many other diseases. Even though tobacco consumption is declining in Sweden, it is not declining in all groups. This study explored socioeconomic and psychosocial circumstances hindering or facilitating smoking cessation in three birth cohorts of women from the general population. Methods: Between 1991 and 1996 a comprehensive questionnaire was administered to 17,319 women, 45–73 years old, from the Malmo¨ Diet and Cancer cohort. Smoking habits were compared in relation to socioeconomic and psychosocial circumstances in three birth cohorts. Results: Of these women, 44% were never smokers, 28% were ex-smokers, and 28% were smokers (regular or occasional). When compared with smokers, ex-smokers were more often married, had a higher socioeconomic position, a longer education, more smoke-free surroundings, better emotional support, higher BMI, and better self-perceived health. Ex-smokers reported less work-related stress and less shift work. A history of cardiovascular disease was not associated with smoking cessation. The socioeconomic differences between current and former smokers were higher for young women as compared with older birth cohorts. Conclusions: Continuing smokers and quitters differ with regard to socioeconomic and psychosocial circumstances and factors related to working life and environmental tobacco exposure. By determining who the quitters are through continued follow-up, useful insights can be gained to develop strategies to achieve successful cessation of smoking.
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| 6. |
- Manjer, Jonas, et al.
(författare)
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Invitation to a population-based cohort study: differences between subjects recruited using various strategies.
- 2002
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 30:2, s. 103-112
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The present study compares subjects recruited to a population-based prospective cohort study by community versus personal invitation, and subjects responding late versus early to personal invitation. Subjects were compared with respect to sociodemographic characteristics, selected lifestyle factors, cancer incidence and mortality. METHODS: The Malmö Diet and Cancer Study recruited a total of 28,098 subjects between 1991 and 1996. Entire birth-year cohorts, born 1923-50, were recruited using community directed (passive) invitation, and a personal letter of invitation (active recruitment). Information on sociodemography and lifestyle was obtained using a self-administered questionnaire. Anthropometric measurements were assessed at a physical examination. Cancer incidence and cause of death were retrieved using record linkage with national registries. RESULTS: Subjects responding to community directed invitation were older, and more often females, than participants recruited using personal invitation. Furthermore, participants recruited through passive invitation had a comparably more favourable situation with regard to sociodemographic and lifestyle factors. They also had a lower frequency of prevalent disease, lower incidence of cancer and lower mortality. Contrary to this, men were more likely to respond late to a personal letter of invitation and late responders were also older, as compared with subjects responding early to personal invitation. Furthermore, those who responded late had a comparatively unfavourable socioeconomic situation and were characterized by a high prevalence of current smoking, obesity, weight change, and prevalent disease. CONCLUSIONS: Subjects who are recruited using different strategies in population-based cohort studies may have different sociodemographic and lifestyle characteristics, and may vary with regard to prevalent disease, cancer incidence and subsequent mortality.
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| 7. |
- Zackrisson, Sophia, et al.
(författare)
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Social predictors of non-attendance in an urban mammographic screening programme: A multilevel analysis
- 2007
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 35:5, s. 548-554
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Rate of non-attendance following invitation for breast cancer screening is related to several socioeconomic conditions. To what extent this reflects differences with regard to individual and environmental circumstances, respectively, has received little attention. The purpose of this study was to investigate the effect of individual socioeconomic and area-level determinants on variations in non-attendance among geographic areas in an urban mammographic service screening programme. Methods: The study population consisted of 32,119 women invited for mammographic screening in 1990-93, residing in 97 neighbourhoods in the city of Malmo in Sweden. The influence of the individual factors age, marital status, education, housing accommodation, household income, and area-level circumstances, e. g. rate of migration and rate of being gainfully employed, on the rate of non-attendance was assessed by multilevel analysis. Results: Area rates of non-attendance ranged from 18% to 63%. Of the total variability in non-attendance, 4.3% was between neighbourhoods. This effect was significantly reduced when adjusting for the individual factors. The area-level factors, migration, and rate of being gainfully employed reduced and almost erased the neighbourhood variance in non-attendance. Conclusion: In addition to individual socioeconomic factors, area-level factors seem to be important determinants of neighbourhood rates of non-attendance in an urban mammographic screening programme. In a public health perspective neighbourhoods may be targeted in order to affect the problem of non-attendance in mammographic screening.
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