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- Hofman-Bang, Claes, et al.
(författare)
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Two year results of a controlled study of a residential rehabilitation for patients treated with percutaneous transluminal coronary angioplasty : A randomized study of a multifactorial programme
- 1999
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 20:20, s. 1465-1474
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Tidskriftsartikel (refereegranskat)abstract
- Aims In a multifactorial lifestyle behaviour programme, of 2 years duration, to study the maintenance of achieved behaviour and risk factor-related changes. Methods and Results Out of a consecutive population of 151 patients treated with percutaneous transluminal angioplasty under 65 years of age, 87 were randomly allocated to an intervention group (n=46) or to a control group (n=41). The programme started with a 4 week residential stay, which was focused on health education and the achievement of behaviour change. During the first year of follow-up, a maintenance programme included regular contacts with a nurse, while no further rehabilitative efforts were offered during the second year. One patient died (control). During the second year the proportion of hospitalized patients was lower in the intervention group (4% vs 20%;P<0·05). Patients in the intervention group improved several lifestyle dependent behaviours: diet (index at 0, 12 and 24 months): 10·5±3·4, 12·9±2·5 and 12·4±2·6 in the intervention group (I) vs 10·1±3·2, 10·7±3·0 and 11·8±3·2 in the control group (C);P<0·05, exercise sessions per week: 2·5±2·3, 4·5±1·9 and 4·4±2·1 (I) vs 3·1±2·2, 3·5±2·3 and 3·7±2·7 (C);P<0·05, and smoking; 18%, 6% and 9% (I) vs 12%, 21% and 18% (C);P<0·05. This corresponded to improvement in exercise capacity (0, 12 and 24 months): 156±42, 174±49 and 165±47W (I) vs 164±40, 163±49 and 156±48 watts (C);P<0·05. There were no significant differences between the two groups with regard to serum cholesterol levels at 0 and 24 months: 5·4±0·8 and 5·2±0·9mmol.l–1(I) vs 5·4±1·0 and 4·9±0·9mmol.l–1(C); ns, low density lipoprotein cholesterol level: 3·6±0·8 and 3·4±0·8mmol.l–1(I) vs 3·7±0·9 and 3·3±0·7mmol.l–1(C); ns, triglyceride level: 2·2±1·6 and 1·8±1·3mmol.l–1(I) vs 2·2±1·4 and 1·6±0·6mmol.l–1(C); ns, body mass index (0, 12 and 24 months): 27·5±4·5, 27·0±4·3 and 27·4± 4·5kg.m–2(I) vs 26·8±2·8, 26·9±2·7 and 26·9± 3·2kg.m–2(C); ns, waist/hip ratio or blood pressure. The two groups did not differ in quality of life, or psychological factors. Return to work after 12 and 24 months was 74% and 78% (I) vs 68% and 61% (C); ns. Conclusion This rehabilitation programme influenced important lifestyle behaviour and reduced some, but not all, important risk factors Key Words: Rehabilitation, risk factors
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- Kivimäki, Mika, et al.
(författare)
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Long working hours as a risk factor for atrial fibrillation : a multi-cohort study
- 2017
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 38:34, s. 2621-2628
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Tidskriftsartikel (refereegranskat)abstract
- Aims Studies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working long hours (>= 55 per week) and those working standard 35-40 h/week. Methods and results In this prospective multi-cohort study from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium, the study population was 85 494 working men and women (mean age 43.4 years) with no recorded atrial fibrillation. Working hours were assessed at study baseline (1991-2004). Mean follow-up for incident atrial fibrillation was 10 years and cases were defined using data on electrocardiograms, hospital records, drug reimbursement registers, and death certificates. We identified 1061 new cases of atrial fibrillation (10-year cumulative incidence 12.4 per 1000). After adjustment for age, sex and socioeconomic status, individuals working long hours had a 1.4-fold increased risk of atrial fibrillation compared with those working standard hours (hazard ratio = 1.42, 95% CI= 1.13-1.80, P= 0.003). There was no significant heterogeneity between the cohort-specific effect estimates (I-2= 0%, P = 0.66) and the finding remained after excluding participants with coronary heart disease or stroke at baseline or during the follow-up (N= 2006, hazard ratio= 1.36, 95% CI= 1.05-1.76, P = 0.0180). Adjustment for potential confounding factors, such as obesity, risky alcohol use and high blood pressure, had little impact on this association. Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.
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