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- Kornitzer, M., et al.
(författare)
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Job stress and major coronary events: results from the Job Stress, Absenteeism and Coronary Heart Disease in Europe study
- 2006
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Ingår i: Eur J Cardiovasc Prev Rehabil. - : Oxford University Press (OUP). - 1741-8267 .- 1741-8275. ; 13:5, s. 695-704
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The intention of this study is to investigate the relationship of the demands/control/strain model with hard coronary events in an epidemiological, prospective, multicenter, European study. METHODS AND RESULTS: Six cohorts (Brussels, Ghent, Lille, Barcelona, Goteborg and Malmo) from four European countries (Belgium, France, Spain and Sweden) consisting of 21 111 middle-aged male subjects participated between 1993 and 1996 in the baseline survey of the Job Stress, Absenteeism and Coronary Heart Disease in Europe (JACE) study. The Karasek strain model of psychological demands (five items)/control (nine items) was used. During a mean follow-up of 40 months 185 acute coronary events or coronary deaths were observed. Age-adjusted hazard ratios (HRs) for developing an acute coronary event were 1.46 [CI 95% confidence interval (1.08-1.97)] for high against low psychological demands and 1.53 (95% CI 1.0-2.35) for strained (high demands plus low control) against relaxed (low demands plus high control) groups. After adjustment for standard cardiovascular risk factors the HR for developing a coronary event for those above or equal to the median against those below the median of psychological demands was 1.46 (95% CI 1.08-1.97) whereas the HR for strained against relaxed groups is 1.46 (95% CI 0.96-2.25). Sensitivity analyses confirmed the robustness of the results. CONCLUSION: In this European, multicenter, prospective, epidemiological study the Karasek job strain model was an independent predictor of acute coronary events, with the psychological demands scale emerging as the important component.
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| 2. |
- Berg, Christina, 1963, et al.
(författare)
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Trends in blood lipid levels, blood pressure, alcohol and smoking habits from 1985 to 2002: results from INTERGENE and GOT-MONICA.
- 2005
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Ingår i: European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology. - 1741-8267. ; 12:2, s. 115-25
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Favourable trends in cardiovascular disease have been observed in Sweden. The aim of this study was to study secular trends in a variety of cardiovascular risk factors. METHODS: Total-, low-density (LDL) and high-density lipoprotein (HDL) serum cholesterol; serum triglycerides; systolic and diastolic blood pressure; self-reported smoking and alcohol consumption were studied in repeated cross-sectional surveys. Data from four population-based samples in Goteborg, Sweden were used-WHO MONICA project 1985, 1990 and 1995, and INTERGENE 2002. A total of 2931 females and 2691 males aged 25-64 consisting of 1021-1624 randomly selected subjects at each survey period participated. RESULTS: Serum cholesterol levels showed downward trends but the decline in both total- and LDL-cholesterol seems to be levelling off from 1995 and onwards. No significant changes were observed in serum triglyceride, HDL-serum cholesterol or blood pressure levels. The majority of the participants had higher total- and LDL-serum cholesterol levels than currently recommended. Antihypertensive medical treatment increased in women and the oldest men. The prevalence of smoking decreased from 39 to 25% in women and 35 to 20% in men respectively from 1985-2002. In contrast, the prevalence of subjects consuming strong beer and wine, respectively, at least once a week almost doubled from 1990-2002. CONCLUSIONS: Cardiovascular risk factor patterns change continuously and need to be monitored. The favourable trends in LDL-serum cholesterol and smoking in the Goteborg surveys were paralleled by less favourable trends in being overweight and alcohol consumption.
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| 3. |
- Dudas, Kerstin, 1963, et al.
(författare)
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Predictors of coronary bypass grafting in a population of middle-aged men
- 2007
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Ingår i: Eur J Cardiovasc Prev Rehabil. - : Oxford University Press (OUP). - 1741-8267. ; 14:1, s. 122-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Coronary bypass grafting is a procedure which is usually undertaken because of extensive coronary heart disease, whereas acute myocardial infarction may occur with patients with moderate or even minimal disease. Having undergone coronary bypass grafting may thus serve as a marker for extensive coronary atherosclerosis. The aim of this study was to assess risk factors for future coronary bypass grafting as a first coronary event, and to compare them with risk factors for a first acute myocardial infarction. DESIGN: This was a prospective cohort study. METHOD: In the Multifactor Primary Prevention Study, 7388 men aged 47-55 years and free of previous acute myocardial infarction or stroke were investigated between 1970 and 1973. During 28 years of follow-up 1664 men (22%) had an acute myocardial infarction or died from coronary disease. One hundred and forty six men (2%) underwent coronary bypass grafting with no prior acute infarction. RESULTS: Serum cholesterol was a stronger predictor of coronary bypass grafting than of acute myocardial infarction. Compared to men with serum cholesterol of 5.0 or lower, men with serum cholesterol 5.1-6.4, 6.5-7.4 and over 7.4 mmol/l had age-adjusted hazard ratios for acute myocardial infarction of 1.22 (1.00-1.49), 1.66 (1.35-2.03) and 2.04 (1.65-2.51). Corresponding hazard ratios for coronary bypass grafting were 1.57 (0.66-3.70), 3.44 (1.47-8.03) and 5.21 (2.20-12.31) (95% confidence interval). In contrast, smoking was a weaker risk factor for coronary bypass grafting than for acute myocardial infarction with no discernible increase in risk except in very heavy smokers (25 g/day or more; n=193); hazard ratio 2.19 (1.02-4.66). Elevated blood pressure predicted coronary bypass grafting and acute myocardial infarction equally well. In multivariate analysis an increase in serum cholesterol of 1 mmol/l was associated with an odds ratio of 1.56 (1.38-1.76) for coronary bypass grafting but only 1.30 (1.24-1.36) for AMI (P for difference in odds ratio 0.004). CONCLUSION: Elevated serum cholesterol is a stronger predictor for future coronary bypass grafting than for acute myocardial infarction. Moderate smoking was not associated with coronary bypass grafting. Different manifestations of coronary disease have different risk factor patterns, suggesting that secular changes in risk factor pattern could potentially influence the clinical expression of the disease.
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| 4. |
- Welin, Lennart, 1941, et al.
(författare)
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Insulin resistance, glucose intolerance, physical activity and other risk factors for coronary heart disease in elderly men. The study of men born in 1913 and 1923.
- 2003
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Ingår i: European Journal of Cardiovascular Prevention and Rehabilitation. - 1741-8267. ; :10, s. 283-288
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We have previously shown that insulin is not a major risk factor for CHD. Our data have been re-analysed with longer follow-up and the homeostasis model assessment (HOMA) method. DESIGN: Prospective cohort study of 57- and 67-year-old men. METHODS: Insulin resistance was estimated with the HOMA equation. Standard methods were used to measure risk factors. The endpoint (CHD) was the combination of non-fatal myocardial infarction and fatal CHD during 13 years of follow-up. RESULTS: The risk of CHD increased 2.5-fold in known diabetics compared with those with normal glucose tolerance, 2.2-fold among those in the highest compared with the lowest quintile of insulin resistance, and 2.4-fold among those in the highest compared with the lowest quintile of fasting insulin. Increased physical activity decreased the risk of CHD by 65%. Cholesterol was also a significant risk factor for CHD but blood pressure, obesity and smoking were not related to the incidence of CHD. CONCLUSION: Insulin resistance is a significant risk factor for CHD. Whether it is a causal risk factor remains to be proven. Regular physical activity protects against CHD. PMID: 14555884 [PubMed - indexed for MEDLINE]
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