| 1. |
- 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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| 2. |
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| 3. |
- 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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| 4. |
- 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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| 5. |
- Janzon, Ellis, et al.
(författare)
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Can physical activity be used as a tool to reduce depression in patients after a cardiac event? What is the evidence? A systematic literature study
- 2015
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Ingår i: Scandinavian Journal of Psychology. - : John Wiley & Sons. - 0036-5564 .- 1467-9450. ; 56:2, s. 175-181
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Tidskriftsartikel (refereegranskat)abstract
- A reduction in the incidence of cardiovascular diseases (CVD) has been reported in the Western world, but post-infarction depression often occurs and is related to poor medical outcomes. The aim of this study was to examine the scientific literature by a systematic review, in order to find evidence for whether physical activity can be a tool to reduce depression in patients who have suffered a cardiac event. Three databases were systematically searched (PubMed, CINAHL, and Cochrane), and the GRADE protocol was used in combination with a revised Amstar-protocol for the systematic review. Scientific reports fitting the area were scarce. Finally, ten studies were included in this study: one meta-analysis, five randomized controlled trials, and four clinical trials. The results showed low to moderate evidence for the use of low to moderate levels of exercise as a tool to reduce depression in post-coronary artery event patients. This study concluded positive effects of physical activity as a tool to reduce depression in post-coronary artery event patients. Physiotherapists could be further involved in increasing physical activity after cardiac events. More studies are needed in the area.
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| 6. |
- Janzon, Ellis, et al.
(författare)
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Changes in blood pressure and body weight following smoking cessation in women.
- 2004
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Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 255:2, s. 266-272
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Few have studied the long-term effects of smoking and smoking cessation on weight gain and blood pressure increase and compared with the age-related increases experienced by most adults. This study compared the development of weight and blood pressure in female never smokers, continuing smokers and smokers who quit smoking. Design. Weight, systolic (SBP) and diastolic (DBP) blood pressure and smoking habits were assessed at baseline and re-assessed after a mean follow-up of 9.0 ± 5.8 years. Setting. Population-based cohort. Subjects. A total of 2381 female never smokers and 1550 female smokers. At the re-examination, 388 of the smokers had quit smoking. Results. Mean weight gain was 7.6 ± 6.1, 3.2 ± 5.8 and 3.7 ± 5.2 kg, respectively, in quitters, continuing smokers and never smokers (P < 0.001). In women without blood pressure treatment, mean SBP increase was 20.9 ± 16.8, 19.1 ± 15.8 and 16.1 ± 16.3 mmHg, respectively, in these groups (P < 0.001). Mean DBP increase was 6.2 ± 8.7, 5.7 ± 9.3 and 3.1 ± 8.0 mmHg, respectively (P < 0.001). After adjustments for potential confounders, the increased weight gain in quitters remained highly significant. The differences in SBP and DBP increase were attenuated after adjustments, but remained significant. Incidence of hypertension (>= 160/95 mmHg or treatment) was significantly higher in quitters [adjusted odds ratio (OR): 1.8; CI: 1.4-2.5] when compared with continuing smokers (OR: 1.3; CI: 1.07-1.6) and never smokers (reference). Conclusion. Over a long follow-up, weight gain was approximately 3-4 kg higher in quitters when compared with continuing smokers or never smokers. Although the differences in blood pressure increase were moderate, smoking cessation was associated with an increased incidence of hypertension.
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| 7. |
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| 8. |
- Janzon, Ellis, et al.
(författare)
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Obesity in Somali migration women due to post migration dietary changes and decreasing self-esteem : a qualitative interview study on diet, knowledge ab out risk of heart disease, inactivity, body image and self-esteem
- 2013
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Ingår i: Journal of research in obesity. - : IBIMA Publishing. - 2333-3707. ; :142971
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Tidskriftsartikel (refereegranskat)abstract
- The last-decade incidence of myocardial infarction (MI) has diminished dramatically in most age groups but not in middle-aged women in Sweden. There has been a large influx of immigrants and it has been shown that immigrant wom en have a higher BMI and are less physically active than Swedish women. Thereby they have a higher risk for heart disease. The aim of the study was to examine post-migration diet ary changes, and knowledge about risks for heart diseases among Somali women. Furthermore, to examine the women’s perceptions of body image, self-esteem, and their knowledge about the positive effect of physical activity. The qualitative research method was used and eight Soma li women aged 40 years or more, who have lived in Sweden longer than ten years, were in terviewed with the help of a semi- structured questionnaire. The study revealed that S omali migrated women in Sweden had changed their diet and experienced weight increase. They reported low self-esteem and little motivation for physical activity. They understood t hat they had a higher risk for heart disease as compared to Swedish women and they had, in gener al, a preference for big body size. The women of this study are, in combination with other risk factors, at a high risk of myocardial infarction. They all revealed a general knowledge a bout the relationship between obesity and inactivity and enhanced risks for heart disease. Th ey had a preference for a larger female body image. They expressed low self-esteem, loneliness, and alienation from society. It is important to address the health issue among migrant Somali wo men in Sweden, but since this study had few informants, larger studies and more science is needed to further investigate the problem.
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| 9. |
- Janzon, Ellis, et al.
(författare)
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Swedish snuff and incidence of cardiovascular disease. A population-based cohort study
- 2009
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The relationship between smoking and an increased incidence of cardiovascular diseases is well known. Whether smokeless tobacco (snuff) is related to myocardial infarction (MI) or stroke is still controversial. Aim of this study was to explore whether snuff users have an increased incidence of MI or stroke. Methods: A total of 16 754 women and 10 473 men (aged 45-73 years), without history of cardiovascular disease (CVD), belonging to the population-based "Malmo Diet and Cancer" study were examined. Incidence of MI and stroke were monitored over 10.3 years. Results: Snuff was used by 737 (7.0%) men and 75 (0.4%) women, respectively. Among men, snuff was significantly associated with low occupation level, single civil status, high BMI and with current and former smoking. In women, snuff was associated with lower systolic blood pressure. A total of 964 individuals (3.5%), i.e. 544 men (5.3%) and 420 (2.5%) women suffered a MI during the follow-up period. The corresponding numbers of incident stroke cases were 1048, i.e. 553 men (5.3%) and 495 (3.0%) women, respectively. Snuff was not associated with any statistically significant increased risk of MI or stroke in men or women. The relative risks (RR) in male snuff users compared to non-users were 1.05 (95% confidence interval (CI): 0.8-1.4, p = 0.740) for incident MI and 0.97 (0.7-1.4, p = 0.878) for stroke, after taking age and potential confounders into account. In women none of the 420 (2.5%) women who were snuff users had a MI and only one suffered a stroke during the follow-up. Conclusion: Several life-style risk factors were more prevalent in snuff-users than in non-users. However, the present study does not support any relationship between snuff and incidence of cardiovascular disease in men.
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| 10. |
- Janzon, Ellis, et al.
(författare)
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Tobacco and myocardial infarction in middle-aged women: a study of factors modifying the risk.
- 2004
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Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 256:2, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- Background. Although myocardial infarction (MI) is strongly related to smoking, few have studied why some smokers are more vulnerable than others. This study explored how the risk of MI in current and former smokers is modified by other cardiovascular risk factors. Methods. Incidence of MI (fatal and nonfatal) amongst 10619 women, 48.3 ± 8.2 years old, were studied in relation to smoking, hypertension, hypercholesterolaemia, diabetes, marital status and occupational level over a mean follow-up of 14 years. Results. Of the 3738 smokers, one-third had at least one major biological risk factor besides smoking; 228 women had MI during follow-up. Smoking and hypertension showed a synergistic effect on incidence of MI. The adjusted relative risks (RR) were 12.2 (95% CI: 7.5-19.8) for smokers with hypertension, 5.3 (CI:3.3-8.1) for smokers with normal blood pressure and 2.4 (CI:1.4-4.3) for never-smokers with hypertension (reference: normotensive never-smokers). The corresponding RRs for diabetic smokers and diabetic never-smokers were 19.0 (CI: 10.2-35.4) and 8.8 (CI: 4.4-17.4), respectively (reference: nondiabetic never-smokers). In terms of attributable risks, hypertension, hypercholesterolaemia and diabetes accounted for 12.9, 11.5 and 7.2%, respectively, of MI in female smokers. Low socio-economic level and being unmarried accounted for 19.6 and 1.6%, respectively. Conclusions. Although smoking is a major risk factor for MI, the risk varies widely between women with similar tobacco consumption. The results illustrate the need of a global risk factor assessment in female smokers and suggest that female smokers should be targets both for intensified risk factor management and programmes to stop smoking.
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