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- Ekbom, Tord, et al.
(författare)
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Cardiovascular events in elderly patients with isolated systolic hypertension. A subgroup analysis of treatment strategies in STOP-Hypertension-2.
- 2004
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Ingår i: Blood pressure. - Oslo : Informa UK Limited. - 0803-7051 .- 1651-1999. ; 13:3, s. 137-41
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To perform a subgroup analysis on those patients in STOP-Hypertension-2 who had isolated systolic hypertension. DESIGN AND METHODS: The STOP-Hypertension-2 study evaluated cardiovascular mortality and morbidity in elderly hypertensives comparing treatment with conventional drugs (diuretics, beta-blockers) with that of newer ones [angiotensin-converting enzyme (ACE) inhibitors, calcium antagonists]. In all, 6614 elderly patients with hypertension (mean age 76.0 years, range 70-84 years at baseline) were included in STOP-Hypertension-2. In the present subgroup analysis of STOP-Hypertension-2, isolated systolic hypertension was defined as systolic blood pressure at least 160 mmHg and diastolic blood pressure below 95 mmHg, in accordance with the Syst-Eur and Syst-China study criteria. In total, 2280 patients in STOP-Hypertension-2 met these criteria. In the study, patients were randomized to one of three treatment groups: "conventional" antihypertensive therapy with beta-blockers or diuretics (atenolol 50 mg, metoprolol 100 mg, pindolol 5 mg, or fixed-ratio hydrochlorothiazide 25 mg plus amiloride 2.5 mg daily); ACE inhibitors (enalapril 10 mg or lisinopril 10 mg daily); or calcium antagonists (felodipine 2.5 mg or isradipine 2.5 mg daily). Analysis was by intention to treat. RESULTS: The blood pressure lowering effect in patients with systolic hypertension was similar with all three therapeutic regimens: 35/13 mmHg in the conventional group (n=717), 34/12 mmHg in the ACE inhibitor group (n = 724), and 35/13 mmHg in the calcium antagonist group (n=708). Prevention of cardiovascular mortality, the primary endpoint of the study, did not differ between the three treatment groups. All stroke events, i.e. fatal and non-fatal stroke together, were significantly reduced by 25% in the newer-drugs group compared with the conventional group (95% CI 0.58-0.97; p=0.027). This difference was attributable to reduction of non-fatal stroke while fatal stroke events did not differ between groups. New cases of atrial fibrillation were significantly increased by 43% (95% CI 1.02-1.99; p=0.037) on "newer" drugs compared with "conventional" therapy, mainly attributable to the calcium antagonists. There were no significant differences between the three treatment groups with respect to the risks of myocardial infarction, sudden death or congestive heart failure. CONCLUSIONS: The analysis demonstrated that "newer" therapy (ACE inhibitors/calcium antagonists) was significantly better (25%) than "conventional" (diuretics/beta-blockers) in preventing all stroke in elderly patients with isolated systolic hypertension.
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- Ekbom, Tord, et al.
(författare)
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Decrease in high density lipoprotein cholesterol during prolonged storage. CELL Study Group
- 1996
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Ingår i: Scandinavian Journal of Clinical & Laboratory Investigation. - : Informa UK Limited. - 1502-7686 .- 0036-5513. ; 56:2, s. 97-101
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Tidskriftsartikel (refereegranskat)abstract
- Different studies on the stability of high density lipoprotein cholesterol (HDL) in frozen serum or plasma have yielded conflicting results, namely increase, decrease, or no change at all during prolonged storage under freezing conditions. As part of a major trial on lipid-lowering strategies we statistically demonstrated a time-related decrease in HDL cholesterol during storage up to 46 months at -20 degrees C. We therefore re-analysed 85 frozen samples that had been analysed fresh and then stored from 26 to 46 months, using the dextran sulphate 500/Mg2+ method. A linear regression analysis of change in HDL cholesterol on time was performed. The slope was significantly negative (p < 0.0005). The regression equation was (decrease in HDL) = 0.05 - 0.008 x (time in months), i.e. after 6 months' storage at -20 degrees C there was almost a 1% decrease in the HDL cholesterol concentration per month of storage.
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- Flygare, Lennart, et al.
(författare)
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Calcified cartilage zone and its dimensional relationship to the articular cartilage in the human temporomandibular joint of elderly individuals
- 1993
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Ingår i: Acta Odontologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850. ; 51:3, s. 183-191
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to describe the appearance of the calcified cartilage zone (CCZ) and to determine its dimensional relationship to the articular cartilage thickness in the normal human temporomandibular joint. An autopsy material comprising 21 joints from 12 elderly individuals was examined microscopically. The appearance of the CCZ was examined, and the thickness of the CCZ and of the total articular cartilage was measured in 18 different positions in each joint. The CCZ was outlined by a flat or gently undulating tidemark and an irregular osteochondral junction. The cellularity of the CCZ varied extensively. The cells were numerous in the CCZ when the overlying articular cartilage displayed high cellularity. Statistical analysis of the measurements demonstrated a relationship (p < 0.001) between the thickness of the CCZ and of the articular cartilage. Our findings, both qualitative and quantitative, indicate a close relationship between the physiology of the CCZ and of the overlying articular cartilage.
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- Gunnarsson, Ronny K, 1955, et al.
(författare)
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The predictive value of microbiologic diagnostic tests if asymptomatic carriers are present
- 2002
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Ingår i: Stat Med. - : Wiley. - 0277-6715 .- 0277-6715 .- 1097-0258. ; 21:12, s. 1773-85
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Tidskriftsartikel (refereegranskat)abstract
- If a proper gold standard is not available, then the predictive value of a test cannot be estimated. In this paper the concept of etiologic predictive value (EPV) is introduced. It is a quantity that will yield the predictive value of a test to predict presence of a specified disease in situations for which no proper gold standard is available. This is achieved by using information obtained from a healthy control population. This quantity requires that the marker in our test is present in all individuals having the specified disease, as in the case where the marker is the aetiologic factor for the specified disease. Furthermore this quantity requires that asymptomatic carriers are present. This means that not all individuals with the marker has the specified disease. EPV is developed with special reference to the evaluation of bacterial cultures, or rapid tests to detect a bacterium, but the quantity might be used in other circumstances as well. EPV is applied to an example in which conventional throat culture is evaluated. Further information concerning EPV can be found at http://www.infovice.se/fou/epv.
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- Holmquist, Björn, et al.
(författare)
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Correlation measures for circular data
- 1985
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Ingår i: Contributions to probability and statistics in honour of Gunnar Blom. ; , s. 157-168
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Bokkapitel (refereegranskat)
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- Horstmann, Vibeke, et al.
(författare)
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Comparing the effects of two treatments on two ordinal outcome variables
- 2015
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- When evaluating whether the effect of one treatment is larger than that of another the first step in the comparison is to decide what should be understood by the statement that one patient has achieved a greater effect than has another patient. When the outcome variable is quantitative, measured on a ratio scale, absolute or relative effects are the most commonly used effect measures; however, such effects are usually not meaningful for ordinal outcome variables. In order to answer the question whether one of two treatments acts more effectively on one of two outcome variables and the other treatment more efficiently on the other we shall present a method of comparing the treatment effects of patients that is based on pair-wise comparisons between patients in analogy with many non-parametrical methods. These comparisons use only the ordinal properties of the outcome variables. We shall even define a measure of the difference between the treatment effects and demonstrate how confidence intervals can be constructed.
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- Iwarsson, Susanne, et al.
(författare)
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ADL dependence in the elderly population living in the community: the influence of functional limitations and physical environmental demand
- 1998
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Ingår i: Occupational Therapy International. - : Wiley. - 1557-0703 .- 0966-7903. ; 5:3, s. 173-193
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Tidskriftsartikel (refereegranskat)abstract
- Empirical research elucidating the relationships between aspects of functional competence and environmental factors is lacking. This study aimed to analyse how functional limitations in the individual and housing accessibility problems influence ADL dependence in the elderly population, and to test Lawton's docility hypothesis. Data were collected from 133 Swedish subjects aged 75–84, who were living in the community. The main finding was that dependence in ADL correlated highly significantly with housing accessibility problems. The results also revealed significantly more ADL disability in the group of respondents in whom the heaviest environmental demands were identified, supporting the docility hypothesis. Although the study had limitations because the data required the use of non-parametric statistics, so restricting possible interpretations of the effects of geriatric comorbidity, the results indicated that interventions such as housing adaptations ought to be most effective with frail individuals. To promote independence in the general population, society has to work towards more accessible housing. More research is needed considering more environmental dimensions and elderly people's subjective apprehension of their housing environment.
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