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- Lissåker, Claudia, et al.
(författare)
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Occupational stress and pregnancy-related hypertension and diabetes : Results from a nationwide prospective cohort
- 2022
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 48:3, s. 239-247
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Using a large, national, prospective cohort, while adjusting for other work exposures, this study aims to investigate whether exposure to occupational stress during pregnancy is associated with hypertensive disorders of pregnancy (HDP) and gestational diabetes.Methods: Our cohort consisted of 1 102 230 singleton births between 1994–2014 in Sweden, based on high-quality register data of Swedish pregnancies. Exposure to occupational stress was obtained from a job exposure matrix (JEM) constructed from 12 questions pertaining to the psychosocial work environment from the 1997–2013 cycles of Swedish Work Environment Survey, including approximately 75 000 individuals. We utilized the decision authority, demands, and social support indices. Decision authority and demands were combined to categorize occupations into low, active, passive, and high strain work. We estimated relative risks (RR) and adjusted for relevant confounders, such as age, smoking and other work exposures.Results: Occupations with lower levels of decision authority were associated with increased risks of 12–23% for HDP and preeclampsia and 36–58% for gestational diabetes compared to occupations with the highest levels of decision authority. Passive occupations had increased risks of 10% for HDP and preeclampsia and 15% for gestational diabetes when compared to low strain jobs. No significant associations were found for high strain occupations.Conclusions: As a whole, occupational stress was not consistently associated with pregnancy outcomes in our study. However, decision authority was associated with an increased risk for pregnancy-related complications. Further studies should investigate whether improvements in working conditions can help decrease these risks.
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- Lissåker, Claudia, et al.
(författare)
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Persistent emotional distress after a first-time myocardial infarction and its assocation to late cardiovascular and non-cardiovascular mortality
- 2019
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 26:14, s. 1510-1518
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Patients with symptoms of depression and/or anxiety - emotional distress - after a myocardial infarction (MI) have been shown to have worse prognosis and increased healthcare costs. However, whether specific subgroups of patients with emotional distress are more vulnerable is less well established. The purpose of this study was to identify the association between different patterns of emotional distress over time with late cardiovascular and non-cardiovascular mortality among first-MI patients aged <75 years in Sweden.METHODS:We utilized data on 57,602 consecutive patients with a first-time MI from the national SWEDEHEART registers. Emotional distress was assessed using the anxiety/depression dimension of the European Quality of Life Five Dimensions questionnaire two and 12 months after the MI, combined into persistent (emotional distress at both time-points), remittent (emotional distress at the first follow-up only), new (emotional distress at the second-follow up only) or no distress. Data on cardiovascular and non-cardiovascular mortality were obtained until the study end-time. We used multiple imputation to create complete datasets and adjusted Cox proportional hazards models to estimate hazard ratios.RESULTS:Patients with persistent emotional distress were more likely to die from cardiovascular (hazard ratio: 1.46, 95% confidence interval: 1.16, 1.84) and non-cardiovascular causes (hazard ratio: 1.54, 95% confidence interval: 1.30, 1.82) than those with no distress. Those with remittent emotional distress were not statistically significantly more likely to die from any cause than those without emotional distress.DISCUSSION:Among patients who survive 12 months, persistent, but not remittent, emotional distress was associated with increased cardiovascular and non-cardiovascular mortality. This indicates a need to identify subgroups of individuals with emotional distress who may benefit from further assessment and specific treatment.
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- Lissåker, Claudia T., et al.
(författare)
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Emotional Distress as a Predictor of Statin Non-adherence among Swedish First-Time Myocardial Infarction Patients, 2006–2013
- 2017
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Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 97, s. 30-37
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Tidskriftsartikel (refereegranskat)abstract
- Background: Emotional distress (depression and anxiety) has been known to affect mortality after a myocardial infarction (MI). One possible mechanism is through medication non-adherence. Few studies have investigated the link between statin adherence and emotional distress, and results are not consistent. We aimed to explore whether emotional distress affects adherence among first-time MI patients younger than 75 years old receiving a prescription for the first time.Methods: We identified first-MI individuals younger than 75 years from the SWEDEHEART national quality registers discharged with a statin prescription. The main exposure was the anxiety/depression portion of the EQ-5D from Interview 1 (6-10 weeks post -MI) and Interview 2 (12-14 months post -MI). We calculated adherence from the Swedish Prescribed Drugs Register during three observation periods (OP): [1] Interview 1 to Interview 2, [2] one year post Interview 2, and [3] two years post Interview 1.Results: Emotional distress at Interview 1 was not associated with statin adherence for OP1 (RR: 0.99, 95% CI: 0.98, 1.01). Emotional distress at Interview 2 was associated with lower adherence one year later (RR: 0.95, 95% CI: 0.93, 0.98). Emotional distress at Interview 1 was associated with a small decrease in adherence in the complete OP for adherence (RR: 0.98, 95% CI: 0.96, 0.99).Conclusion: Emotional distress was marginally, but independently, associated with lower adherence to statin two years after the MI. Our study suggests that emotional distress may be an important factor for long-term statin adherence, and, thus, may play a clinically important role in long-term outcome.
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| 5. |
- Norlund, Fredrika, et al.
(författare)
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Factors associated with emotional distress in patients with myocardial infarction : Results from the SWEDEHEART registry
- 2018
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 25:9, s. 910-920
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Tidskriftsartikel (refereegranskat)abstract
- Background: Emotional distress, symptoms of depression and anxiety, is common among patients after a myocardial infarction (MI), and is associated with an increased risk of cardiovascular morbidity. Real world population data on factors associated with emotional distress in MI patients are scarce. The aim was to determine factors associated with incident emotional distress two and 12 months post MI respectively, and with persistent emotional distress, versus remittent, in patients <75 years old.Design: This was a registry-based observational study.Methods: Data from the national SWEDEHEART registry on 27,267 consecutive patients with a first-time MI, followed up at two and 12 months post MI ( n = 22,911), were included in the analyses. Emotional distress was assessed with the EuroQol-5D questionnaire. Several candidate sociodemographic and clinical factors were analysed for their association with emotional distress in multivariate models.Results: Symptoms of emotional distress were prevalent in 38% and 33% at two and 12 months post MI respectively. At both time-points, previous depression and/or anxiety, readmission for new cardiovascular event, female gender, younger age, born outside the neighbouring Nordic countries, smoking and being neither employed nor retired showed the strongest associations with emotional distress. Other factors related to medical history, the MI and its care or were only modestly associated with emotional distress. Persistent emotional distress was associated with younger age, female gender, smoking and being born outside of the Nordic countries.Conclusion: Previous depression/anxiety, female gender, younger age, smoking, born outside of the Nordic countries, neither employed nor retired and readmission due to cardiovascular events were strongly associated with emotional distress post MI. These factors may be of relevance in tailoring rehabilitation programmes.
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- Wallert, John, et al.
(författare)
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Young adulthood cognitive ability predicts statin adherence in middle-aged men after first myocardial infarction : a Swedish National Registry study
- 2017
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Ingår i: European Journal of Preventive Cardiology. - : Sage Publications. - 2047-4873 .- 2047-4881. ; 24:6, s. 639-646
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cognitive ability (CA) is positively related to later health, health literacy, health behaviours and longevity. Accordingly, a lower CA is expected to be associated with poorer adherence to medication. We investigated the long-term role of CA in adherence to prescribed statins in male patients after a first myocardial infarction (MI). Methods: CA was estimated at 18-20 years of age from Military Conscript Register data for first MI male patients (<= 60 years) and was related to the one- and two-year post-MI statin adherence on average 30 years later. Background and clinical data were retrieved through register linkage with the unselected national quality register SWEDEHEART for acute coronary events (Register of Information and Knowledge about Swedish Heart Intensive Care Admissions) and secondary prevention (Secondary Prevention after Heart Intensive Care Admission). Previous and present statin prescription data were obtained from the Prescribed Drug Register and adherence was calculated as >= 80% of prescribed dispensations assuming standard dosage. Logistic regression was used to estimate crude and adjusted associations. The primary analyses used 2613 complete cases and imputing incomplete cases rendered a sample of 4061 cases for use in secondary (replicated) analyses. Results: One standard deviation increase in CA was positively associated with both one-year (OR 1.15 (CI 1.01-1.31), P< 0.05) and two-year (OR 1.14 (CI 1.02-1.27), P< 0.05) adherence to prescribed statins. Only smoking attenuated the CA-adherence association after adjustment for a range of > 20 covariates. Imputed and complete case analyses yielded very similar results. Conclusions: CA estimated on average 30 years earlier in young adulthood is a risk indicator for statin adherence in first MI male patients aged <= 60 years. Future research should include older and female patients and more socioeconomic variables.
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