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| 2. |
- Blom, M, et al.
(author)
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Social relations in women with coronary heart disease : the effects of work and marital stress
- 2003
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In: Journal of Cardiovascular Risk. - Karolinska Hosp, Karolinska Inst, Dept Publ Hlth Sci, S-17176 Stockholm, Sweden. Semmelweis Univ, Inst Behav Sci, H-1085 Budapest, Hungary. Swedish Natl Inst Publ Hlth, Stockholm, Sweden. : LIPPINCOTT WILLIAMS & WILKINS. - 1350-6277 .- 1473-5652. ; 10:3, s. 201-206
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Journal article (peer-reviewed)abstract
- Background Studies have previously shown that psychosocial stress, related to both work and family, is associated with the increased risk of coronary heart disease (CHD) morbidity and mortality. The objective of this study was to examine how social relations are affected by marital stress and work stress in a population-based sample of Swedish women with CHD. Method Data was obtained from the Stockholm Female Coronary Risk Study, comprising 292 women aged 65 years or younger, with a mean age of 56 (SD = 7) years admitted for an acute event of CHD and examined 3-6 months after hospitalization. Marital and work stress was assessed using the Stockholm Marital Stress Scale and the Swedish version of the Karasek demand-control questionnaire, respectively. Condensed versions of the Interview Schedule for Social Interaction (ISSI) and of Interpersonal Support Evaluation List (ISEL) were used to assess social relations and social support. Results Marital stress was associated with less social integration (P< 0.001), less appraisal support (P< 0.001), a lower sense of belonging (P<0.01) and less tangible support (P< 0.01) even after controlling for work stress. Adjustment for age, socioeconomic status (education and occupational status) did not alter these results significantly. Work stress did not show statistically significant effects on any of the measured social relations. Conclusion The present study showed that marital stress influenced women's social relations. These results suggest that marital stress needs to be further investigated not only as an independent but also as an interactive risk factor for women with CHD. J Cardiovasc Risk 10:201-206 (C) 2003 Lippincott Williams Wilkins.
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| 4. |
- Engström, Gunnar, et al.
(author)
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Respiratory decline in smokers and ex-smokers--an independent risk factor for cardiovascular disease and death
- 2000
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In: Journal of Cardiovascular Risk. - 1350-6277. ; 7:4, s. 267-272
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Journal article (peer-reviewed)abstract
- BACKGROUND AND OBJECTIVE: Although smoking is associated with an increased incidence of cardiovascular disease and death, many smokers remain healthy after many years of smoking. Our objective was to assess whether this variation is related to rate of decline of respiratory function. DESIGN: This was a population-based cohort study, its subjects being men born in 1914 from Malmo, Sweden. METHODS: All 291 smokers who since the baseline examination in 1969 had remained in Malmo were invited to a follow-up examination in 1982. Of the 242 participants, 199 men without history of myocardial infarction or stroke were included in the study. Eighty-four of them had quit smoking. The incidence of cardiovascular disease and death during 14 years was studied in relation to the decline in lung function [forced expiratory volume during 1 second (FEV1.0) and vital capacity] between 55 and 68 years of age. RESULTS: Fifty-nine (51%) smokers and 43 (51%) ex-smokers died. Forty-four (38%) smokers and 29 (35%) ex-smokers suffered a cardiovascular event. The mortality rate among smokers in the high, middle and low thirds with regard to the decline in FEV1.0 was 66.5, 44.0, and 37.6, respectively, per 1000 person-years (P for trend = 0.04). The corresponding figures in ex-smokers were 88.7, 42.0, and 35.1 (P for trend = 0.002). The cardiovascular event rate among smokers in these three groups was 56.0, 41.0, and 22.7 events, respectively, per 1000 person-years (P for trend = 0.01). The association remained significant after adjustments for potential confounders. A change in vital capacity was associated with a similar pattern of disease and death. CONCLUSION: Although smoking is associated with an accelerated respiratory decline, there are marked differences between smokers. The increased cardiovascular event and death rates among those whose lung function declined the most suggests that the change in respiratory function can be used as a measure of individual susceptibility.
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| 5. |
- Hallman, T, et al.
(author)
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Psychosocial risk factors for coronary heart disease (CHD), their importance compared with other risk factors and gender differences in sensitivity
- 2001
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In: Journal of Cardiovascular Risk. - 1350-6277 .- 1473-5652. ; 8:1, s. 39-49
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Journal article (peer-reviewed)abstract
- BACKGROUND: Few studies have focused on risk factors in women's lives concerning psychosocial factors and coronary heart disease (CHD). The present study is one of a series in which a wide range of psychosocial factors will be analysed with a focus on women. Women and men have been compared with respect to sensitivity to psychosocial risk factors regarding CHD. The importance of psychosocial risk factors for women, compared with biomedical risk factors has also been studied. METHODS: A questionnaire (The Stress Profile) was answered by 538 rehabilitation participants (97 women, 441 men) and a reference group (5308 women, 5177 men), aged 40-65 years. Psychosocial factors were investigated using means and b-coefficients. Comparisons between psychosocial and biomedical risk factors were made, with respect to the product of the beta-coefficient and the standard deviation for each compared risk factor. RESULTS: Significant differences appeared concerning five areas: work content, workload and control, physical stress reactions, emotional stress reactions and burnout. All showed that the relative sensitivity was larger for women than for men. Predictive psychosocial risk factors for women with respect to CHD were physical stress reactions, emotional stress reactions, burnout, family relationships and daily hassles/satisfactions, and they were on approximately the same level as biomedical risk factors. CONCLUSIONS: Women appear to be more sensitive than men with respect to psychosocial risk factors for CHD, and the predictive ability of psychosocial risk factors shows great importance. Actions against unhealthy psychosocial conditions are recommended. Both presumptive CHD patients and others might benefit from preventive actions, and since women are more sensitive they will probably gain more than men.
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| 7. |
- Hedbäck, Bo, 1944-, et al.
(author)
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Cardiac rehabilitation after coronary artery bypass surgery : 10-Year results on mortality, morbidity and readmissions to hospital
- 2001
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In: Journal of Cardiovascular Risk. - : Ovid Technologies (Wolters Kluwer Health). - 1350-6277 .- 1473-5652. ; 8:3, s. 153-158
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Journal article (peer-reviewed)abstract
- Aim: To evaluate the long-term secondary preventive effect of a comprehensive rehabilitation programme after coronary artery bypass grafting (CABG). Methods: The study group included 49 consecutive patients who underwent bypass surgery and were then offered a rehabilitation programme consisting of education in risk-factor control, a physical training programme and regular follow-up at a post-CABG clinic. The control group (n = 98), consisting of two well-matched CABG patients for each study patient, was offered the usual care with no access to a cardiac rehabilitation programme. The two groups were followed for 10 years and the results regarding cardiovascular mortality, morbidity, total cardiac events and readmissions to hospital were compared. Results: The total mortality (study group 8.2%, control group 20.4%) and cardiovascular mortality (8.2 versus 15.3%) after 10 years did not differ significantly between the groups. In the study group, nine patients (18.4%) had 10 cardiac events (four cardiovascular deaths, five non-fatal myocardial infarctions and one CABG) compared to 34 patients (34.7%, P < 0.05) suffering 46 (P < 0.01) cardiac events (15 cardiovascular deaths, 18 non-fatal myocardial infarctions, eight CABG, five coronary angioplasties) in the control group. The number of readmissions to hospital (2.1 versus 3.5 per patient) and length of admissions (11 versus 26 days per patient) was significantly lower in the study group (P < 0.01). Conclusion: A comprehensive cardiac rehabilitation programme offered to patients after coronary artery bypass surgery will improve the long-term prognosis and reduce the need for hospital care.
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| 10. |
- Horsten, M, et al.
(author)
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Social relations and the metabolic syndrome in middle-aged Swedish women
- 1999
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In: Journal of Cardiovascular Risk. - Karolinska Inst, Novum, Div Prevent Med, Dept Publ Hlth Sci, S-14157 Huddinge, Sweden. Beth Israel Deaconess Med Ctr, Div Cardiovasc, Boston, MA USA. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. Karolinska Hosp, Dept Cardiol, S-10401 Stockholm, Sweden. : LIPPINCOTT WILLIAMS & WILKINS. - 1350-6277 .- 1473-5652 .- 1741-8267 .- 1741-8275. ; 6:6, s. 391-397
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Journal article (peer-reviewed)abstract
- Background Both social isolation and the metabolic syndrome are independently associated with greater than normal cardiovascular risk. Design A population-based cross-sectional study of middle-aged Swedish women. Methods The study group consisted of 300 healthy women (aged 31-65 years) who were representative of women living in the greater Stockholm area. Social isolation was measured by using a condensed Version of the Interpersonal Support Evaluation List. Health behaviours were assessed and a full serum-lipid-level and haemostatic profile was obtained by standardized methods, The metabolic syndrome was defined as the presence of two or more of these components: fasting serum level of glucose greater than or equal to 7.0 mmol/l, arterial blood pressure greater than or equal to 160/90 mmHg, fasting serum level of triglycerides greater than or equal to 1.7 mmol/l or high-density lipoprotein < 1.0 mmol/l, or both, and central obesity (waist:hip ratio > 0.85 or body mass index > 30 kg/m(2), or both), Results After adjustment for age, menopausal status, educational level, smoking, exercise habits and consumption of alcohol, the risk ratio for the metabolic syndrome for women in the lower compared with women in the upper social-support quartile was 3.5 (95% confidence interval 1.1-11.4), whereas that of women in the two middle quartiles was 2.2 (95% confidence interval 0.67-7.2; P for trend 0.02). Conclusions Social isolation was associated with the metabolic syndrome for these middle-aged women. The findings suggest that the metabolic syndrome and its components may be mediators of the reported association between social isolation and cardiovascular disease, (C) 1999 Lippincott Williams & Wilkins.
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| 13. |
- Kjellgren, Karin I, 1950, et al.
(author)
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Patients' and physicians' assessment of risks associated with hypertension and benefits from treatment.
- 1998
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In: Journal of cardiovascular risk. - 1350-6277. ; 5:3, s. 161-6
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Journal article (peer-reviewed)abstract
- BACKGROUND: Perceptions of effects of a medical regimen may affect patients' adherence to therapy. OBJECTIVE: To assess concordance between patients' and physicians' estimations of the risks of hypertension and benefits of treatment during a regular follow-up appointment. DESIGN: A population-based Swedish multicentre study. Patients were included consecutively from a randomized selection of centres (55 primary health care centres and 11 clinics of internal medicine). METHODS: A questionnaire was given to 1013 patients undergoing their individually prescribed antihypertensive therapy and 212 physicians who were caring for these patients. RESULTS: Without therapy, patients perceived the risks of cardiovascular complications to be higher than did their physicians. Patients were not aware that an increasing number of risk factors has an impact on the risk of complications. Patients furthermore rated the benefits of treatment higher than did their physicians (P<0.001). Of the patients, 14% had blood pressures < or = 140/90 mmHg. Most of the patients (61%) were not aware of their target blood pressure. However, when the target pressure was communicated to patients by the physician, patients remembered it accurately. The patients were generally not willing to trade even minor side effects from antihypertensive therapy for benefits of treatment. CONCLUSIONS: There was a high degree of inconsistency between patients' and physicians' estimations of risks of hypertension. Patients estimated the effects of treatment to be more beneficial than did their physicians.
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| 14. |
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| 15. |
- Lind, Lars, et al.
(author)
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Endothelium-dependent vasodilation is impaired in apparently healthy subjects with a family history of myocardial infarction
- 2002
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In: Journal of Cardiovascular Risk. - : Oxford University Press (OUP). - 1350-6277 .- 1473-5652. ; 9:1, s. 53-57
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To investigate whether endothelial-dependent vasodilation is altered in healthy subjects with a family history of myocardial infarction. SETTING: Tertiary University Hospital SUBJECTS AND DESIGN: Fifty apparently healthy subjects selected from the general population were subjected to an evaluation of endothelial-dependent vasodilation (EDV) and endothelial-independent vasodilation (EIDV) by means of local infusion of methacholine (MCh, 2 and 4 microg/min) and sodium nitroprusside (SNP, 5 and 10 microg/min) with measurements of forearm blood flow with venous occlusion plethysmography. The occurrence of plaque and the intima-media thickness of the carotid arteries were determined by ultrasonography. RESULTS: Subjects reporting at least one parent suffering from myocardial infarction (n = 11) showed a significantly lower EDV than subjects without such a family history (21 +/- 3.7 vs. 26 +/- 6.7 ml/min/100 ml tissue at MCh 4 microg/min, P<0.05). EIDV was not significantly different between the groups (21 +/- 6.8 vs. 18 +/- 5.4 ml/min/100 ml tissue at SNP 10 microg/min). Age, sex distribution, body mass index, waist to hip ratio, blood pressure, lipids, fasting blood glucose, smoking habits and status of the carotid arteries were not significantly different between the groups. CONCLUSION: A family history of myocardial infarction was found to be associated with an impaired endothelial-dependent vasodilation in the forearm of apparently healthy subjects. The risk factor profile was not different from the control group, suggesting that genetic factors are responsible for the impaired endothelial-dependent vasodilation.
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| 16. |
- Luepker, RV, et al.
(author)
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Differences in the treatment of acute myocardial infarction between regions of countries and the impact on prognosis
- 1999
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In: Journal of Cardiovascular Risk. - : Sage Publications Ltd.. - 1350-6277 .- 1473-5652. ; 6:2, s. 77-98
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Journal article (peer-reviewed)abstract
- Differences in the incidence, prevalence of and mortality from coronary heart disease (CHD) are observed between and within countries. These differences are believed to be related to differing levels of CHD risk factors and medical care. Medical care for acute myocardial infarction has changed significantly in the past decades, with the development of new methods for diagnosis and treatment. Although widely known, these technologies are not consistently applied for reasons of availability and cost, as well as local medical cultures and traditions. The outcomes of medical care for acute myocardial infarction are best measured by case fatality of those hospitalized. Since the early 1960s, case fatality has fallen to less than half that observed previously. This has occurred in the context of widespread use of coronary care unit monitoring, innovative pharmacologic agents and invasive reperfusion treatments. A common debate compares aggressive invasive management with more conservative pharmacologic methods. In this context, studies have produced mixed results with no clear advantage to one approach when both methods are available and effectively applied to appropriately selected patients.
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| 17. |
- Nilsson, TK, et al.
(author)
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Quantitative measurement of carotid atherosclerosis in relation to levels of von Willebrand factor and fibrinolytic variables in plasma - a 2-year follow-up study
- 2002
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In: Journal of Cardiovascular Risk. - 1350-6277. ; 9:4, s. 215-221
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Journal article (peer-reviewed)abstract
- Background It has been proposed that the mechanism of action of the new risk factors for myocardial infarction and stroke, von Willebrand factor (vWF), tissue plasminogen activator (tPA) and tissue plasminogen activator inhibitor-1 (PAI-1) could possibly be mediated via a primary effect on atherogenesis but there is little data to substantiate this. Design A prospective single-centre cohort study of progression of atherosclerosis. Methods Carotid plaque area was quantitated by two-dimensional (2D) ultrasound in 258 subjects at entry and after 1 and 2 years. Plasma and serum samples were drawn at baseline and serum lipids and plasma levels of haemostatic factors were measured. Results The traditional risk factors, smoking, total cholesterol, hypertension and male gender explained 51% of the variance in plaque area at baseline and 48% at 1-year followup. There were small positive associations of plaque area with vWF, tPA and tPA/PAI-1 complex and a tendency to negative associations with PAI-1 levels, independent from the traditional risk factors. The additional explanatory power of the haemostatic factors did not exceed 3%. Conclusion The data accord with a marginal role in atherogenesis of vWF and tPA, and underline the major impact of smoking, hypertension and cholesterol on carotid plaque area progression. (C) 2002 Lippincott Williams Wilkins.
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| 19. |
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| 20. |
- Welin, Catharina, 1945, et al.
(author)
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Behavioural characteristics in patients with myocardial infarction: a case-control study
- 1995
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In: Journal of Cardiovascular Risk. - 1350-6277. ; 2:3, s. 247-254
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Journal article (peer-reviewed)abstract
- BACKGROUND: Over the past 10-20 years, evidence has accumulated suggesting that it is not just biological risk factors that are important for the development of coronary heart disease. The present study is one of a series of case-control studies in which a wide range of psychosocial factors have been analysed in the same population to obtain information on their relationship with myocardial infarction, as well as of the interaction between psychosocial and biomedical variables. METHODS: The relationship between behavioural factors and non-fatal myocardial infarction was studied by comparing consecutively admitted male (n = 288) and female (n = 55) patients with a population sample of 283 men and 129 women. All participants were under 65 years of age. The behavioural variables (type-A behaviour, health locus of control, sleep problems and alcohol consumption) were investigated by means of a self-administered questionnaire. RESULTS: No significant differences emerged between patients with myocardial infarction and controls in terms of their type-A behaviour pattern. After controlling for traditional risk factors (smoking, hypertension, serum cholesterol level and diabetes), men with myocardial infarction reported a significantly stronger external health locus of control (i.e. a weak belief in their capacity to control their health) compared with their controls, as well as more problems with sleep and a lower alcohol consumption; women with myocardial infarction reported significantly more problems with sleep than their controls. CONCLUSION: The importance of health locus of control, sleep problems and alcohol consumption is amplified by the fact that they are related to myocardial infarction independently of conventional biomedical risk factors. These behavioural factors should be studied further in prospective investigations. PMID: 7584801 [PubMed - indexed for MEDLINE]
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| 21. |
- Welin, Catharina, 1945, et al.
(author)
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Social relationships and myocardial infarction: a case-control study.
- 1996
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In: Journal of Cardiovascular Risk. - 1350-6277. ; 3:2, s. 183-190
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Journal article (peer-reviewed)abstract
- BACKGROUND: For more than 10 years there has been increasing evidence that not only biological risk factors are important for the development of coronary heart disease. The present study is one of a series of case-control studies in which a wide range of psychosocial factors in the same population have been analysed to obtain information on their relationship with myocardial infarction, and of the interaction between psychosocial and biomedical variables. METHODS: The association between social relationships and nonfatal myocardial infarction was studied by comparing consecutively admitted male (n = 288) and female (n = 55) patients with myocardial infarction with a population sample of 283 men and 129 women. All participants were under 65 years of age. The social relationships were investigated by means of a self-administered questionnaire. RESULTS: Men with myocardial infarction reported significantly lower perceived emotional support compared with their controls, as well as less social activity. Women with myocardial infarction reported significantly less social activity than their controls. There were no significant differences between cases and controls in social integration (number and frequency of social relationships and contacts). Neither did dissatisfaction with social relationships differ significantly between patients with myocardial infarction and controls. After controlling for traditional risk factors (smoking, hypertension, serum cholesterol level, diabetes) perceived emotional support remained significantly related to myocardial infarction in men, and so did the amount of social activity in both men and women. CONCLUSION: The importance of perceived emotional support and lack of social activity is amplified by the fact that they are related to myocardial infarction independently of conventional biomedical risk factors. These social factors should be studied further in prospective investigations. PMID: 8836861 [PubMed - indexed for MEDLINE]
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