| 11. |
- C-Bergstrand, Ingar, et al.
(författare)
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Timolol increased retrobulbar flow velocities in untreated glaucoma eyes but not in ocular hypertension
- 2001
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Ingår i: Acta Ophthalmologica Scandinavica. - : Wiley. - 1395-3907. ; 79:5, s. 455-461
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate retrobulbar blood flow velocities and the effects of topical timolol treatment in eyes with newly detected, previously untreated open angle glaucoma or ocular hypertension. METHODS: Fifteen eyes with open angle glaucoma (OAG) and 12 eyes with ocular hypertension (OH), in the same number of patients, all untreated and newly detected, were examined with colour Doppler imaging of retrobulbar vessels before and after 1 month of topical timolol treatment (0.5% Timoptic BID). RESULTS: Baseline central retinal artery end diastolic velocity was lower (48%, p=0.0002) and resistive index higher (7.6%, p=0.018) in the OAG group than in the OH group. In the glaucoma group mean end diastolic velocity increased by 41%, (p=0.006) while resistive index decreased by 5.8%, (p=0.02) on treatment, while no significant changes were seen in the OH group. Blood flow velocities in the ophthalmic artery did not change with treatment. Baseline IOP and IOP reduction did not differ between OAG and OH group. CONCLUSION: Peripheral resistance to blood flow was found to be increased in untreated glaucoma eyes as compared to a similar group of eyes with ocular hypertension. Timolol treatment diminished resistance significantly in the glaucoma group, but not in the ocular hypertension group. Thus the two groups responded differently to timolol treatment. The reaction to IOP lowering treatment could indicate defective autoregulation in the glaucoma group.
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| 12. |
- Dahlback, M, et al.
(författare)
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Enhanced insulin absorption in the rabbit airways and lung by sodium dioctyl sulfosuccinate
- 2002
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Ingår i: Journal of Aerosol Medicine. - : Mary Ann Liebert Inc. - 0894-2684 .- 1557-9026. ; 15:1, s. 27-36
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this investigation was to study regional absorption of inhaled insulin together with an enhancer (sodium di-octyl-sulfosuccinate [DOSS]) in the rabbit airways and lung. Insulin was administered with or without DOSS by aerosol inhalation, intratracheal infusion, intranasally, sublingually, and without DOSS intravenously. Blood glucose and plasma levels of insulin were measured during 100 min from the start of administration. Inhalation of insulin (3 U) with 0.25% or 1% DOSS decreased average blood glucose levels significantly more than inhalation of insulin (3 U) without DOSS. Intratracheal administration of 1.5 U of insulin with 0.25% DOSS in 0.3 mL of vehicle decreased the average blood glucose level significantly compared with intratracheal administration of 1.5 U of insulin and no DOSS in 0.3 mL of vehicle and compared with 1.5 U of insulin with 0.25% DOSS in 0.15 mL of vehicle. Intravenous insulin (1.5 U) and inhaled (1.5 U) insulin in 0.25% DOSS decreased average blood glucose levels significantly compared with intratracheal (0.15 mL), intranasal, and sublingual administration of 1.5 U of insulin with 0.25% DOSS. The bioavailability of inhaled insulin (1.5 U) with 0.25% DOSS was estimated to be 16% in comparison with 7% for intratracheally (0.15 mL), 1% intranasally, and 0.8% sublingually administered insulin (1.5 U with 0.25% DOSS), respectively. Inhaled insulin together with the absorption enhancer DOSS decreased the blood glucose level more effectively than insulin given intratracheally, intranasally, or sublingually. The effect on blood glucose reflected the difference in plasma insulin concentration for the different routes of administration.
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| 16. |
- Engström, Gunnar, et al.
(författare)
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Asymptomatic leg atherosclerosis is reduced by regular physical activity. Longitudinal results from the cohort "men born in 1914"
- 2001
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 21:6, s. 502-507
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study whether physical activity is associated with reduced occurrence of asymptomatic leg atherosclerosis. DESIGN: Longitudinal and cross-sectional analyses of the population-based cohort "men born in 1914". METHODS: Comparison of the systolic ankle/arm pressure index (AAI) at age 68 in groups who were sedentary, performed some activity, and performed regular physical training at 55 and 68 years of age. RESULTS: At 55 years of age, 100 (27%) were sedentary, 209 (58%) reported some physical activity and 54 (15%) reported regular physical training. At 68 years, 194 men (53%) reported the same degree of physical activity, 127 (35%) reported a higher physical activity, and 42 (12%) reported lower physical activity. Physical activity at 55 years (p =0.03) and increased physical activity between 55 and 68 years (p =0.03) were both associated with higher AAI at 68 after adjusting for potential confounders. At 68 years, AAI was 0.89+/-0.21, 1.01+/-0.13 and 1.05+/-0.11, respectively, in men who were sedentary, reported some physical activity, and regular physical training (p =0.0002). This association remained significant after adjustments for potential confounders. CONCLUSIONS: regular physical activity is associated with reduced occurrence of asymptomatic leg atherosclerosis, even in men taking up exercise after age of 55.
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| 17. |
- Engström, Gunnar, et al.
(författare)
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Blood pressure increase between 55 and 68 years of age is inversely related to lung function: longitudinal results from the cohort study 'Men born in 1914'
- 2001
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Ingår i: Journal of Hypertension. - 1473-5598. ; 19:7, s. 1203-1208
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although age is associated with increasing blood pressure, there is a substantial heterogeneity within a certain birth cohort. Whether increase in systolic and diastolic blood pressure is related to pulmonary function is largely unknown. OBJECTIVE: To study blood pressure elevation between 55 and 68 years of age in relation to vital capacity (VC) and forced expiratory volume (FEV1.0) at 55. DESIGN: Population-based cohort study. PARTICIPANTS: A total of 375 men without antihypertensive medication at baseline. MAIN OUTCOME MEASURE: Change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) over 13 years. RESULTS: Blood pressure increase between 55 and 68 years was highest among men who at 55 years had low vital capacity. Average increase in systolic blood pressure for men with vital capacity in the first, second, third and fourth quartile was 20.4, 18.7, 16.5 and 11.1 mmHg, respectively (P for trend = 0.005). Average increase in diastolic blood pressure was 10.6, 9.9, 9.0 and 6.3 mmHg, respectively (P= 0.02). The trends remained statistically significant after adjustments for baseline blood pressure, tobacco consumption, smoking cessation between 55 and 68, weight change between 55 and 68, physical activity and diabetes. Further analysis showed that the relationships could be found among men with blood pressures < or = 140/ 90 mmHg at baseline, whereas no significant association was found for men whose baseline SBP or DBP exceeded 140/90 mmHg. FEV1.0 showed similar associations with change in blood pressure. CONCLUSION: Lung function is inversely associated with future blood pressure increase. It is suggested that this association could contribute to the relationships between lung function and incidence of cardiovascular disease.
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| 18. |
- Engström, Gunnar, et al.
(författare)
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Lung function and cardiovascular risk: relationship with inflammation-sensitive plasma proteins.
- 2002
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Ingår i: Circulation. - 1524-4539. ; 106:20, s. 2555-2560
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Tidskriftsartikel (refereegranskat)abstract
- Background— The inverse relationship between pulmonary function and incidence of cardiovascular disease remains largely unexplained. This prospective study explored the hypothesis of a relationship with inflammation-sensitive plasma proteins. Methods and Results— Forced vital capacity (FVC) and plasma levels of fibrinogen, {alpha} 1-antitrypsin, haptoglobin, ceruloplasmin, and orosomucoid were determined in 5064 healthy men aged 28 to 61 years. All-cause mortality, cardiovascular mortality, and incidence of myocardial infarction were monitored over a mean follow-up period of 18.4 years. Low FVC (fourth quartile) was associated with higher protein levels and with increased incidences of myocardial infarction and cardiovascular death. Adjustments for protein levels reduced the age-adjusted relative risks (RRs) for myocardial infarction (from 1.99, 95% CI 1.5 to 2.6, to 1.70, 95% CI 1.3 to 2.2) and cardiovascular death (from 2.71, 95% CI 1.9 to 3.9, to 2.28, 95% CI 1.6 to 3.3) among men with low FVC, corresponding to {approx}25% of the excess risk. The risk factor–adjusted RRs were reduced from 1.45 (95% CI 1.1 to 1.9) to 1.38 (95% CI 1.1 to 1.8) and from 1.96 (95% CI 1.4 to 2.8) to 1.85 (95% CI 1.3 to 2.7) for myocardial infarction and cardiovascular death, respectively, corresponding to {approx}10% to 15% of the excess risk. Among men with low FVC, the risk factor–adjusted RR for myocardial infarction was 2.5 (95% CI 1.7 to 3.6) for those with high protein levels (>=2 proteins in top quartile) and 1.7 (95% CI 1.1 to 2.4) for those with low protein levels (<=1 protein in top quartile; reference, top quartile of FVC and low protein levels). Conclusions— FVC is significantly and inversely associated with plasma levels of inflammation-sensitive plasma proteins. This relationship contributes to but cannot fully explain the increased cardiovascular risk among men with low FVC.
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| 19. |
- Engström, Gunnar, et al.
(författare)
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Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study.
- 2003
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Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 253:5, s. 574-581
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To explore whether a reduced lung function is a risk factor for developing diabetes and insulin resistance (IR), and whether such relationship contributes to the largely unexplained association between lung function and incidence of cardiovascular disease (CVD). Design. Forced vital capacity (FVC) was assessed at baseline. Incidence of diabetes and IR [according to the homeostasis model assessment (HOMA) model] was assessed in a follow-up examination after 13.9 ± 2.6 and 9.4 ± 3.6 years for men and women, respectively. After the follow-up examination, incidence of CVD (stroke, myocardial infarction or cardiovascular death) was monitored over 7 years. Setting. Populations-based cohort study. Subjects. Initially nondiabetic men (n = 1436, mean age 44.6 years) and women (n = 896, mean age 49.8 years). Results. Prevalence of IR at the follow-up examination was 34, 26, 21 and 21%, respectively, for men in the first (lowest), second, third and fourth quartile of baseline FVC (P for trend <0.0001). The corresponding values for women were 30, 29, 25 and 17%, respectively (P for trend <0.001). Adjusted for potential confounders, the odds ratio (OR) for IR (per 10% increase in FVC) was 0.91 (CI: 0.84-0.99) for men and 0.89 (CI: 0.80-0.98) for women. FVC was similarly significantly associated with the incidence of diabetes (OR = 0.90, CI: 0.81-1.00), adjusted for sex and other confounders. The incidence of CVD after the follow-up examination was significantly increased only amongst subjects with low FVC who had developed IR (RR = 1.7, CI: 1.02-2.7). Conclusion. Subjects with a moderately reduced FVC have an increased risk of developing IR and diabetes. This relationship seems to contribute to the largely unexplained association between reduced lung function and incidence of CVD.
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| 20. |
- Engström, Gunnar, et al.
(författare)
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Occurrence and prognostic significance of ventricular arrhythmia is related to pulmonary function: a study from "men born in 1914," Malmo, Sweden
- 2001
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Ingår i: Circulation. - 1524-4539. ; 103:25, s. 3086-3091
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Reduced lung function has been associated with increased rates of myocardial infarction. Whether the occurrence and prognostic significance of ventricular arrhythmia is related to lung function is largely unknown. METHODS AND RESULTS: We performed a population-based study of 68-year-old men without a history of stroke or myocardial infarction; 402 men participated. Mortality and coronary events (fatal or nonfatal) were studied in relation to ventricular arrhythmia during 24 hours, percentage of the predicted forced expiratory volume (FEV1(%pred)), vital capacity (VC(%pred)), and the FEV/VC ratio. During 14 years of follow-up, 181 men died and 87 experienced a coronary event. Occurrence of frequent or complex ventricular arrhythmia (Lown class 2 to 5) was significantly and inversely associated with FEV1(%pred). Men with Lown class 2 to 5 and a low FEV1(%pred) (below median) had significantly higher mortality (71.5 versus 26.8 per 1000 person-years; P<0.0001) and coronary event rates (37.7 versus 18.0; P=0.02) than men with Lown class 2 to 5 and a high FEV1(%pred). These associations remained significant after adjustments for potential confounders (mortality: relative risk [RR], 2.91; 95% CI,1.68 to 5.04; coronary events: RR, 2.16; 95% CI, 1.07 to 4.37). In men without frequent or complex arrhythmia (Lown 0 to 1), a low FEV1(%pred) was not significantly associated with mortality (RR, 1.37; 95% CI, 0.92 to 2.05) or coronary events (RR, 1.24; 95% CI, 0.67 to 2.27) after adjustments for confounders. The FEV/VC ratio showed similar associations with arrhythmia, mortality, and coronary events. CONCLUSIONS: Lung function is inversely associated with the occurrence of ventricular arrhythmia. The increased incidence of myocardial infarction and death associated with arrhythmia was mainly limited to men with a low FEV1(%pred) or FEV/VC. We suggest that lung function should be considered when assessing the prognostic significance of ventricular arrhythmia.
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