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- Horsten, M, et al.
(författare)
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Social relations and the metabolic syndrome in middle-aged Swedish women
- 1999
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Ingår i: 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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Tidskriftsartikel (refereegranskat)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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| 5. |
- Kjellgren, Karin I, 1950, et al.
(författare)
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Patients' and physicians' assessment of risks associated with hypertension and benefits from treatment.
- 1998
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Ingår i: Journal of cardiovascular risk. - 1350-6277. ; 5:3, s. 161-6
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Tidskriftsartikel (refereegranskat)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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- Luepker, RV, et al.
(författare)
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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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Ingår i: Journal of Cardiovascular Risk. - : Sage Publications Ltd.. - 1350-6277 .- 1473-5652. ; 6:2, s. 77-98
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Tidskriftsartikel (refereegranskat)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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| 8. |
- Welin, Catharina, 1945, et al.
(författare)
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Behavioural characteristics in patients with myocardial infarction: a case-control study
- 1995
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Ingår i: Journal of Cardiovascular Risk. - 1350-6277. ; 2:3, s. 247-254
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Tidskriftsartikel (refereegranskat)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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- Welin, Catharina, 1945, et al.
(författare)
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Social relationships and myocardial infarction: a case-control study.
- 1996
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Ingår i: Journal of Cardiovascular Risk. - 1350-6277. ; 3:2, s. 183-190
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Tidskriftsartikel (refereegranskat)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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