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The ability of an electrocardiogram to predict fatal and non-fatal cardiac events in asymptomatic middle-aged subjects.

https://arctichealth.org/en/permalink/ahliterature283977
Source
Ann Med. 2016 Nov;48(7):525-531
Publication Type
Article
Date
Nov-2016
Author
Henri K Terho
Jani T Tikkanen
Tuomas V Kenttä
M Juhani Junttila
Aapo L Aro
Olli Anttonen
Tuomas Kerola
Harri A Rissanen
Paul Knekt
Antti Reunanen
Heikki V Huikuri
Source
Ann Med. 2016 Nov;48(7):525-531
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - mortality - physiopathology
Electrocardiography - methods
Female
Finland
Humans
Male
Middle Aged
Predictive value of tests
Prognosis
Registries
Risk factors
Abstract
The long-term prognostic value of a standard 12-lead electrocardiogram (ECG) for predicting cardiac events in apparently healthy middle-aged subjects is not well defined.
A total of 9511 middle-aged subjects (mean age 43?±?8.2 years, 52% males) without a known cardiac disease and with a follow-up 40 years were included in the study. Fatal and non-fatal cardiac events were collected from the national registries. The predictive value of ECG was separately analyzed for 10 and 30 years. Major ECG abnormalities were classified according to the Minnesota code.
Subjects with major ECG abnormalities (N?=?1131) had an increased risk of cardiac death after 10-years (adjusted hazard ratio [HR] 1.7; 95% confidence interval [95% CI], 1.1-2.5, p?=?0.009) and 30-years of follow-up (HR 1.3, 95% CI, 1.1-1.5, p?
PubMed ID
27684209 View in PubMed
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Adding a low-dose antihypertensive regimen would substantially improve the control of hypertension and reduce cardiovascular morbidity among uncomplicated hypertensive patients.

https://arctichealth.org/en/permalink/ahliterature134219
Source
Eur J Prev Cardiol. 2012 Aug;19(4):712-22
Publication Type
Article
Date
Aug-2012
Author
Teemu L Ahola
Ilkka M Kantola
Juhani Mäki
Antti Reunanen
Antti M Jula
Author Affiliation
National Institute for Health and Welfare, Department of Chronic Disease Prevention, Turku/Helsinki, Finland. teemu.ahola@pp3.inet.fi
Source
Eur J Prev Cardiol. 2012 Aug;19(4):712-22
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Aged
Antihypertensive Agents - administration & dosage
Blood Pressure - drug effects
Cardiovascular Diseases - epidemiology - prevention & control
Chi-Square Distribution
Dose-Response Relationship, Drug
Drug Therapy, Combination
Drug Utilization
Female
Finland - epidemiology
Guideline Adherence
Humans
Hypertension - diagnosis - drug therapy - epidemiology - physiopathology
Male
Middle Aged
Physician's Practice Patterns
Practice Guidelines as Topic
Prevalence
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
To assess the utilization of antihypertensive drugs among uncomplicated hypertensive patients in Finland between 2000 and 2006 and to calculate the achievable reduction in cardiovascular morbidity, with intensified antihypertensive treatment.
From the databases of the Social Insurance Institution of Finland, 428,986 treated hypertensives without diabetes or cardiac disease (further named uncomplicated hypertensives) in 2000 and 591,206 in 2006, respectively, were identified. In addition, from the Health 2000 survey representing the whole Finnish adult population, 729 uncomplicated hypertensives were determined to assess their characteristics and control of hypertension. Applying Law's meta-analyses we calculated the reduction of blood pressure (BP) by intensifying the treatment with low-dose antihypertensive regimens for those with a BP =140/90?mmHg.
The nationwide data suggests a relative overuse of beta-blockers. Combination antihypertensive treatment increased relatively 8%, while at least three drug combinations increased from 19.8% to 21.6% between 2000 and 2006. However, calculated prevalence of controlled BP (
PubMed ID
21609976 View in PubMed
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Age-related differences in the frequency of ketoacidosis at diagnosis of type 1 diabetes in children and adolescents.

https://arctichealth.org/en/permalink/ahliterature97233
Source
Diabetes Care. 2010 Jul;33(7):1500-2
Publication Type
Article
Date
Jul-2010
Author
Anne Hekkala
Antti Reunanen
Matti Koski
Mikael Knip
Riitta Veijola
Author Affiliation
Department of Pediatrics, University of Oulu, Oulu University Hospital, Oulu, Finland. anne.hekkala@oulu.fi
Source
Diabetes Care. 2010 Jul;33(7):1500-2
Date
Jul-2010
Language
English
Publication Type
Article
Abstract
OBJECTIVE: We studied the prevalence of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in children in Finland. RESEARCH DESIGN: AND METHODS: From 2002 to 2005, data on virtually all children
PubMed ID
20413519 View in PubMed
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Antibodies to periodontal pathogens and stroke risk.

https://arctichealth.org/en/permalink/ahliterature179360
Source
Stroke. 2004 Sep;35(9):2020-3
Publication Type
Article
Date
Sep-2004
Author
Pirkko J Pussinen
Georg Alfthan
Harri Rissanen
Antti Reunanen
Sirkka Asikainen
Paul Knekt
Author Affiliation
Institute of Dentistry, University of Helsinki, P.O. Box 63 (Haartmaninkatu 8), FIN-00014 Helsinki, Finland. pirkko.pussinen@helsinki.fi
Source
Stroke. 2004 Sep;35(9):2020-3
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Aggregatibacter actinomycetemcomitans - immunology
Antibodies, Bacterial - blood - immunology
Antibody Specificity
Case-Control Studies
Comorbidity
Coronary Disease - epidemiology - immunology
Diabetes Mellitus - epidemiology
Enzyme-Linked Immunosorbent Assay
Female
Finland - epidemiology
Humans
Hypertension - epidemiology
Immunoglobulin A - blood - immunology
Immunoglobulin G - blood - immunology
Male
Middle Aged
Periodontitis - immunology - microbiology
Porphyromonas gingivalis - immunology
Risk
Stroke - epidemiology - immunology
Abstract
The association between cerebrovascular events and periodontitis has been found in few studies based on clinical periodontal examinations. However, evidence on the association between periodontal pathogens and stroke is lacking. Therefore, the aim of the study was to investigate whether elevated levels of serum antibodies to major periodontal pathogens predict stroke in a case-control study.
The study population comprised 6950 subjects (aged 45 to 64 years) who participated in the Mobile Clinic Health Survey in 1973 to 1976 in Finland. During a follow-up of 13 years, a total of 173 subjects had a stroke. From these, 64 subjects had already experienced a stroke or had signs of coronary heart disease (CHD) at baseline, whereas 109 subjects were apparently healthy. Two controls per case were matched for age, gender, municipality, and disease status. Serum IgG and IgA class antibody levels to the periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis, were determined by multiserotype enzyme-linked immunosorbent assay.
The cases identified during the follow-up that were free of stroke or CHD at baseline were more often IgA-seropositive for A. actinomycetemcomitans than were their controls, 41.3% versus 29.3%. Compared with the seronegative, the seropositive subjects had a multivariate odds ratio of 1.6 (95% CI, 1.0 to 2.6) for stroke. The patients with a history of stroke or CHD at baseline were more often IgA-seropositive for P. gingivalis than were their controls, 79.7% versus 70.2%. When compared with the seronegative, the seropositive subjects had an odds ratio of 2.6 (1.0 to 7.0) for secondary stroke.
The present prospective study provides serological evidence that an infection caused by major periodontal pathogens is associated with future stroke.
PubMed ID
15232116 View in PubMed
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Are there socioeconomic differences in myocardial infarction event rates and fatality among patients with angina pectoris?

https://arctichealth.org/en/permalink/ahliterature169785
Source
J Epidemiol Community Health. 2006 May;60(5):442-7
Publication Type
Article
Date
May-2006
Author
Kristiina Manderbacka
Tiina Hetemaa
Ilmo Keskimäki
Pekka Luukkainen
Seppo Koskinen
Antti Reunanen
Author Affiliation
Outcomes and Equity Research Group, National Research and Development Centre for Welfare and Health (STAKES), PO Box 220, 00531 Helsinki, Finland. kristiina.manderbacka@stakes.fi
Source
J Epidemiol Community Health. 2006 May;60(5):442-7
Date
May-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Angina Pectoris - mortality
Cohort Studies
Female
Finland - epidemiology
Humans
Incidence
Logistic Models
Male
Middle Aged
Myocardial Infarction - mortality
Social Class
Abstract
Systematic socioeconomic differences in mortality have been reported among myocardial infarction (MI) patients in many countries, including Finland. The findings have been similar irrespective of country, study period, age group, or length of follow up, but few studies have examined the disparities among other groups of coronary patients. This study examined whether similar socioeconomic differences in outcomes exist among patients with angina pectoris (AP).
The data were based on individual register linkages among a population based 40-79 year-old cohort of 61,350 patients with incident AP or MI during 1995-1998 in Finland. Two year coronary heart disease mortality and one year MI incidence and its 28 day case fatality was studied among AP patients using Cox's and logistic regression analysis, and the results compared with those of the MI patient group.
A clear socioeconomic pattern was found in two year coronary heart disease (CHD) mortality: the lower the socioeconomic group the higher the mortality risk. The socioeconomic patterning of mortality was similar to that found among MI patients. Controlling for comorbidity or disease severity did not change the results. Among AP patients a similar pattern was also found in MI incidence during the follow up, but no systematic socioeconomic differences were detected in its 28 day case fatality.
Socioeconomic differences in CHD outcomes also exist among angina patients. These results suggest that targeted measures of secondary prevention are needed among CHD patients with lower socioeconomic status to reduce socioeconomic disparities in fatal and non-fatal coronary events.
Notes
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PubMed ID
16614336 View in PubMed
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Carotid artery intima-media thickness and elasticity in relation to glucose tolerance.

https://arctichealth.org/en/permalink/ahliterature134291
Source
Acta Diabetol. 2012 Jun;49(3):215-23
Publication Type
Article
Date
Jun-2012
Author
Kalle Sipilä
Mika Kähönen
Veikko Salomaa
Markku Päivänsalo
Hannu Karanko
Marjut Varpula
Antti Jula
Risto Kaaja
Y Antero Kesäniemi
Antti Reunanen
Leena Moilanen
Author Affiliation
Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland. kalle.sipila@uta.fi
Source
Acta Diabetol. 2012 Jun;49(3):215-23
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Atherosclerosis - pathology - ultrasonography
Blood Pressure - physiology
Carotid Artery, Common - pathology - ultrasonography
Carotid Intima-Media Thickness
Chi-Square Distribution
Cross-Sectional Studies
Female
Finland
Glucose Intolerance - pathology
Glucose Tolerance Test
Humans
Male
Middle Aged
Sex Factors
Abstract
The association between diabetes and subclinical atherosclerosis is well established. The effect of non-diabetic glucose intolerance on early atherosclerosis is not as straightforward, and the data regarding sex-related differences in this matter are limited. Therefore, our aim was to investigate these associations in men and women separately. We studied 1,304 Finnish men and women over 45 years of age who participated in the Finnish Health 2000 Survey. Ultrasonically determined carotid artery intima-media thickness and elasticity were used as markers of early atherosclerosis. Glucose tolerance was categorized according to the American Diabetes Association criteria for diabetes mellitus. Age-adjusted means for carotid artery intima-media thickness and elasticity indices were significantly (P
PubMed ID
21604003 View in PubMed
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Changing patterns of secondary preventive medication among newly diagnosed coronary heart disease patients with diabetes in Finland: a register-based study.

https://arctichealth.org/en/permalink/ahliterature144891
Source
Scand J Public Health. 2010 May;38(3):317-24
Publication Type
Article
Date
May-2010
Author
Tuulikki Vehko
Kristna Manderbacka
Martti Arffman
Reijo Sund
Antti Reunanen
Ilmo Keskimäki
Author Affiliation
National Institute for Health and Welfare (THL), Helsinki, Finland. tuulikki.vehko@thl.fi
Source
Scand J Public Health. 2010 May;38(3):317-24
Date
May-2010
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - administration & dosage
Adult
Aged
Angiotensin II Type 1 Receptor Blockers - administration & dosage
Angiotensin-Converting Enzyme Inhibitors - administration & dosage
Coronary Disease - diagnosis - etiology - prevention & control
Diabetes Mellitus, Type 1 - complications - drug therapy
Diabetes Mellitus, Type 2 - complications - drug therapy
Drug Prescriptions - economics - statistics & numerical data
Drug Utilization - economics - statistics & numerical data
Female
Finland
Humans
Hypolipidemic Agents - administration & dosage
Male
Middle Aged
Practice Guidelines as Topic
Registries
Reimbursement Mechanisms
Secondary Prevention
Socioeconomic Factors
Abstract
Information on medicine use among coronary heart disease (CHD) patients with diabetes in unselected patient populations is scarce. This study examines the use of medication to prevent new cardiac events among newly diagnosed CHD patients with diabetes comparing them to patients without diabetes and examines socioeconomic differences in medicine use in these patient groups.
Data on CHD patients (43,501 men and 31,125 women) with or without diabetes were individually linked from nationwide registers (covering both patients treated in ambulatory and in hospital inpatient care). Age-standardised rates for medication use were calculated and differences between patient groups examined using Poisson regression.
beta-blocker use was high in all patient groups in 1997-2002, angiotensin-converting enzyme (ACE) inhibitor and angiotensin II antagonist use increased and remained higher among patients with diabetes. More than half of men and women with diabetes used ACE inhibitors and one out of five used angiotensin II antagonists in 2002. Lipid-lowering medication use increased, especially among women. In 1997-98 it was lower in lower socioeconomic groups; among men with diabetes the use remained lower than among others.
beta-blocker use was constant and ACE inhibitor and angiotensin II antagonist use increased. Lipid-lowering medication use increased considerably after a health insurance reform in 2000, in which elevated reimbursement of drug costs (75%) was extended to include all CHD patients with hyperlipidaemia.Socioeconomic differences in medication use disappeared after the reform. However, lipid-lowering medication use remained at a lower level among men with diabetes, suggesting that their treatment did not follow guidelines.
PubMed ID
20228159 View in PubMed
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Coffee consumption and risk of type 2 diabetes mellitus.

https://arctichealth.org/en/permalink/ahliterature186498
Source
Lancet. 2003 Feb 22;361(9358):702-3; author reply 703
Publication Type
Article
Date
Feb-22-2003

Comparison of agreement between clinic and home-measured blood pressure in the Finnish population: the Finn-HOME Study.

https://arctichealth.org/en/permalink/ahliterature168100
Source
J Hypertens. 2006 Aug;24(8):1549-55
Publication Type
Article
Date
Aug-2006
Author
Teemu J Niiranen
Antti M Jula
Ilkka M Kantola
Antti Reunanen
Author Affiliation
Department of Health and Functional Capacity, National Public Health Institute, Turku, Finland. teemu.niiranen@utu.fi
Source
J Hypertens. 2006 Aug;24(8):1549-55
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Aged
Antihypertensive Agents - therapeutic use
Blood pressure
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm
Confounding Factors (Epidemiology)
Female
Finland - epidemiology
Health Surveys
Humans
Hypertension - diagnosis - drug therapy - epidemiology - physiopathology - prevention & control
Male
Middle Aged
Observer Variation
Office Visits
Prevalence
Self Care
Abstract
The purpose of this study was to assess the agreement, mean difference, and the detection and control rates of hypertension, between home and clinic blood pressure (BP) measurement in the Finnish population. Variation in home BP during the measurements was also examined.
We studied a representative sample of the adult population (2051 45-74-year-old individuals) in Finland. Subjects included in the study underwent a clinical interview and measurement of clinic and home BP. Thresholds for elevated clinic and home BP were 140/90 and 135/85 mmHg.
The mean difference between home and clinic BP, which increased with BP, was 7.7/3.4 mmHg. Overall agreement in diagnosis was only 75.2% (kappa coefficient 0.50). As compared with home BP, clinic BP overestimated the prevalence of hypertension (48.8 versus 42.5%, P
PubMed ID
16877957 View in PubMed
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Consumption of sweetened beverages and intakes of fructose and glucose predict type 2 diabetes occurrence.

https://arctichealth.org/en/permalink/ahliterature163474
Source
J Nutr. 2007 Jun;137(6):1447-54
Publication Type
Article
Date
Jun-2007
Author
Jukka Montonen
Ritva Järvinen
Paul Knekt
Markku Heliövaara
Antti Reunanen
Author Affiliation
National Public Health Institute, Helsinki FIN, Finland. jukka.montonen@ktl.fi
Source
J Nutr. 2007 Jun;137(6):1447-54
Date
Jun-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Beverages
Cohort Studies
Diabetes Mellitus, Type 2 - chemically induced - epidemiology
Diet Surveys
Energy intake
Female
Finland - epidemiology
Fructose - administration & dosage - adverse effects
Glucose - administration & dosage - adverse effects
Humans
Incidence
Male
Middle Aged
Questionnaires
Abstract
The role of intakes of different sugars in the development of type 2 diabetes was studied in a cohort of 4,304 men and women aged 40-60 y and initially free of diabetes at baseline in 1967-1972. Food consumption data were collected using a dietary history interview covering the habitual diet during the previous year. The intakes of different sugars were calculated and divided in quartiles. During a 12-y follow-up, 177 incidents of type 2 diabetes cases were identified from a nationwide register. Combined intake of fructose and glucose was associated with the risk of type 2 diabetes but no significant association was observed for intakes of sucrose, lactose, or maltose. The relative risk between the highest and lowest quartiles of combined fructose and glucose intake was 1.87 (95% [CI] = 1.19, 2.93; P = 0.003). The corresponding relative risks between the extreme quartiles of consumption of food items contributing to sugar intakes were 1.69 (95% [CI] = 1.17, 2.43; P
Notes
Comment In: J Nutr. 2008 Jan;138(1):138; author reply 13918156416
PubMed ID
17513405 View in PubMed
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68 records – page 1 of 7.