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Adaptive behavior in stressful situations and stroke incidence in hypertensive men: results from prospective cohort study "men born in 1914" in Malmö, Sweden.

https://arctichealth.org/en/permalink/ahliterature193833
Source
Stroke. 2001 Aug;32(8):1712-20
Publication Type
Article
Date
Aug-2001
Author
L. André-Petersson
G. Engström
B. Hagberg
L. Janzon
G. Steen
Author Affiliation
Division of Epidemiology, Department of Community Medicine, Malmö University Hospital, Lund University, Malmö, Sweden. Lena.Andre-Petersson@psychology.lu.ses
Source
Stroke. 2001 Aug;32(8):1712-20
Date
Aug-2001
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological - classification
Cohort Studies
Comorbidity
Disease-Free Survival
Follow-Up Studies
Humans
Hypertension - epidemiology
Incidence
Male
Multivariate Analysis
Neuropsychological Tests
Prospective Studies
Risk factors
Stress, Psychological - epidemiology - psychology
Stroke - epidemiology
Sweden - epidemiology
Abstract
Although hypertension is a major risk factor for stroke, many hypertensive persons remain healthy. The aim of the present study was to analyze whether adaptation in a stressful situation was associated with the incidence of stroke in hypertensive men.
Two hundred thirty-eight hypertensive men were followed from baseline in 1982/1983 until first stroke, death, or December 31, 1996. Adaptation to stress was studied with the serial Color-Word Test. In the Regression dimension, 4 patterns of adaptation could be distinguished according to mastering of the test. Successful mastering of the test was shown in stabilized patterns, increasing difficulty in cumulative patterns, fluctuating difficulty in dissociative patterns, and fluctuating difficulty that increased during testing in cumulative-dissociative patterns. The patterns were compared regarding stroke incidence.
Forty-three men experienced a stroke during follow-up. Stroke rates per 1000 person-years were 12.6 for men with stabilized patterns, 14.3 for men with cumulative patterns, 16.2 for men with dissociative patterns, and 31.2 for men with cumulative-dissociative patterns. Multivariate analysis, adjusted for relevant cerebrovascular risk factors, showed that the cumulative-dissociative pattern of the Regression dimension was associated with an increased risk of stroke during follow-up (relative risk 3.00, 95% CI 1.32 to 6.81).
The specific behavior pattern, characterized by the greatest difficulties in managing the test, was associated with incidence of stroke in hypertensive men. One interpretation is that hypertensive men who chronically fail to find successful strategies in stressful situations are vulnerable to the damaging effects of stress and thereby at an increased risk of a future stroke.
PubMed ID
11486095 View in PubMed
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Area social characteristics and carotid atherosclerosis.

https://arctichealth.org/en/permalink/ahliterature166391
Source
Eur J Public Health. 2007 Aug;17(4):333-9
Publication Type
Article
Date
Aug-2007
Author
M. Rosvall
G. Engström
B. Hedblad
L. Janzon
G. Berglund
Author Affiliation
Department of Health Sciences, Lund University, Malmö University Hospital, Malmö, Sweden. maria.rosvall@med.lu.se
Source
Eur J Public Health. 2007 Aug;17(4):333-9
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular diseases
Carotid Artery Diseases - epidemiology - physiopathology
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Risk factors
Socioeconomic Factors
Sweden - epidemiology
Abstract
To explore the effect of social characteristics of residential areas on carotid atherosclerosis prevalence.
The associations among area social characteristics and B-mode ultrasound determined carotid plaque-score (a semi-quantitative scale measuring the degree of atherosclerosis in the carotid bifurcation area) were cross-sectionally investigated in a general population sample of 4033 men and women. Area socioeconomic circumstances were described through a social deprivation index calculated from migration rate, percentage residents with foreign citizenship among those with foreign background, dependency on social welfare support, and employment rate. Living in socially deprived areas was associated with an increased carotid plaque-score in both men (P for trend = 0.004) and women (P for trend = 0.007). These associations were only slightly reduced after adjustment for individual level indicators with a decrease of the absolute mean difference in carotid plaque-score between worse-off and better-off areas of 9% for men and 13% for women, whereas adjustment for risk factors turned the trend non-significant in women, however, not in men.
Those living in socially deprived areas in general had more extensive carotid atherosclerosis. However, in these areas there were a substantial number of individuals with low degrees of carotid atherosclerosis and vice versa. Thus, with regard to conceptual ideas of causal inference, the social characteristics of an area seem to be associated with the prevalence of carotid atherosclerosis. However, with regard to benefits of prevention, focusing on geographical areas would probably give a restricted benefit, where only some high-risk individuals would be reached.
PubMed ID
17121741 View in PubMed
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Association between sucrose intake and acute coronary event risk and effect modification by lifestyle factors: Malmö Diet and Cancer Cohort Study.

https://arctichealth.org/en/permalink/ahliterature282792
Source
Br J Nutr. 2016 Nov;116(9):1611-1620
Publication Type
Article
Date
Nov-2016
Author
K. Warfa
I. Drake
P. Wallström
G. Engström
E. Sonestedt
Source
Br J Nutr. 2016 Nov;116(9):1611-1620
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Confounding Factors (Epidemiology)
Diet - adverse effects - ethnology
Dietary Sucrose - administration & dosage - adverse effects
Energy Intake - ethnology
Feeding Behavior - ethnology
Female
Follow-Up Studies
Healthy Lifestyle
Humans
Incidence
Life Style - ethnology
Male
Middle Aged
Myocardial Ischemia - epidemiology - ethnology - etiology - prevention & control
Proportional Hazards Models
Prospective Studies
Registries
Risk factors
Self Report
Sweden - epidemiology
Urban Health - ethnology
Abstract
Previous studies have suggested that a high intake of sugar-sweetened beverages is positively associated with the risk of a coronary event. However, a few studies have examined the association between sucrose (the most common extrinsic sugar in Sweden) and incident coronary events. The objective of the present study was to examine the associations between sucrose intake and coronary event risk and to determine whether these associations are specific to certain subgroups of the population (i.e. according to physical activity, obesity status, educational level, alcohol consumption, smoking habits, intake of fat and intake of fruits and vegetables). We performed a prospective analysis on 26 190 individuals (62 % women) free from diabetes and without a history of CVD from the Swedish population-based Malmö Diet and Cancer cohort. Over an average of 17 years of follow-up (457 131 person-years), 2493 incident cases of coronary events were identified. Sucrose intake was obtained from an interview-based diet history method, including 7-d records of prepared meals and cold beverages and a 168-item diet questionnaire covering other foods. Participants who consumed >15 % of their energy intake (E%) from sucrose showed a 37 (95 % CI 13, 66) % increased risk of a coronary event compared with the lowest sucrose consumers (
PubMed ID
27774913 View in PubMed
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Associations between lung function and alcohol consumption--assessed by both a questionnaire and a blood marker.

https://arctichealth.org/en/permalink/ahliterature258350
Source
Respir Med. 2014 Jan;108(1):114-21
Publication Type
Article
Date
Jan-2014
Author
S. Frantz
P. Wollmer
M. Dencker
G. Engström
U. Nihlén
Author Affiliation
Clinical Physiology and Nuclear Medicine Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden. Electronic address: sophia.frantz@med.lu.se.
Source
Respir Med. 2014 Jan;108(1):114-21
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Aged
Alcohol Drinking
Biological Markers - blood
Bronchitis, Chronic - physiopathology
C-Reactive Protein - metabolism
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Plethysmography, Whole Body
Pulmonary Diffusing Capacity
Pulmonary Disease, Chronic Obstructive - blood - physiopathology
Pulmonary Emphysema - physiopathology
Questionnaires
Respiratory Function Tests
Risk factors
Smoking - adverse effects
Sweden
Transferrin - analogs & derivatives - metabolism
Abstract
Studies on the influence of alcohol consumption on lung function have shown conflicting results. Self-reported alcohol consumption may be inaccurate. This study used both a validated alcohol questionnaire and a blood marker of heavy alcohol consumption, and examined potential associations with different lung physiological variables.
The study population (450 subjects) answered an alcohol questionnaire (AUDIT-C) and performed spirometry, body plethysmography and a test for diffusing capacity for CO (DL,CO). Carbohydrate deficient transferrin (CDT), a clinically used blood marker for identifying heavy alcohol consumption, and C-reactive protein (CRP), a marker of systemic inflammation were analysed.
Using AUDIT-C, 407 subjects were alcohol drinkers and 29 non-drinkers. Of the alcohol drinkers, 224 subjects were "hazardous drinkers" and 183 "moderate drinkers". Thirty-four subjects had a CDT =2.0% (=heavy drinkers). There was no difference in lung function between hazardous and moderate drinkers. Heavy drinkers had lower DL,CO (74% vs 83% PN, p = 0.003), more symptoms of chronic bronchitis (p = 0.001) and higher AUDIT-C scores (p 
PubMed ID
24064346 View in PubMed
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Asymptomatic leg and carotid atherosclerosis in smokers is related to degree of ventilatory capacity: longitudinal and cross-sectional results from 'Men born in 1914', Sweden.

https://arctichealth.org/en/permalink/ahliterature10282
Source
Atherosclerosis. 2001 Mar;155(1):237-43
Publication Type
Article
Date
Mar-2001
Author
G. Engström
B. Hedblad
S. Valind
L. Janzon
Author Affiliation
Department of Community Medicine, Malmö University Hospital, S-20502, Malmö, Sweden. gunnar.esgstrom@smi.mas.lu.se
Source
Atherosclerosis. 2001 Mar;155(1):237-43
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Aged
Arteriosclerosis - physiopathology
Blood pressure
Carotid Artery Diseases - physiopathology
Cohort Studies
Cross-Sectional Studies
Forced expiratory volume
Humans
Leg - blood supply
Lipids - blood
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Respiratory Mechanics
Risk factors
Smoking - adverse effects
Sweden
Vital Capacity
Abstract
Although smoking is associated with cardiovascular disease (CVD), many individuals remain healthy after many years of smoking. The population based cohort 'Men born in 1914' was used to investigate whether the occurrence of non-invasively detected atherosclerosis among smokers is associated with lung function [(i.e. height-adjusted forced expiratory volume during 1 s (FEV1.0) and vital capacity (VC)]. Two hundred and seven smokers without history of CVD were examined with spirometry and calf plethysmography at 55 years, and with spirometry, ankle-arm blood pressure recordings and ultrasound examinations of the carotid arteries at 68 years. Eighty-three men had atherosclerosis defined as carotid stenosis >30% or ankle-arm index
PubMed ID
11223447 View in PubMed
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Asymptomatic leg atherosclerosis is reduced by regular physical activity. Longitudinal results from the cohort "men born in 1914".

https://arctichealth.org/en/permalink/ahliterature49883
Source
Eur J Vasc Endovasc Surg. 2001 Jun;21(6):502-7
Publication Type
Article
Date
Jun-2001
Author
G. Engström
M. Ogren
B. Hedblad
P. Wollmer
L. Janzon
Author Affiliation
Division of Epidemiology, Department of Community Medicine, Malmö University Hospital, Lund University, Malmö, Sweden.
Source
Eur J Vasc Endovasc Surg. 2001 Jun;21(6):502-7
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Aged
Analysis of Variance
Arteriosclerosis - epidemiology - prevention & control
Cross-Sectional Studies
Exercise
Follow-Up Studies
Humans
Leg - blood supply
Male
Middle Aged
Prevalence
Research Support, Non-U.S. Gov't
Sweden - epidemiology
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.
PubMed ID
11397023 View in PubMed
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[Blood reinfusion in orthopedic surgery in Sweden. The most common method is wound reinfusion].

https://arctichealth.org/en/permalink/ahliterature210540
Source
Lakartidningen. 1996 Nov 27;93(48):4448, 4451-2
Publication Type
Article
Date
Nov-27-1996
Author
T. Dalén
G. Engström
Author Affiliation
Norrlands universitetssjukhus, Umeå.
Source
Lakartidningen. 1996 Nov 27;93(48):4448, 4451-2
Date
Nov-27-1996
Language
Swedish
Publication Type
Article
Keywords
Blood Loss, Surgical
Blood Substitutes - administration & dosage
Blood Transfusion, Autologous - methods
Humans
Intraoperative Care - methods
Orthopedics
Preoperative Care - methods
Questionnaires
Sweden
PubMed ID
8992171 View in PubMed
Less detail

Can differences in benefit levels explain duration and outcome of sickness absence?

https://arctichealth.org/en/permalink/ahliterature71521
Source
Disabil Rehabil. 2002 Sep 20;24(14):713-8
Publication Type
Article
Date
Sep-20-2002
Author
L-G Engström
T. Eriksen
Author Affiliation
Division of Social Sciences, University of Karlstad, 651 88 Karlstad, Sweden. larsgunnar.engstrom@fk17.sfa.se
Source
Disabil Rehabil. 2002 Sep 20;24(14):713-8
Date
Sep-20-2002
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Female
Health Benefit Plans, Employee - economics
Humans
Insurance Benefits - economics
Insurance, Disability
Long-Term Care
Male
Sex Factors
Sick Leave - economics
Sweden
Time Factors
Treatment Outcome
Abstract
PURPOSE: The aim of this study is to examine the long- and short-term economic incentives inherent in the sickness and unemployment insurances. In particular, how the differences, in, for instance, benefit levels between the two systems, affect the duration and outcome of long-term sickness for the unemployed. METHOD: A sample of 280 sick-registered unemployed in the county of Värmland, Sweden was used in two regression models. Sickness duration was modelled in a linear regression and the outcome (healthy and non-healthy) in a logistic regression. RESULTS AND CONCLUSION: The study shows that economic incentives, i.e. differences in benefit levels, help in explaining sickness duration. The proven fact, that benefits from the sickness insurance are in general higher than from the unemployment insurance, results in the sickness spells being prolonged. Indications are also found of a preference for long-term income security through the sickness and disability insurances, using the length of unemployment before sickness registration, as a determinant of the outcome of the sickness spell.
PubMed ID
12396656 View in PubMed
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Cardiac arrhythmias and stroke: increased risk in men with high frequency of atrial ectopic beats.

https://arctichealth.org/en/permalink/ahliterature54147
Source
Stroke. 2000 Dec;31(12):2925-9
Publication Type
Article
Date
Dec-2000
Author
G. Engström
B. Hedblad
S. Juul-Möller
P. Tydén
L. Janzon
Author Affiliation
Department of Community Medicine, Malmö University Hospital (Sweden). Gunnar.Engstrom@smi.mas.lu.se
Source
Stroke. 2000 Dec;31(12):2925-9
Date
Dec-2000
Language
English
Publication Type
Article
Keywords
Aged
Arrhythmia - diagnosis - epidemiology
Atrial Premature Complexes - diagnosis - epidemiology
Cause of Death
Cerebrovascular Accident - diagnosis - epidemiology - mortality
Comorbidity
Drug Resistance, Multiple
Electrocardiography, Ambulatory - statistics & numerical data
Humans
Incidence
Male
Prospective Studies
Registries
Research Support, Non-U.S. Gov't
Risk factors
Sampling Studies
Sex Factors
Sweden - epidemiology
Abstract
BACKGROUND AND PURPOSE: With the exception of atrial fibrillation (AF), little scientific attention has been given the associations between cardiac arrhythmias and incidence of stroke. We sought to study whether atrial and ventricular arrhythmias assessed during a 24-hour ambulatory ECG registration are associated with incidence of stroke. METHODS: The population-based cohort "Men Born in 1914" was examined with 24-hour ambulatory ECG registrations at 68 years of age. Four hundred two men without previous myocardial infarction or stroke were included, and 236 of them had hypertension (>/=160/95 mm Hg or treatment). Fourteen-year rates of stroke (fatal and nonfatal) and all-cause mortality were updated from national and regional registers. Frequent or complex ventricular arrhythmias was defined as Lown class 2 to 5. A high frequency of atrial ectopic beats (AEB) was defined as the fifth quintile (ie, >/=218 AEB per 24 hours). RESULTS: Fifty-eight men suffered a first stroke during the follow-up. Stroke rates (per 1000 person-years) among men with AF (n=14), with frequent AEB (n=77), and without AF or frequent AEB (n=311) were 34.5, 19.5, and 11.6, respectively. The corresponding values among men with hypertension were 40.7, 32.3, and 14.7, respectively. Frequent AEB (compared with absence of AF and frequent AEB) was significantly associated with stroke among all men (relative risk=1.9; 95% CI, 1.02 to 3.4; P:=0.04) and among hypertensive men (relative risk=2.5; 95% CI, 1.3 to 4.8; P:=0.009) after adjustments for potential confounders. The increased stroke rates among men with Lown class 2 to 5 did not reach statistical significance. CONCLUSIONS: A high frequency of AEB is associated with an increased incidence of stroke.
Notes
Comment In: Stroke. 2001 Jun;32(6):1443-811387515
PubMed ID
11108750 View in PubMed
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Ceruloplasmin and atrial fibrillation: evidence of causality from a population-based Mendelian randomization study.

https://arctichealth.org/en/permalink/ahliterature106739
Source
J Intern Med. 2014 Feb;275(2):164-71
Publication Type
Article
Date
Feb-2014
Author
S. Adamsson Eryd
M. Sjögren
J G Smith
P M Nilsson
O. Melander
B. Hedblad
G. Engström
Author Affiliation
Department of Clinical Sciences, Lund University, Malmö, Sweden.
Source
J Intern Med. 2014 Feb;275(2):164-71
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Adult
Atrial Fibrillation - blood - epidemiology - genetics
Biological Markers - blood
Ceruloplasmin - genetics - metabolism
Cohort Studies
Follow-Up Studies
Gene Frequency
Humans
Incidence
Male
Mendelian Randomization Analysis
Middle Aged
Odds Ratio
Polymorphism, Single Nucleotide
Promoter Regions, Genetic
Sweden - epidemiology
Abstract
Inflammatory diseases and inflammatory markers secreted by the liver, including C-reactive protein (CRP) and ceruloplasmin, have been associated with incident atrial fibrillation (AF). Genetic studies have not supported a causal relationship between CRP and AF, but the relationship between ceruloplasmin and AF has not been studied. The purpose of this Mendelian randomization study was to explore whether genetic polymorphisms in the gene encoding ceruloplasmin are associated with elevated ceruloplasmin levels, and whether such genetic polymorphisms are also associated with the incidence of AF.
Genetic polymorphisms in the ceruloplasmin gene (CP) were genotyped in a population-based cohort study of men from southern Sweden (Malmö Preventive Project; n = 3900). Genetic polymorphisms associated with plasma ceruloplasmin concentration were also investigated for association with incident AF (n = 520) during a mean follow-up of 29 years in the same cohort. Findings were replicated in an independent case-control sample (The Malmö AF cohort; n = 2247 cases, 2208 controls).
A single nucleotide polymorphism (rs11708215, minor allele frequency 0.12) located in the CP gene promoter was strongly associated with increased levels of plasma ceruloplasmin (P = 9 × 10(-10) ) and with AF in both the discovery cohort [hazard ratio 1.24 per risk allele, 95% confidence interval (CI) 1.06-1.44, P = 0.006] and the replication cohort (odds ratio 1.13, 95% CI 1.02-1.26, P = 0.02).
Our findings indicate a causal role of ceruloplasmin in AF pathophysiology and suggest that ceruloplasmin might be a mediator in a specific inflammatory pathway that causally links inflammatory diseases and incidence of AF.
Notes
Comment In: J Intern Med. 2014 Feb;275(2):191-424188106
PubMed ID
24118451 View in PubMed
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53 records – page 1 of 6.