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Adherence to prescription guidelines and achievement of treatment goals among persons with coronary heart disease in Tromsø 7.

https://arctichealth.org/en/permalink/ahliterature303664
Source
BMC Cardiovasc Disord. 2021 Jan 21; 21(1):44
Publication Type
Journal Article
Date
Jan-21-2021
Author
Elisabeth Pedersen
Beate Hennie Garcia
Kjell H Halvorsen
Anne Elise Eggen
Henrik Schirmer
Marit Waaseth
Author Affiliation
Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway. elisabeth.pedersen@uit.no.
Source
BMC Cardiovasc Disord. 2021 Jan 21; 21(1):44
Date
Jan-21-2021
Language
English
Publication Type
Journal Article
Abstract
Adherence to clinical practice guidelines for coronary heart disease (CHD) reduces morbidity, mortality and treatment costs. We aimed to describe and compare adherence to prescription guidelines for persons with CHD, and explore its association with treatment goal achievement.
We included all participants reporting myocardial infarction, angina, percutaneous coronary intervention and/or coronary artery bypass surgery in the seventh wave of the Tromsø Study (2015-2016, n?=?1483). Medication use and treatment goal measures (blood pressure, low-density lipoprotein (LDL)-cholesterol and HbA1c) were compared to clinical practice guidelines on secondary CHD prevention. Propensity score matched logistic regression was used to assess the association between the use of antihypertensive drugs and achievement of treatment goal for blood pressure, and the use of lipid-lowering drugs (LLDs) and achievement of treatment goal for LDL-cholesterol.
The prevalence of pharmacological CHD treatment was 76% for LLDs, 72% for antihypertensive drugs and 66% for acetylsalicylic acid. The blood pressure goal (
PubMed ID
33478404 View in PubMed
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Ageing and mental health: changes in self-reported health due to physical illness and mental health status with consecutive cross-sectional analyses.

https://arctichealth.org/en/permalink/ahliterature279278
Source
BMJ Open. 2017 Jan 18;7(1):e013629
Publication Type
Article
Date
Jan-18-2017
Author
Geir Fagerjord Lorem
Henrik Schirmer
Catharina E A Wang
Nina Emaus
Source
BMJ Open. 2017 Jan 18;7(1):e013629
Date
Jan-18-2017
Language
English
Publication Type
Article
Abstract
It is known that self-reported health (SRH) declines with increasing age and that comorbidity increases with age. We wished to examine how age transfers its effect to SRH through comorbid disease and mental illness and whether these processes remained stable from 1994 until 2008. The hypothesis is that ageing and/or the increased age-related burden of pathology explains the declining SRH.
The Tromsø Study (TS) is a cohort study using a survey approach with repeated physical examinations. It was conducted in the municipality of Tromsø, Norway, from 1974 to 2008.
A total of 21 199 women and 19 229 men participated.
SRH is the outcome of interest. We calculated and compared the effect sizes of age, comorbidity and mental health symptoms using multimediator analysis based on OLS regression.
Ageing had a negative impact on SRH, but the total effect of age decreased from 1994 to 2007. We assessed the direct effect of age and then the proportion of indirect age-related effects through physical illness and mental health symptoms on the total effect. The direct effect of age represented 79.3% of the total effect in 1994 and decreased to 58.8% in 2007. Physical illness emerged as an increasingly important factor and increased its influence from 15.7% to 41.2% of the total effect. Age alone had a protective effect on mental health symptoms and this increased (2.5% to 17.3%), but we found a stronger association between mental health symptoms and physical disease in the later waves of the study (increasing from 3.7% to 14.8%).
The results suggest that the effect on SRH of mental health symptoms caused by physical illness is an increasing public health problem. Treatment and care for specific medical conditions must therefore focus more strongly on how these conditions affect the patient's mental health and address these concerns accordingly.
PubMed ID
28100564 View in PubMed
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Assessment of risk factors for developing incident aortic stenosis: the Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature257544
Source
Eur J Epidemiol. 2014 Aug;29(8):567-75
Publication Type
Article
Date
Aug-2014
Author
Gry Wisthus Eveborn
Henrik Schirmer
Per Lunde
Geir Heggelund
John-Bjarne Hansen
Knut Rasmussen
Author Affiliation
Division of Cardiothoracic and Respiratory Medicine, Department of Heart Disease, University Hospital of Northern Norway, Tromsö, Norway, gry.eveborn@unn.no.
Source
Eur J Epidemiol. 2014 Aug;29(8):567-75
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Aged
Aortic Valve - ultrasonography
Aortic Valve Stenosis - diagnosis - epidemiology
Blood pressure
Body mass index
Echocardiography
Female
Follow-Up Studies
Humans
Hypercholesterolemia - epidemiology
Hypertension - epidemiology
Incidence
Male
Middle Aged
Multivariate Analysis
Norway - epidemiology
Obesity - epidemiology
Proportional Hazards Models
Prospective Studies
Risk assessment
Risk factors
Smoking - adverse effects - epidemiology
Waist Circumference
Abstract
To disclose risk factors of incident aortic stenosis (AS) and progression of established AS. A prospective cohort study. The Tromsø Study, a population based health survey. Over a 14 years span we performed three repeated echocardiographic examinations (1994, 2001 and 2008) of a random sample of initially 3,243 participants. Data from the only hospital serving this population were included in the follow up. Throughout the study 132 participants were diagnosed with incident AS, defined as mean aortic valve gradient =15 mmHg. Cox proportional hazards regression disclosed age (HR 1.11, 95 %CI 1.08-1.14), systolic blood pressure (BP) (HR 1.01, 95 % CI 1.00-1.02), active smoking (HR 1.71, 95 % CI 1.09-2.67), and waist circumference (HR 1.02, 95 % CI 1.00-1.03) as independent predictors of incident AS. Analysis of risk factors for progression of AS disclosed a higher mean aortic gradient at first measurement (p = 0.015), weight (p = 0.015), a low haemoglobin (Hgb) (p = 0.030) and high density lipoprotein (HDL) (p = 0.032) as significant independent predictors. Age, systolic BP, smoking and waist circumference were independent predictors of incident AS, whereas cholesterol was not. Mean aortic gradient at first measurement, weight, an elevated HDL and low Hgb increase the progression rate of the disease. Our data indicate that calcific aortic valve disease is a distinct pathophysiological process, with age, smoking and "wear and tear" of the valve being major contributors to the disease development.
PubMed ID
25023627 View in PubMed
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Association between diastolic dysfunction and future atrial fibrillation in the Tromsø Study from 1994 to 2010.

https://arctichealth.org/en/permalink/ahliterature262594
Source
Heart. 2015 May 13;
Publication Type
Article
Date
May-13-2015
Author
Sweta Tiwari
Henrik Schirmer
Bjarne K Jacobsen
Laila A Hopstock
Audhild Nyrnes
Geir Heggelund
Inger Njølstad
Ellisiv B Mathiesen
Maja-Lisa Løchen
Source
Heart. 2015 May 13;
Date
May-13-2015
Language
English
Publication Type
Article
Abstract
To investigate the association between echocardiographic measurements with emphasis on diastolic dysfunction and risk of atrial fibrillation (AF) in a population-based cohort study.
We followed 2406 participants from the Tromsø Study from 1994 to 2010. Left atrial (LA) size and mitral Doppler indices as measured by echocardiography were used for evaluating diastolic dysfunction. Information concerning age, systolic blood pressure, height, heart rate, body mass index, total and high-density lipoprotein cholesterol, self-reported use of alcohol, smoking, coffee, physical activity, antihypertensive treatment, prevalent coronary heart disease, valvular heart disease, heart failure, hypertrophy, diabetes and palpitations were obtained at baseline. The outcome measure was clinical AF, documented by an ECG.
AF was detected in 462 subjects (193 women). Mean age at baseline was 62.6 years. Incidence rate of clinical AF was 12.6 per 1000 person-years. In multivariable Cox proportional hazards regression analysis, moderately enlarged LA was associated with 60% (95% CI 1.2 to 2.0) increased risk of AF. Severely enlarged LA had HR for AF of 4.2 (95% CI 2.7 to 6.5) with p value for linear trend
PubMed ID
25972269 View in PubMed
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Association of endogenous testosterone with blood pressure and left ventricular mass in men. The Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature182106
Source
Eur J Endocrinol. 2004 Jan;150(1):65-71
Publication Type
Article
Date
Jan-2004
Author
Johan Svartberg
Denise von Mühlen
Henrik Schirmer
Elizabeth Barrett-Connor
Johan Sundfjord
Rolf Jorde
Author Affiliation
Department of Medicine, University Hospital of North Norway, 9038 Tromsø, Norway. johan.svartberg@unn.no
Source
Eur J Endocrinol. 2004 Jan;150(1):65-71
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Aged
Blood pressure
Cross-Sectional Studies
Humans
Hypertension - blood - epidemiology
Hypertrophy, Left Ventricular - blood - epidemiology
Male
Middle Aged
Regression Analysis
Risk factors
Sex Hormone-Binding Globulin - metabolism
Testosterone - blood
Abstract
To test the hypothesis that lower endogenous testosterone levels are associated with higher blood pressure, left ventricular mass, and left ventricular hypertrophy.
Population-based cross-sectional study.
Sex hormone levels, measured by immunoassay, anthropometric measurements and resting blood pressure were studied in 1548 men aged 25-84 Years; echocardiography was completed in 1264 of these men. Partial correlations and multiple regressions were used to estimate the associations between sex hormones, blood pressure and left ventricular mass by height. Analyses of variance and covariance were used to compare men with categorical hypertension and left ventricular hypertrophy.
In age-adjusted partial correlations, total testosterone and sex hormone-binding globulin (SHBG) were each inversely associated with systolic blood pressure (SBP) (P or =140 or diastolic blood pressure (DBP)> or =90 mmHg) had lower levels of total and free testosterone and SHBG before (P
PubMed ID
14713281 View in PubMed
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The association of grip strength from midlife onwards with all-cause and cause-specific mortality over 17 years of follow-up in the Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature273326
Source
J Epidemiol Community Health. 2016 May 26;
Publication Type
Article
Date
May-26-2016
Author
Bjørn Heine Strand
Rachel Cooper
Astrid Bergland
Lone Jørgensen
Henrik Schirmer
Vegard Skirbekk
Nina Emaus
Source
J Epidemiol Community Health. 2016 May 26;
Date
May-26-2016
Language
English
Publication Type
Article
Abstract
Grip strength has consistently been found to predict all-cause mortality rates. However, few studies have examined cause-specific mortality or tested age differences in these associations.
In 1994, grip strength was measured in the population-based Tromsø Study, covering the ages 50-80 years (N=6850). Grip strength was categorised into fifths, and as z-scores. In this cohort study, models with all-cause mortality and deaths from specific causes as the outcome were performed, stratified by sex and age using Cox regression, adjusting for lifestyle-related and health-related factors.
During 17 years of follow-up, 2338 participants died. A 1 SD reduction in grip strength was associated with HR=1.17 (95% CI 1.12 to 1.22) for all-cause mortality in a model adjusted for age, gender and body size. This association was similar across all age groups, in men and women, and robust to adjustment for a range of lifestyle-related and health-related factors. Results for deaths due to cardiovascular disease (CVD), respiratory diseases and external causes resembled those for all-cause mortality, while for cancer, the association was much weaker and not significant after adjustment for lifestyle-related and health-related factors.
Weaker grip strength was associated with increased all-cause mortality rates, with similar effects on deaths due to CVD, respiratory disease and external causes, while a much weaker association was observed for cancer-related deaths. These associations were similar in both genders and across age groups, which supports the hypothesis that grip strength might be a biomarker of ageing over the lifespan.
PubMed ID
27229009 View in PubMed
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Association of occasional smoking with total mortality in the population-based Tromsø study, 2001-2015.

https://arctichealth.org/en/permalink/ahliterature294424
Source
BMJ Open. 2017 12 28; 7(12):e019107
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-28-2017
Author
Maja-Lisa Løchen
Inger Torhild Gram
Jan Mannsverk
Ellisiv B Mathiesen
Inger Njølstad
Henrik Schirmer
Tom Wilsgaard
Bjarne K Jacobsen
Author Affiliation
Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Source
BMJ Open. 2017 12 28; 7(12):e019107
Date
12-28-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Aged, 80 and over
Female
Humans
Longitudinal Studies
Male
Middle Aged
Mortality
Motivation
Norway - epidemiology
Proportional Hazards Models
Risk factors
Smoking - epidemiology
Surveys and Questionnaires
Abstract
There is a shift in the smoking population from daily smokers to light or occasional smokers. The knowledge about possible adverse health effects of this new smoking pattern is limited. We investigated smoking habits with focus on occasional smoking in relation to total mortality in a follow-up study of a Norwegian general population.
A population study in Tromsø, Norway.
We collected smoking habits and relevant risk factors in 4020 women and 3033 men aged 30-89 years in the Tromsø Study in 2001. The subjects were followed up regarding total mortality through June 2015.
Among the participants, there were 7% occasional smokers. Occasional smokers were younger, more educated and used alcohol more frequently than other participants. A total of 766 women and 882 men died during the follow-up. After the adjustment for confounders, we found that occasional smoking significantly increased mortality by 38% (95% CI 8% to 76%) compared with never smokers. We report a dose-response relationship in the hazards of smoking (daily, occasional, former and never smoking).
Occasional smoking is not a safe smoking alternative. There is a need for information to the general public and health workers about the health hazards of occasional smoking. More work should be done to motivate this often well-educated group to quit smoking completely.
Notes
Cites: Eur J Epidemiol. 2013 Aug;28(8):659-67 PMID 23443581
Cites: Tidsskr Nor Laegeforen. 1998 May 30;118(14):2165-8 PMID 9656812
Cites: Arch Intern Med. 2009 Oct 26;169(19):1742-4 PMID 19858429
Cites: BMC Public Health. 2014 Jan 30;14 :95 PMID 24479663
Cites: Lancet. 2013 Mar 2;381(9868):708-9 PMID 23465425
Cites: Nicotine Tob Res. 2000 May;2(2):133-9 PMID 11072451
Cites: Am J Prev Med. 2009 Aug;37(2):124-31 PMID 19589449
Cites: JAMA Intern Med. 2017 Jan 1;177(1):87-95 PMID 27918784
Cites: J Epidemiol Community Health. 2014 Aug;68(8):712-9 PMID 24675289
Cites: Int J Epidemiol. 2012 Aug;41(4):961-7 PMID 21422063
Cites: Psychopharmacology (Berl). 2013 Mar;226(2):321-33 PMID 23142992
Cites: Nicotine Tob Res. 2013 Mar;15(3):662-9 PMID 22965789
Cites: Circulation. 2010 Apr 6;121(13):1518-22 PMID 20368531
Cites: Tob Control. 2005 Oct;14(5):315-20 PMID 16183982
PubMed ID
29288187 View in PubMed
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Association of occasional smoking with total mortality in the population-based Tromsø study, 2001-2015.

https://arctichealth.org/en/permalink/ahliterature288019
Source
BMJ Open. 2017 12 28;7(12):e019107
Publication Type
Article
Date
12-28-2017
Author
Maja-Lisa Løchen
Inger Torhild Gram
Jan Mannsverk
Ellisiv B Mathiesen
Inger Njølstad
Henrik Schirmer
Tom Wilsgaard
Bjarne K Jacobsen
Source
BMJ Open. 2017 12 28;7(12):e019107
Date
12-28-2017
Language
English
Publication Type
Article
Abstract
There is a shift in the smoking population from daily smokers to light or occasional smokers. The knowledge about possible adverse health effects of this new smoking pattern is limited. We investigated smoking habits with focus on occasional smoking in relation to total mortality in a follow-up study of a Norwegian general population.
A population study in Tromsø, Norway.
We collected smoking habits and relevant risk factors in 4020 women and 3033 men aged 30-89 years in the Tromsø Study in 2001. The subjects were followed up regarding total mortality through June 2015.
Among the participants, there were 7% occasional smokers. Occasional smokers were younger, more educated and used alcohol more frequently than other participants. A total of 766 women and 882 men died during the follow-up. After the adjustment for confounders, we found that occasional smoking significantly increased mortality by 38% (95% CI 8% to 76%) compared with never smokers. We report a dose-response relationship in the hazards of smoking (daily, occasional, former and never smoking).
Occasional smoking is not a safe smoking alternative. There is a need for information to the general public and health workers about the health hazards of occasional smoking. More work should be done to motivate this often well-educated group to quit smoking completely.
Notes
Cites: Eur J Epidemiol. 2013 Aug;28(8):659-6723443581
Cites: Tidsskr Nor Laegeforen. 1998 May 30;118(14):2165-89656812
Cites: Arch Intern Med. 2009 Oct 26;169(19):1742-419858429
Cites: BMC Public Health. 2014 Jan 30;14 :9524479663
Cites: Lancet. 2013 Mar 2;381(9868):708-923465425
Cites: Nicotine Tob Res. 2000 May;2(2):133-911072451
Cites: Am J Prev Med. 2009 Aug;37(2):124-3119589449
Cites: JAMA Intern Med. 2017 Jan 1;177(1):87-9527918784
Cites: J Epidemiol Community Health. 2014 Aug;68(8):712-924675289
Cites: Int J Epidemiol. 2012 Aug;41(4):961-721422063
Cites: Psychopharmacology (Berl). 2013 Mar;226(2):321-3323142992
Cites: Nicotine Tob Res. 2013 Mar;15(3):662-922965789
Cites: Circulation. 2010 Apr 6;121(13):1518-2220368531
Cites: Tob Control. 2005 Oct;14(5):315-2016183982
PubMed ID
29288187 View in PubMed
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Cardiac rehabilitation after percutaneous coronary intervention: Results from a nationwide survey.

https://arctichealth.org/en/permalink/ahliterature299212
Source
Eur J Cardiovasc Nurs. 2018 03; 17(3):273-279
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
03-2018
Author
Siv Js Olsen
Henrik Schirmer
Kaare H Bønaa
Tove A Hanssen
Author Affiliation
1 Division of Internal Medicine, University Hospital of North Norway, Norway.
Source
Eur J Cardiovasc Nurs. 2018 03; 17(3):273-279
Date
03-2018
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Aged
Cardiac Rehabilitation
Cohort Studies
Coronary Artery Bypass
Coronary Disease - psychology - rehabilitation - surgery
Female
Humans
Male
Middle Aged
Norway
Odds Ratio
Patient Acceptance of Health Care
Percutaneous Coronary Intervention - rehabilitation
Risk factors
Surveys and Questionnaires
Abstract
The purpose of this study was to estimate the proportion of Norwegian coronary heart disease patients participating in cardiac rehabilitation programmes after percutaneous coronary intervention, and to determine predictors of cardiac rehabilitation participation.
Participants were patients enrolled in the Norwegian Coronary Stent Trial. We assessed cardiac rehabilitation participation in 9013 of these patients who had undergone their first percutaneous coronary intervention during 2008-2011. Of these, 7068 patients (82%) completed a self-administered questionnaire on cardiac rehabilitation participation within three years after their percutaneous coronary intervention.
Twenty-eight per cent of the participants reported engaging in cardiac rehabilitation. Participation rate differed among the four regional health authorities in Norway, varying from 20%-31%. Patients undergoing percutaneous coronary intervention for an acute coronary syndrome were more likely to participate in cardiac rehabilitation than patients with stable angina (odds ratio 3.2; 95% confidence interval 2.74-3.76). A multivariate statistical model revealed that men had a 28% lower probability ( p12 years (odds ratio 1.50; 95% confidence interval 1.32-1.71) and body mass index>25 (odds ratio 1.19; 95% confidence interval 1.05-1.36). Prior coronary artery bypass graft was associated with lower odds of cardiac rehabilitation participation (odds ratio 0.47; 95% confidence interval 0.32-0.70) Conclusion: The estimated cardiac rehabilitation participation rate among patients undergoing first-time percutaneous coronary intervention is low in Norway. The typical participant is young, overweight, well-educated, and had an acute coronary event. These results varied by geographical region.
PubMed ID
29048205 View in PubMed
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Cardiac rehabilitation and symptoms of anxiety and depression after percutaneous coronary intervention.

https://arctichealth.org/en/permalink/ahliterature303201
Source
Eur J Prev Cardiol. 2018 07; 25(10):1017-1025
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
07-2018
Author
Siv Js Olsen
Henrik Schirmer
Tom Wilsgaard
Kaare H Bønaa
Tove A Hanssen
Author Affiliation
1 Division of Internal Medicine, University Hospital of North Norway, Norway.
Source
Eur J Prev Cardiol. 2018 07; 25(10):1017-1025
Date
07-2018
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Age Factors
Aged
Anxiety - diagnosis - epidemiology - psychology
Cardiac Rehabilitation - adverse effects - psychology
Comorbidity
Coronary Disease - diagnosis - epidemiology - psychology - therapy
Depression - diagnosis - epidemiology - psychology
Educational Status
Female
Humans
Male
Middle Aged
Norway - epidemiology
Percutaneous Coronary Intervention - adverse effects - psychology
Prevalence
Prospective Studies
Risk assessment
Risk factors
Sex Factors
Time Factors
Treatment Outcome
Abstract
Background Anxiety and depression are related to coronary heart disease, and psychological support is recommended in cardiac rehabilitation. Purpose The aims of this study were: to compare the prevalence of anxiety and depression with respect to cardiac rehabilitation participation among patients who have been treated with percutaneous coronary intervention; to examine prevalence of anxiety and depression among percutaneous coronary intervention patients compared to the general population; and to identify predictors of symptomatic anxiety and depression among percutaneous coronary intervention patients. Methods We included 9013 patients undergoing first-time percutaneous coronary intervention. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale in a representative sample of 775 patients at baseline and after three years of follow-up, and in the entire cohort at three-year follow-up. Results Cardiac rehabilitation participants had more anxiety and depression than cardiac rehabilitation non-participants at baseline, and both groups had a more anxiety than the general population. The levels of anxiety and depression fell significantly during three years of follow-up, but the changes did not differ between cardiac rehabilitation participants and cardiac rehabilitation non-participants. Three years after percutaneous coronary intervention the prevalence of anxiety was 32% ( p?
Notes
CommentIn: Eur J Prev Cardiol. 2018 Jul;25(10):1015-1016 PMID 29707962
PubMed ID
29846117 View in PubMed
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86 records – page 1 of 9.