STUDY OBJECTIVES: Little is known about the natural development of snoring, and this survey was conducted to study the development of snoring in men over a 10-year period. DESIGN: Population-based prospective survey. SETTING: The Municipality of Uppsala, Sweden. PARTICIPANTS AND MEASUREMENTS: In 1984, 3,201 randomly selected men aged 30 to 69 years answered a questionnaire on snoring and sleep disturbances. Of the 2,975 survivors in 1994, 2,668 (89.7%) answered a new questionnaire with identical questions to those used at baseline. Questions about smoking habits, alcohol, and physical activity were also added. RESULTS: Habitual snoring was reported by 393 men (15.0%) in 1984 and by 529 (20.4%) 10 years later. In both 1984 and 1994, the prevalence of snoring increased until age 50 to 60 years and then decreased. Risk factors for being a habitual snorer at the follow-up were investigated using multiple logistic regression with adjustments for previous snoring status, age, body mass index (BMI), weight gain, smoking habits, and physical activity. In men aged 30 to 49 years at baseline, the predictors of habitual snoring at the follow-up, in addition to previous snoring status, were as follows: persistent smoking (adjusted odds ratio, 95% confidence interval) (1.4, 1.1 to 1.9), BMI 1984 (1.1, 1.02 to 1.1/kg/m2) and weight gain (1.1, 1.03 to 1.2/kg/m2). Among men aged 50 to 69 years, after adjustments for previous snoring status and age, weight gain was the only significant risk factor for developing habitual snoring (1.2, 1.05 to 1.4/kg/m2). CONCLUSIONS: In men, the prevalence of snoring increases up to the age of 50 to 60 years and is then followed by a decrease. Weight gain is a risk factor for snoring in all age groups, while smoking is mainly associated with snoring in men
Risk factors for the development of stroke was studied in a prospective long-term investigation of 855 male in a random population sampled of the same age. After 13 years of follow-up 25 participants had suffered from stroke, which gives an incidence of 19/10,000 annually. At the 1963 year investigation several parametras were studied. The stroke-prone person had higher values of systolic and diastolic blood pressure and had a significant greater total heart volume. Blood parametras as the fasting of serum cholesterole, triglyceride and erytrocyte sedimentation rate were significantly elevated in those who developed stroke. They also tended to consume more coffee and showed a higher tobacco consumption. By applying the multiple regression model it was disclosed that the most predective risk-variables were diastolic blood pressure, erytrocyte sedimentation rate and smoking habits.
In a prospective study of risk factors for ischaemic heart disease 792 54 year old men selected by year of birth (1913) and residence in Gothenburg agreed to attend for questioning and a battery of anthropometric and other measurements in 1967. Thirteen years later these baseline findings were reviewed in relation to the numbers of men who had subsequently suffered a stroke, ischaemic heart disease, or death from all causes. Neither quintiles nor deciles of initial indices of obesity (body mass index, sum of three skinfold thickness measurements, waist or hip circumference) showed a significant correlation with any of the three end points studied. Statistically significant associations were, however, found between the waist to hip circumference ratio and the occurrence of stroke (p = 0.002) and ischaemic heart disease (p = 0.04). When the confounding effect of body mass index or the sum of three skinfold thicknesses was accounted for the waist to hip circumference ratio was significantly associated with all three end points. This ratio, however, was not an independent long term predictor of these end points when smoking, systolic blood pressure, and serum cholesterol concentration were taken into account. These results indicate that in middle aged men the distribution of fat deposits may be a better predictor of cardiovascular disease and death than the degree of adiposity.
The problem studied concerns how patients and physicians talk about and make use of information regarding patient life style in the daily practice of primary health care. The study has been carried out at two primary health care centers in central Sweden. Transcribed dialogues between 42 patients and 12 physicians have been used as a data corpus. The analyses concern the interactional patterns in the dialogues between patient and physician, how the interlocutors address life style and for what purposes. The results show a similarity between patients and physicians with respect to the extent to which they use the discourse space. However, salient differences were found in the following way: the physicians not only introduced and closed life style topics more frequently than the patients did, they also used what is referred to as an agenda driven strategy to introduce them. The patients, on the other hand, used an interactively anchored strategy. The patients, by taking the reference in the life world and by making use of the life style topics, present and articulate their identity. The physicians subsume life style issues under a medical framing of the patients' problem and they mainly address life style in order to construe a proto-typical patient rather than an individual.
Geographical variations in cardiovascular mortality have been reported from Mid-Sweden. IHD mortality for men aged 45-64 was 60% higher in the western part than in the east. Mortality from stroke for men aged 45-74 was 73% higher on the west. Similar differences were found for women. One possible explanation could be that there are no incidence differences but that the mortality differences are due to different survival rates or to differences certifying the cause of death. These two possible explanations were tested in this study. Data for all patients hospitalised during the 10-year period 1972-1981 for myocardial infarction or stroke in a high mortality area, the County of Värmland in the west, and a low mortality area, the County of Uppsala in the east, were collected. In addition, a substudy was performed where the basis for the death certificate diagnosis was studied. The western area generally had a higher case fatality rate than the eastern. However, a larger proportion of the deaths the eastern area, occurred outside hospital, so that the net effect would be that the differences found were not large enough to explain the mortality differences. The autopsy rate in the western part was lower than in the east but since a larger proportion of the deaths occurred in hospital the rank order for IHD and stroke mortality between east and west was the same whether all IHD or stroke deaths were counted or only those considered the most well documented.
OBJECTIVE: To study the need for health screening among elderly people. SETTING, DESIGN AND SUBJECTS: A random sample of 605 people 75 years or older from the general population of Uppsala, Sweden received a postal questionnaire on health issues, and a random subsample of 101 persons were offered a health survey. MAIN OUTCOME MEASURES: Symptoms and signs of disease in questionnaire or at health examination. RESULTS: Thirty-nine people came to the health examination at the primary health care centre (PHCC), 15 were examined in their homes, and 11 were interviewed by telephone. Seventy-eight findings were made in the PHCC group, out of which 60 were known by the proband and 18 were new. In ten cases some action was taken. Of the 54 people examined, 50 persons had one or several findings. The most prevalent problems were hypertension, urinary incontinence, and hearing problems. However, few of these problems warranted referral to a general practitioner or hospital. CONCLUSIONS: It appears that a health survey of elderly people yielded little new information on the state of health among those surveyed at the time of the data collection. The bearing on the present-day situation is discussed.
In a previous report, a large regional variation was reported in total mortality and mortality rate from ischaemic heart disease (IHD) in mid-Sweden. In this report, IHD prevalence and risk factor data are presented. A postal questionnaire was sent out to a random sample of men aged 45-64 years in each of 40 communities. 14,675 men (88%) responded. Based on a validity study, IHD cases were defined as those with a history of myocardial infarction and/or angina pectoris. Age, smoking habits, antihypertensive treatment, body mass index, food habits, stress and physical activity during leisure time were used as risk factors. IHD prevalence showed the same geographical variation as IHD mortality, with a low prevalence in the east and a high prevalence in the west. There was a moderate variation in risk factor levels over the 40 communities. When this variation was taken into account the geographical IHD variation was somewhat smaller but still substantial. Other factors may involve socio-economics, drinking water qualities, mineral soil content or other environmental factors. Which of these cause the largest IHD variation is at present unknown, but is subject to systematic examination in this project.
OBJECTIVES: To analyse whether there is a relation-ship between birth weight and cardiovascular risk factors given the influence of potential modifying factors from birth time, former generations and adult life. DESIGN: Population-based cohort followed until 80 years of age. SETTING: Sweden. SUBJECTS: A total of 478 singleton men born in 1913 and participating in a population study in Gothenburg, Sweden, from age 50. MAIN OUTCOME MEASURES: Systolic blood pressure (SBP), antihypertensive treatment, incident diabetes mellitus, and serum total cholesterol, serum triglycerides and waist circumference as both continuous variables and in the highest quintiles of their distributions. RESULTS: After adjustment for the influence of birth time variables, hereditary factors and anthropometric and socio-economic adult life variables, SBP decreased by 3.7 mmHg per 1000 g increase of birth weight, the prevalence of antihypertensive treatment decreased by 32%, diabetes decreased by 53%, serum total cholesterol decreased by 0.20 mmol L(-1) and being in the top quintile of serum cholesterol decreased by 23%. The population risk percentage due to a birth weight