Skip header and navigation

Refine By

23 records – page 1 of 3.

The association between circulating angiotensin-converting enzyme and cardiovascular risk in the elderly: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature137532
Source
J Renin Angiotensin Aldosterone Syst. 2011 Sep;12(3):281-9
Publication Type
Article
Date
Sep-2011
Author
Liza Ljungberg
Urban Alehagen
Toste Länne
Hanna Björck
Rachel De Basso
Ulf Dahlström
Karin Persson
Author Affiliation
Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden. liza.ljungberg@liu.se
Source
J Renin Angiotensin Aldosterone Syst. 2011 Sep;12(3):281-9
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cardiovascular diseases - blood - epidemiology - genetics
Cross-Sectional Studies
Female
Genetic Predisposition to Disease
Humans
INDEL Mutation - genetics
Male
Peptidyl-Dipeptidase A - blood - genetics
Polymorphism, Genetic
Risk factors
Sweden - epidemiology
Abstract
A polymorphism in the angiotensin-converting enzyme gene (ACE I/D polymorphism) has been associated with increased risk for cardiovascular disease (CVD). This polymorphism affects the level of circulating ACE, but there is great individual variation, even between those with the same genotype. Few previous studies have investigated the link between circulating ACE and cardiovascular risk. The aim of this study was to investigate this association, and to examine the relationship between ACE level, ACE genotype and CVD.
The study population consisted of 322 men and 350 women aged 69-87. Plasma ACE level was determined using enzyme-linked immunosorbent assay (ELISA), and ACE genotype was analysed using PCR followed by gel electrophoresis.
In men, ACE levels increased with increasing number of cardiovascular risk factors (p = 0.003). There was a significant association in men between increased ACE level and both diabetes (p = 0.007) and smoking (p = 0.037).
This study shows that cardiovascular risk factors (such as smoking and diabetes) are associated with higher levels of circulating ACE in men. High ACE levels may represent one of the cellular mechanisms involved in producing the vascular damage associated with cardiovascular risk factors.
PubMed ID
21273224 View in PubMed
Less detail

Association Between Use of Statins and Mortality in Patients With Heart Failure and Ejection Fraction of =50.

https://arctichealth.org/en/permalink/ahliterature268202
Source
Circ Heart Fail. 2015 Sep;8(5):862-70
Publication Type
Article
Date
Sep-2015
Author
Urban Alehagen
Lina Benson
Magnus Edner
Ulf Dahlström
Lars H Lund
Source
Circ Heart Fail. 2015 Sep;8(5):862-70
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Aged
Cause of Death - trends
Female
Follow-Up Studies
Heart Failure - drug therapy - mortality - physiopathology
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Propensity Score
Retrospective Studies
Risk Assessment - methods
Stroke Volume - physiology
Survival Rate - trends
Sweden - epidemiology
Abstract
The pathophysiology of heart failure with preserved ejection fraction is poorly understood, but may involve a systemic proinflammatory state. Therefore, statins might improve outcomes in patients with heart failure with preserved ejection fraction defined as =50%.
Of 46 959 unique patients in the prospective Swedish Heart Failure Registry, 9140 patients had heart failure and ejection fraction =50% (age 77±11 years, 54.0% women), and of these, 3427 (37.5%) were treated with statins. Propensity scores for statin treatment were derived from 40 baseline variables. The association between statin use and primary (all-cause mortality) and secondary (separately, cardiovascular mortality, and combined all-cause mortality or cardiovascular hospitalization) end points was assessed with Cox regressions in a population matched 1:1 based on age and propensity score. In the matched population, 1-year survival was 85.1% for statin-treated versus 80.9% for untreated patients (hazard ratio, 0.80; 95% confidence interval, 0.72-0.89; P
PubMed ID
26243795 View in PubMed
Less detail

Association between use of statins and outcomes in heart failure with reduced ejection fraction: prospective propensity score matched cohort study of 21 864 patients in the Swedish Heart Failure Registry.

https://arctichealth.org/en/permalink/ahliterature264802
Source
Circ Heart Fail. 2015 Mar;8(2):252-60
Publication Type
Article
Date
Mar-2015
Author
Urban Alehagen
Lina Benson
Magnus Edner
Ulf Dahlström
Lars H Lund
Source
Circ Heart Fail. 2015 Mar;8(2):252-60
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Female
Heart Failure - drug therapy - mortality - physiopathology
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Kaplan-Meier Estimate
Male
Matched-Pair Analysis
Middle Aged
Outcome Assessment (Health Care)
Propensity Score
Registries
Stroke Volume
Sweden - epidemiology
Abstract
In heart failure (HF) with reduced ejection fraction, randomized trials of statins did not demonstrate improved outcomes. However, randomized trials may not always be generalizable. The aim was to determine whether statins are associated with improved outcomes in an unselected nationwide population of patients with HF with reduced ejection fraction overall and in relation to ischemic heart disease (IHD).
In the Swedish Heart Failure Registry, 21?864 patients with HF with reduced ejection fraction (age ± SD, 72±12 years; 29% women), of whom 10?345 (47%) were treated with statins, were studied. Propensity scores for statin use were derived from 42 baseline variables. The associations between statin use and outcomes were assessed with Cox regressions in a population matched 1:1 based on propensity score and age and in the overall population with adjustment for propensity score and age. The primary outcome was all-cause mortality; secondary outcomes were cardiovascular mortality; HF hospitalization; and combined all-cause mortality or cardiovascular hospitalization. Survival at 1 year in the matched population was 83% for statin-treated versus 79% for untreated patients (hazard ratio, 0.81; 95% confidence interval, 0.76-0.86; P
PubMed ID
25575580 View in PubMed
Less detail

Association of copeptin and N-terminal proBNP concentrations with risk of cardiovascular death in older patients with symptoms of heart failure.

https://arctichealth.org/en/permalink/ahliterature134213
Source
JAMA. 2011 May 25;305(20):2088-95
Publication Type
Article
Date
May-25-2011
Author
Urban Alehagen
Ulf Dahlström
Jens F Rehfeld
Jens P Goetze
Author Affiliation
Division of Cardiovascular Medicine, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden. urban.alehagen@liu.se
Source
JAMA. 2011 May 25;305(20):2088-95
Date
May-25-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Biological Markers - blood
Cause of Death
Cohort Studies
Female
Glycopeptides - blood
Heart Failure - blood - mortality
Humans
Male
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Pituitary Gland - metabolism
Predictive value of tests
Prognosis
Risk
Sweden - epidemiology
Vasopressins - metabolism
Abstract
Measurement of plasma concentrations of the biomarker copeptin may help identify patients with heart failure at high and low risk of mortality, although the value of copeptin measurement in elderly patients is not fully known.
To evaluate the association between plasma concentrations of copeptin, a surrogate marker of vasopressin, combined with concentrations of the N-terminal fragment of the precursor to B-type natriuretic peptide (NT-proBNP), and mortality in a cohort of elderly patients with symptoms of heart failure.
Primary health care population in Sweden enrolling 470 elderly patients with heart failure symptoms between January and December 1996. Clinical examination, echocardiography, and measurement of peptide concentrations were performed, with follow-up through December 2009.
All-cause mortality and cardiovascular mortality.
After a median follow-up of 13 years, there were 226 deaths from all causes, including 146 deaths from cardiovascular causes. Increased concentration of copeptin was associated with increased risk of all-cause mortality (fourth quartile vs first quartile: 69.5% vs 38.5%, respectively; hazard ratio [HR], 2.04 [95% confidence interval {CI}, 1.38-3.02]) and cardiovascular mortality (fourth quartile vs first quartile: 46.6% vs 26.5%; HR, 1.94 [95% CI, 1.20-3.13]). The combination of elevated NT-proBNP concentrations and elevated copeptin concentrations also was associated with increased risk of all-cause mortality (copeptin fourth quartile: HR, 1.63 [95% CI, 1.08-2.47]; P = .01; NT-proBNP fourth quartile: HR, 3.17 [95% CI, 2.02-4.98]; P
PubMed ID
21610241 View in PubMed
Less detail

The benefits of using a heart failure management programme in Swedish primary healthcare.

https://arctichealth.org/en/permalink/ahliterature119362
Source
Eur J Heart Fail. 2013 Feb;15(2):228-36
Publication Type
Article
Date
Feb-2013
Author
Björn Agvall
Urban Alehagen
Ulf Dahlström
Author Affiliation
County Council of Östergötland, Local Health Care Services in Central Östergötland, Primary Health Care Centres, Linköping University, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping, Sweden. Bjorn.Agvall@lio.se
Source
Eur J Heart Fail. 2013 Feb;15(2):228-36
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Disease Management
Diuretics - therapeutic use
Female
Follow-Up Studies
Furosemide - therapeutic use
General practice
Guideline Adherence
Heart Failure, Systolic - diagnosis - drug therapy - mortality - physiopathology
Humans
Male
Natriuretic Peptide, Brain - blood
Nurse Clinicians
Patient care team
Patient Education as Topic
Patient Readmission - statistics & numerical data
Peptide Fragments - blood
Primary Health Care
Prospective Studies
Stroke Volume - drug effects - physiology
Sweden
Abstract
Heart failure (HF) is a common condition with which high mortality, morbidity, and poor quality of life are associated. It has previously been shown that use of HF management programmes (HFMPs) in HF clinics can be beneficial. The purpose of this study was to evaluate if the use of HFMPs also has beneficial effects on HF patients in primary healthcare (PHC).
This is a randomized, prospective, open-label study including 160 patients from five PHC centres with systolic HF and a mean age of 75 years (standard deviation 7.8). In the intervention group, an intensive follow-up was performed by HF nurses and physicians providing information and education about HF and the optimization of HF treatment according to recognized guidelines. There was a significant improvement of composite endpoints in the intervention group. Significantly more patients with reduced N-terminal pro brain natriuretic peptide (P = 0.012), improved cardiac function (P = 0.03), fewer healthcare contacts (P = 0.04), and fewer emergency room visits and admittances (P = 0.0002 and P = 0.03, respectively) could be seen in the intervention group when compared with the control group.
The use of a HFMP in a PHC setting was found to have beneficial effects in terms of reducing the number of healthcare contacts and hospital admissions, and improving cardiac function in patients with systolic HF, even if the result should be interpreted with caution. It can therefore be recommended that HFMPs should be used in PHC.
PubMed ID
23109650 View in PubMed
Less detail

Brain natriuretic peptide-guided treatment does not improve morbidity and mortality in extensively treated patients with chronic heart failure: responders to treatment have a significantly better outcome.

https://arctichealth.org/en/permalink/ahliterature133323
Source
Eur J Heart Fail. 2011 Oct;13(10):1096-103
Publication Type
Article
Date
Oct-2011
Author
Patric Karlström
Urban Alehagen
Kurt Boman
Ulf Dahlström
Author Affiliation
Division of Cardiology, Department of Medicine, County Hospital Ryhov, Jönköping, Sweden. patric.karlstrom@lj.se
Source
Eur J Heart Fail. 2011 Oct;13(10):1096-103
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - administration & dosage
Aged
Angiotensin-Converting Enzyme Inhibitors - administration & dosage
Cardiovascular Agents - administration & dosage
Chronic Disease
Disease-Free Survival
Female
Heart Failure - blood - drug therapy - mortality
Hospitals
Humans
Male
Natriuretic Peptide, Brain - blood - drug effects
Norway
Severity of Illness Index
Sweden
Treatment Outcome
Abstract
To determine whether brain natriuretic peptide (BNP)-guided heart failure (HF) treatment improves morbidity and/or mortality when compared with conventional treatment.
UPSTEP was an investigator-initiated, randomized, parallel group, multicentre study with a PROBE design. Symptomatic patients with worsening HF, New York Heart Association class II-IV, ejection fraction 30% decrease in baseline BNP value) vs. non-responders found improved survival among responders (P
Notes
Comment In: Eur J Heart Fail. 2011 Oct;13(10):1046-821873341
Erratum In: Eur J Heart Fail. 2012 May;14(5):563von den Luederer Tomas [corrected to von Lueder, Thomas G]
PubMed ID
21715446 View in PubMed
Less detail

Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens.

https://arctichealth.org/en/permalink/ahliterature124080
Source
Int J Cardiol. 2013 Sep 1;167(5):1860-6
Publication Type
Article
Date
Sep-1-2013
Author
Urban Alehagen
Peter Johansson
Mikael Björnstedt
Anders Rosén
Ulf Dahlström
Author Affiliation
Division of Cardiovascular Medicine, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden. Urban.Alehagen@liu.se
Source
Int J Cardiol. 2013 Sep 1;167(5):1860-6
Date
Sep-1-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Biological Markers - blood
Cardiovascular Diseases - blood - drug therapy - mortality
Cohort Studies
Dietary Supplements
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Male
Natriuretic Peptide, Brain - antagonists & inhibitors - biosynthesis - blood
Peptide Fragments - antagonists & inhibitors - biosynthesis - blood
Prospective Studies
Selenium - administration & dosage
Sweden - epidemiology
Ubiquinone - administration & dosage - analogs & derivatives
Abstract
Selenium and coenzyme Q10 are essential for the cell. Low cardiac contents of selenium and coenzyme Q10 have been shown in patients with cardiomyopathy, but inconsistent results are published on the effect of supplementation of the two components separately. A vital relationship exists between the two substances to obtain optimal function of the cell. However, reports on combined supplements are lacking.
A 5-year prospective randomized double-blind placebo-controlled trial among Swedish citizens aged 70 to 88 was performed in 443 participants given combined supplementation of selenium and coenzyme Q10 or a placebo. Clinical examinations, echocardiography and biomarker measurements were performed. Participants were monitored every 6th month throughout the intervention. The cardiac biomarker N-terminal proBNP (NT-proBNP) and echocardiographic changes were monitored and mortalities were registered. End-points of mortality were evaluated by Kaplan-Meier plots and Cox proportional hazard ratios were adjusted for potential confounding factors. Intention-to-treat and per-protocol analyses were applied.
During a follow up time of 5.2 years a significant reduction of cardiovascular mortality was found in the active treatment group vs. the placebo group (5.9% vs. 12.6%; P=0.015). NT-proBNP levels were significantly lower in the active group compared with the placebo group (mean values: 214 ng/L vs. 302 ng/L at 48 months; P=0.014). In echocardiography a significant better cardiac function score was found in the active supplementation compared to the placebo group (P=0.03).
Long-term supplementation of selenium/coenzyme Q10 reduces cardiovascular mortality. The positive effects could also be seen in NT-proBNP levels and on echocardiography.
PubMed ID
22626835 View in PubMed
Less detail

Clinical characteristics and mortality risk in relation to obstructive and central sleep apnoea in community-dwelling elderly individuals: a 7-year follow-up.

https://arctichealth.org/en/permalink/ahliterature125918
Source
Age Ageing. 2012 Jul;41(4):468-74
Publication Type
Article
Date
Jul-2012
Author
Peter Johansson
Urban Alehagen
Eva Svanborg
Ulf Dahlström
Anders Broström
Author Affiliation
Department of Cardiology, Linkoping University Hospital, Linkoping, Sweden. peter.johansson@aries.vokby.se
Source
Age Ageing. 2012 Jul;41(4):468-74
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging
Cardiovascular Diseases - mortality - physiopathology
Cause of Death
Comorbidity
Female
Follow-Up Studies
Humans
Independent living
Kaplan-Meier Estimate
Male
Proportional Hazards Models
Risk assessment
Risk factors
Sleep
Sleep Apnea, Central - mortality - physiopathology
Sleep Apnea, Obstructive - mortality - physiopathology
Stroke Volume
Sweden - epidemiology
Systole
Time Factors
Ventricular Function, Left
Abstract
little is known about demographic and clinical characteristics associated with sleep-disordered breathing (SDB) and obstructive sleep apnoea (OSA) or central sleep apnoea (CSA) in community-dwelling elderly. We also examined these (OSA and CSA) associations to all-cause and cardiovascular (CV) mortality.
a total of 331 community-dwelling elderly aged 71-87 years underwent a clinical examination and one-night polygraphic recordings in their homes. Mortality data were collected after seven years.
a total of 55% had SDB, 38% had OSA and 17% had CSA. Compared with those with no SDB and OSA, more participants with CSA had a left ventricular ejection fraction 75 years does not appear to be associated with cardiovascular disease (CVD) disease or mortality, whereas CSA might be a pathological marker of CVD and impaired systolic function associated with higher mortality.
PubMed ID
22440587 View in PubMed
Less detail

The contribution of heart failure to sleep disturbances and depressive symptoms in older adults.

https://arctichealth.org/en/permalink/ahliterature119220
Source
J Geriatr Psychiatry Neurol. 2012 Sep;25(3):179-87
Publication Type
Article
Date
Sep-2012
Author
Peter Johansson
Barbara Riegel
Erland Svensson
Anders Broström
Urban Alehagen
Ulf Dahlström
Tiny Jaarsma
Author Affiliation
Department of Cardiology, Linköping University Hospital, S-58185 Linköping, Sweden. peter.johansson@aries.vokby.se
Source
J Geriatr Psychiatry Neurol. 2012 Sep;25(3):179-87
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Aged
Comorbidity
Depression - epidemiology - psychology
Electrocardiography - methods - statistics & numerical data
Female
Geriatric Assessment - methods - statistics & numerical data
Heart Failure - epidemiology - psychology
Humans
Male
Questionnaires
Sleep Disorders - epidemiology - psychology
Sweden - epidemiology
Abstract
The aim of this study was to explore the associations between physical symptoms, sleep disturbances, and depressive symptoms in community-dwelling elderly individuals, comparing persons with and without heart failure (HF).
A total of 613 older adults (mean age 78 years) underwent clinical and echocardiographic examinations. Questionnaires were used to evaluate sleep disturbances and depressive symptoms. A model was developed in those with HF (n = 107) and compared with those without HF (n = 506).
Cardiopulmonary symptoms (ie, dyspnea and nighttime palpitations) and pain had significant direct associations with sleep disturbances, which indirectly affected depressive symptoms. The model was essentially the same in those with and without HF except that the effect of sleep disturbances on depressive symptoms was stronger in those with HF (ß = 0.64 vs ß = 0.45, P = .006).
In community-dwelling older adults, regardless of their diagnosis, physical symptoms had a direct effect on sleep disturbances and an indirect effect on depressive symptoms.
PubMed ID
23124012 View in PubMed
Less detail

23 records – page 1 of 3.