The objective of the present study was to examine the possible associations between low molecular weight (LMW) apolipoprotein(a) (apo(a)) isoforms (F,B,S1,S2) and coronary heart disease (CHD). We conducted a nested case-control (prospective) study of five cohorts of white men: The 1936 cohort (baseline 1976, n = 548) and four cohorts from MONICA I born in 1923 (n = 463), 1933 (n = 491), 1943 (n = 504) and 1953 (n = 448) studied at baseline in 1983. At follow up in 1991, 52 subjects had developed a first myocardial infarction and 22 had been hospitalized with angina pectoris. Plasma samples obtained at baseline were stored frozen until 1993-94, when case samples (n = 74) were analyzed together with samples from matched (disease free) controls (n = 190). In a statistical model (conditional logistic regression) including all age groups, cholesterol (or apo B) level (P
By means of an interview investigation of a representative random sample of the adult Danish population of 16 years and more and comprising a total of 4,753 persons, blood pressure screening in the present Danish health service is illustrated. 6.7% stated that their blood pressure had never been measured. 48.3% had had blood pressure measurements within the past year and 71.4% had had blood pressure measurements within the past three years. The proportion of blood pressure measurements was significantly more frequent in men than in women and was greatest in the age group 16-24 years. 6.5% of those who stated that they had raised blood pressure had not had blood pressure measurements within the past year and this proportion was greatest among patients who did not receive medicinal treatment than those receiving medicinal treatment for raised blood pressure. Fewer risk factors for raised blood pressure were found among persons without blood pressure measurements than among others. 3.7% of those who had been in contact with their general practitioner within the past three months had never had their blood pressures measured. A number of suggestions are made to improve tracing of persons with raised blood pressures in the primary health service.
A population survey was conducted on 3608 randomly selected Danes aged 30, 40, 50 and 60 years respectively. Of these, 3400 were not in medical treatment for arterial hypertension. The following parameters were investigated: sex, age, serum lipid levels (total cholesterol, HDL cholesterol, triglycerides), presence of diabetes mellitus, height, body mass index (BMI), and average daily consumption of coffee, tobacco and alcohol. Analysis with multiple linear regression showed that all variables with the exception of triglycerides, HDL cholesterol and height were significantly associated with systolic blood pressure. Likewise all factors except diabetes, triglycerides and height were significantly associated with diastolic blood pressure. Further analysis in which the effect of each parameter was corrected for by the effects of the remaining variables, demonstrated that apart from age and sex only BMI and high alcohol consumption were positively associated with differences in blood pressure greater than a few mmHg. However, the variation in both systolic and diastolic blood pressures was only partly accounted for by the parameters studied--in the covariates analysis R2 for systolic blood pressure was 0.28 and R2 for diastolic blood pressure was 0.30. In conclusion, this investigation demonstrated that blood pressure is relatively independent of other factors important in the development of cardiovascular disease. Of the above-mentioned factors with some influence on blood pressure only age, BMI and high alcohol consumption have potential clinical importance.
OBJECTIVES: To assess the development in frequency and clustering of hypertension, hypercholesterolaemia, high body mass index (BMI), physical inactivity and tobacco smoking in the period 1964-1992, and to evaluate any sex and age differences. DESIGN: Five cross-sectional investigations on cardiovascular risk factors performed in 1964, 1978, 1982-1984, 1986-1987 and 1991-1992 comprising random samples in a suburban area of Copenhagen, Denmark. Physical activity during leisure time and smoking habits were assessed by self-administered questionnaire. Blood pressure, weight, height and serum total cholesterol were measured according to WHO standards. RESULTS: A total of 8644 persons aged 30, 40, 50 and 60 years participated with an equal number of men and women. Women had fewer risk factors than men and younger persons had fewer risk factors than older persons. In the period 1964-1992 there was a decreasing number of risk factors. The 50 year olds show a sex difference in the period 1982-1992, whereas there was no sex difference among the 60 year olds. Tobacco smoking was the most common risk factor. BMI > 27.5 has become more and more frequent throughout the period, especially in men. The BMI has conquered third place in all age groups. The association of BMI > 27.5 and sedentary leisure time physical activity has become the most frequent. CONCLUSION: Clustering among risk factors decreased over time in both sexes. The association of elevated BMI and sedentary leisure time activity may contribute to the rising frequency of chronic disease such as diabetes mellitus and cardiovascular disease.
The results concerning exercise habits from four Danish health investigations among school pupils in the sixth and eight forms in the Municipality of Frederiksberg, adults aged 20-65 years in the County of Vejle and in Glostrup and the surrounding district and persons aged 70-75 years in the County of Roskilde, respectively, are compared. 70-80% of the Danish population take part in sports in their leisure time. Men of all ages take part in more strenuous exercise than women. The physically most active are those who have the best education and who live in their own houses. In the course of the nineteen eighties, the population has become more aware of the significance of exercise for cardiovascular disease. Similarly, during the same period, the proportion who take part in exercise has apparently increased by approximately 15%. The attitude that exercise is of significance for cardiovascular disease was connected with personal participation in sport. The knowledge that too little exercise constituted a risk factor for cardiovascular disease was increasingly realised although the connection was not definite. The social differences in exercise habits may be an explanation of the corresponding differences which have been observed in several western countries during the past decades in the mortality from cardiovascular disease.
Mortality rates in Denmark from ischaemic heart diseases (IHD), other heart diseases and sudden death of unknown cause are presented for the period 1968-1992. In all age groups, mortality from IHD is higher at the beginning of the period than at the end. For other heart disease, the plot of the mortality rate is U-shaped for the age groups 65-84 and > or = 85, whereas for the age group 30-64 it first decreases and is then constant. There are an increasing number of deaths from symptomatic heart disease. For the group of unknown cause, the rates are increasing for all sex and age groups The relationship between deaths from IHD and death from unknown cause varies with period, age, sex and region. For women in Copenhagen in the age group 30-64, the mortality rate from unknown cause is higher than the rate for IHD at the end of period. Vital statistics must therefore be used cautiously in analysing trends for IHD, and even the validity of temporal changes within a country must be questioned.
Mortality rates in Denmark from ischemic heart diseases (IHD), other heart diseases and unknown causes are presented for the period 1968-92. In all age groups, mortality from IHD is higher at the beginning of the period than at the end. For other heart disease, the plot of the mortality rate is U-shaped for the age groups 65-84 and > or = 85, but first decreases and is then constant for the age group 30-64. There are an increasing number of deaths from symptomatic heart disease. For the group of unknown causes, the rates are increasing for all sex and age groups. The relationship between deaths from IHD and deaths from unknown causes varies with period, age, sex and region. For women in Copenhagen in the age group 30-64, the mortality rate from unknown cause is higher than the rate for IHD at the end of period. Vital statistics must therefore be used cautiously in analysing trends for IHD, and even the validity of temporal changes within a country must be questioned.
As part of the World Health Organisation initiated MONICA project, 2000 men and women aged 30, 40, 50, and 60 from the general population were invited to undergo a medical examination with special emphasis on cardiovascular disease. A total of 1504 (75%) participated, 1209 of whom were employed. The participants answered a questionnaire on working, social, and health conditions and underwent clinical examinations that included the measurement of blood pressure and serum cholesterol, triglyceride, high density lipoprotein, fibrinogen, and glycated haemoglobin (HbA1C) concentrations. Using the demand-control model for measuring job strain suggested by Karasek, the employed people were classified according to those who had suffered job strain and those who had not in two different ways. The subjective classification was based on the participants' statements regarding demand and control in their jobs whereas the objective classification was based on job title and mode of payment. More women than men were classified as having high strain jobs. After adjusting for age and sex no significant association was found between coronary risk factors and subjective job strain. A tendency for an association between fibrinogen and job strain was found. Body mass index and HbA1C concentration were significantly associated with objective job strain independent of confounders.
The simulation model "Prevent" estimates the effect on mortality of changes of exposures to risk factors taking the multifactorial nature of the associations between risk factors and diseases, time dimensions, and demography into account. The objective of the study is to compare the actual development of ischaemic heart disease mortality in Danmark from 1982 to 1991 with the estimated mortality based on the development of four risk factors. The sources of data used in the study are national population data and mortality rates and prevalences of risk factors from population surveys (Glostrup Population Studies). Relative risk estimates are those implemented in the Dutch version of Prevent based on international literature. The risk factors are: tobacco smoking, hypertension, cholesterol, and alcohol consumption. Results are given for ages below 65 years. The pronounced decline in mortality of ischaemic heart disease in Denmark cannot be foreseen by the model based on the development of the associated risk factors. However, the combined trend of risk factors for the last 10 to 15 years is only modest and does not indicate the dramatic decline in mortality. Prevent is too simple to make a satisfactory forecast of mortality, which however, is not the main purpose of the model. By comparing the development of a reference and an intervention population the effects of unknown factors are to some extent eliminated and the model may therefore give a good impression of the benefits of preventive interventions.