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Acute stroke alert activation, emergency service use, and reperfusion therapy in Sweden.

https://arctichealth.org/en/permalink/ahliterature282026
Source
Brain Behav. 2017 Apr;7(4):e00654
Publication Type
Article
Date
Apr-2017
Author
Marie Eriksson
Eva-Lotta Glader
Bo Norrving
Birgitta Stegmayr
Kjell Asplund
Source
Brain Behav. 2017 Apr;7(4):e00654
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Emergency Medical Services - methods - statistics & numerical data
Female
Humans
Male
Middle Aged
Registries
Reperfusion - statistics & numerical data
Socioeconomic Factors
Stroke - epidemiology - therapy
Sweden - epidemiology
Time Factors
Young Adult
Abstract
Ambulance services and stroke alerts reduce the time from stroke onset to acute stroke diagnosis. We describe the use of stroke alerts and ambulance services in different hospitals and patient groups and their relationship with reperfusion therapy.
This nationwide study included 49,907 patients admitted with acute stroke who were registered in The Swedish Stroke Register (Riksstroke) in 2011-2012.
The proportions of patients admitted as stroke alerts out of all acute stroke admissions varied from 12.2% to 45.7% in university hospitals (n = 9), 0.5% to 38.7% in specialized nonuniversity hospitals (n = 22), and 4.2% to 40.3% in community hospitals (n = 41). Younger age, atrial fibrillation (AF), living in an institution, reduced consciousness upon admission, and hemorrhagic stroke were factors associated with a higher probability of stroke alerts. Living alone, primary school education, non-European origin, previous stroke, diabetes, smoking, and dependency in activities of daily living (ADL) were associated with a lower probability of stroke alert. The proportion of patients arriving at the hospital by ambulance varied from 60.3% to 94.5%. Older age, living alone, primary school education, being born in a European country, previous stroke, AF, dependency in ADL, living in an institution, reduced consciousness upon admission, and hemorrhagic stroke were associated with ambulance services. Hospital stroke alert frequencies correlated strongly with reperfusion rates (r = .75).
Acute stroke alerts have a significant potential to improve stroke reperfusion rates. Prehospital stroke management varies conspicuously between hospitals and patient groups, and the elderly and patients living alone have a markedly reduced likelihood of stroke alerts.
Notes
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PubMed ID
28413705 View in PubMed
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Associations among 25-year trends in diet, cholesterol and BMI from 140,000 observations in men and women in Northern Sweden.

https://arctichealth.org/en/permalink/ahliterature123566
Source
Nutr J. 2012;11:40
Publication Type
Article
Date
2012
Author
Ingegerd Johansson
Lena Maria Nilsson
Birgitta Stegmayr
Kurt Boman
Göran Hallmans
Anna Winkvist
Author Affiliation
Department of Odontology, Umeå University, 901 87, Umeå, Sweden. ingegerd.johansson@odont.umu.se
Source
Nutr J. 2012;11:40
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - adverse effects - trends
Body mass index
Cholesterol - blood
Cohort Studies
Cross-Sectional Studies
Diet Surveys
Diet, Carbohydrate-Restricted - adverse effects
Diet, High-Fat - adverse effects
Diet, Reducing - adverse effects - trends
Female
Follow-Up Studies
Health promotion
Humans
Male
Mass Media - trends
Middle Aged
Patient Compliance - ethnology
Sex Characteristics
Sweden
Weight Gain
Abstract
In the 1970s, men in northern Sweden had among the highest prevalences of cardiovascular diseases (CVD) worldwide. An intervention program combining population- and individual-oriented activities was initiated in 1985. Concurrently, collection of information on medical risk factors, lifestyle and anthropometry started. Today, these data make up one of the largest databases in the world on diet intake in a population-based sample, both in terms of sample size and follow-up period. The study examines trends in food and nutrient intake, serum cholesterol and body mass index (BMI) from 1986 to 2010 in northern Sweden.
Cross-sectional information on self-reported food and nutrient intake and measured body weight, height, and serum cholesterol were compiled for over 140,000 observations. Trends and trend breaks over the 25-year period were evaluated for energy-providing nutrients, foods contributing to fat intake, serum cholesterol and BMI.
Reported intake of fat exhibited two significant trend breaks in both sexes: a decrease between 1986 and 1992 and an increase from 2002 (women) or 2004 (men). A reverse trend was noted for carbohydrates, whereas protein intake remained unchanged during the 25-year period. Significant trend breaks in intake of foods contributing to total fat intake were seen. Reported intake of wine increased sharply for both sexes (more so for women) and export beer increased for men. BMI increased continuously for both sexes, whereas serum cholesterol levels decreased during 1986 - 2004, remained unchanged until 2007 and then began to rise. The increase in serum cholesterol coincided with the increase in fat intake, especially with intake of saturated fat and fats for spreading on bread and cooking.
Men and women in northern Sweden decreased their reported fat intake in the first 7 years (1986-1992) of an intervention program. After 2004 fat intake increased sharply for both genders, which coincided with introduction of a positive media support for low carbohydrate-high-fat (LCHF) diet. The decrease and following increase in cholesterol levels occurred simultaneously with the time trends in food selection, whereas a constant increase in BMI remained unaltered. These changes in risk factors may have important effects on primary and secondary prevention of cardiovascular disease (CVD).
Notes
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PubMed ID
22686621 View in PubMed
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Cardiovascular disease and diabetes in the Northern Sweden Health and Disease Study Cohort - evaluation of risk factors and their interactions.

https://arctichealth.org/en/permalink/ahliterature47322
Source
Scand J Public Health Suppl. 2003;61:18-24
Publication Type
Article
Date
2003
Author
Göran Hallmans
Asa Agren
Gerd Johansson
Anders Johansson
Birgitta Stegmayr
Jan-Håkan Jansson
Bernt Lindahl
Olle Rolandsson
Stefan Söderberg
Mats Nilsson
Ingegerd Johansson
Lars Weinehall
Author Affiliation
Nutritional Research, Department of Public Health and Clinical Medicine, Umeå University Hospital, Umeå, Sweden. goran.hallmans@nutrires.umu.se
Source
Scand J Public Health Suppl. 2003;61:18-24
Date
2003
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - epidemiology
Cohort Studies
Diabetes Mellitus - epidemiology
Humans
Risk factors
Sweden - epidemiology
Abstract
The purpose of this paper is, first, to describe the organization, sampling procedures, availability of samples/database, ethical considerations, and quality control program of the Northern Sweden Health and Disease Study Cohort. Secondly, some examples are given of studies on cardiovascular disease and diabetes with a focus on the biomarker programme. The cohort has been positioned as a national and international resource for scientific research.
PubMed ID
14660243 View in PubMed
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Cardiovascular risk factor levels differ between communities of different sizes in the Northern Sweden MONICA Project.

https://arctichealth.org/en/permalink/ahliterature47340
Source
Scand J Public Health. 2003;31(5):359-66
Publication Type
Article
Date
2003
Author
Torbjörn Messner
Vivan Lundberg
Birgitta Stegmayr
Author Affiliation
Department of Public Health and Clinical Medicine, Umeå University Hospital, Umeå, Sweden. torbjorn@kiruna.se
Source
Scand J Public Health. 2003;31(5):359-66
Date
2003
Language
English
Publication Type
Article
Keywords
Adult
Blood pressure
Body mass index
Cardiovascular Diseases - etiology
Cholesterol - blood
Diabetes Complications
Diabetes Mellitus - epidemiology
Educational Status
Female
Humans
Male
Middle Aged
Prevalence
Research Support, Non-U.S. Gov't
Risk factors
Sex Distribution
Smoking - adverse effects - epidemiology
Sweden - epidemiology
Abstract
AIM: To compare the levels of the main cardiovascular risk factors in communities of different sizes in northern Sweden. METHODS: Blood pressure, cholesterol, smoking habits, the prevalence of diabetes mellitus, and body mass index for 6167 men and women below age 65 were examined in the Northern Sweden MONICA surveys in 1986, 1990, 1994, and 1999. The size of the community where each individual lived and the levels of relevant confounders were also recorded. RESULTS: The proportion of persons with a higher educational level decreased gradually with decreasing community size. Total serum cholesterol, systolic blood pressure, the prevalence of diabetes mellitus and the body mass index were significantly higher in the smallest communities (15000 inhabitants) but there were fewer smokers among men in the smallest communities. The time trends indicated an overall decreasing serum cholesterol level and increasing body mass index for both sexes and a decreasing proportion of smokers among men during the years surveyed. CONCLUSIONS: There are differences in levels of cardiovascular risk factors between communities of different sizes in the Northern Sweden MONICA area, mainly to the disadvantage of the smallest communities.
PubMed ID
14555372 View in PubMed
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Chronic neck pain of traumatic and non-traumatic origin: a population-based study.

https://arctichealth.org/en/permalink/ahliterature67295
Source
Acta Orthop Scand. 2003 Oct;74(5):576-9
Publication Type
Article
Date
Oct-2003
Author
Michel Guez
Christer Hildingsson
Birgitta Stegmayr
Göran Toolanen
Author Affiliation
Department of Orthopaedics, University Hospital, Umeå, Sweden. michel.guez@orthop.umu.se
Source
Acta Orthop Scand. 2003 Oct;74(5):576-9
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Adult
Chronic Disease
Female
Health status
Humans
Logistic Models
Male
Middle Aged
Neck Injuries - complications - epidemiology
Neck Pain - epidemiology - etiology
Research Support, Non-U.S. Gov't
Workload
Abstract
Chronic neck pain is a common cause of disability. The effect of neck trauma on the development of chronic neck pain has been debated. In this population-based study, 8,356 persons (25-79 years) were randomly selected from a geographically well-defined area in northern Sweden. 6000 answered a self-administered questionnaire. We evaluated the data from all participants in the age range 25-64 years, a total of 4,392 persons. 18% reported chronic neck pain, defined as continuous pain of more than 6 months duration. 5% had a history of neck trauma and 13% had no such history. Of all patients with chronic neck pain, 30% had a history of neck injury. We divided all subjects with a chronic neck pain into two groups: those with or without a history of neck trauma. When studying the effect of sociodemographic data, self-perceived health and working conditions, multiple regression analysis showed that the trauma group consisted of significantly more younger men, who were more frequently on sick-leave and that their perceived health was worse than those without a neck injury. We found no significant differences concerning BMI, marital status, educational level, smoking habits, psychosocial work situation on the Karasek questionnaire or physical activity during leisure time or at work.
PubMed ID
14620979 View in PubMed
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C-reactive protein is a determinant of first-ever stroke: prospective nested case-referent study.

https://arctichealth.org/en/permalink/ahliterature151353
Source
Cerebrovasc Dis. 2009;27(6):544-51
Publication Type
Article
Date
2009
Author
Jonas Andersson
Lars Johansson
Per Ladenvall
Per-Gunnar Wiklund
Birgitta Stegmayr
Christina Jern
Kurt Boman
Author Affiliation
Department of Medicine and Geriatrics, Skellefteå County Hospital, Skellefteå, Sweden. jonas.so.andersson@vll.se
Source
Cerebrovasc Dis. 2009;27(6):544-51
Date
2009
Language
English
Publication Type
Article
Keywords
C-Reactive Protein - genetics - metabolism
Case-Control Studies
Cerebral Hemorrhage - blood - epidemiology - ethnology
Female
Humans
Male
Middle Aged
Multivariate Analysis
Polymorphism, Genetic - genetics
Predictive value of tests
Prospective Studies
Risk factors
Stroke - blood - epidemiology - ethnology
Sweden
Abstract
C-reactive protein (CRP) is a determinant of stroke, but there are no prospective studies on CRP and first ischemic stroke divided into etiologic subtypes. Our primary aim was to study CRP as a determinant of ischemic stroke, classified according to Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria, and intracerebral hemorrhage (ICH) in a prospective study. A secondary aim was to study the relationship between the 1444C>T polymorphism, plasma levels of CRP and stroke.
The study was a prospective population-based case-referent study nested within the Northern Sweden Cohorts. We defined 308 cases of ischemic stroke and 61 ICH. Two controls for each case were defined from the same cohort.
The OR for the highest (>3 mg/l) versus lowest group (T polymorphism and any stroke subtype.
PubMed ID
19390179 View in PubMed
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The decline of smoking in northern Sweden.

https://arctichealth.org/en/permalink/ahliterature67157
Source
Scand J Public Health. 2005;33(4):321-4; discussion 243
Publication Type
Article
Date
2005
Author
Birgitta Stegmayr
Mats Eliasson
Brad Rodu
Author Affiliation
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. birgitta.stegmayr@medicin.umu.se
Source
Scand J Public Health. 2005;33(4):321-4; discussion 243
Date
2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Comparative Study
Female
Humans
Male
Middle Aged
Prevalence
Research Support, Non-U.S. Gov't
Smoking - epidemiology - trends
Sweden - epidemiology
Tobacco, Smokeless
Abstract
For decades men in Sweden have smoked at far lower rates than those in comparable countries. Previous studies showed that snus use played a major role in low smoking rates among men in northern Sweden; daily smoking declined from 19% (95% CI 16-22%) in 1986 to 11% (CI 8.9-14%) in 1999. The prevalence of smoking among all men is now 9% (CI 7.0-11%) and only 3% (CI 0.1-5.4%) among men age 25-34 years; the prevalence of exclusive snus use is 27% (CI 24-30%) and 34% (CI 27-42%) respectively. Combined smoking and snus use, an unstable and transient category, was under 5% in all surveys and was 2.2% (CI 1.4-3.4%) by 2004. For the first time snus use is also associated with a decrease in smoking prevalence among women. These patterns of tobacco use have implications for all smoking-dominated societies.
PubMed ID
16087495 View in PubMed
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Declining mortality from subarachnoid hemorrhage: changes in incidence and case fatality from 1985 through 2000.

https://arctichealth.org/en/permalink/ahliterature179121
Source
Stroke. 2004 Sep;35(9):2059-63
Publication Type
Article
Date
Sep-2004
Author
Birgitta Stegmayr
Marie Eriksson
Kjell Asplund
Author Affiliation
Department Public Health and Clinical Medicine, Umeå University Hospital, SE-901 85 Umeå, Sweden. birgitta.stegmayr@medicin.umu.se
Source
Stroke. 2004 Sep;35(9):2059-63
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Female
Humans
Incidence
Male
Middle Aged
Sex Distribution
Subarachnoid Hemorrhage - epidemiology - mortality
Sweden - epidemiology
Abstract
Northern Sweden has one of the highest incidence rates of subarachnoid hemorrhage (SAH) among the populations covered by the WHO MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) Project, approximately twice as high as in the other populations in Europe. In this study, trends in incidence, 28-day case fatality (CF), and mortality in SAH were followed over a 16-year period.
Since 1985, all SAHs in northern Sweden among patients 25 to 74 years old have been validated using strict MONICA criteria. From 1985 through 2000, 392 men and 592 women had SAH. During 3 years, 1997 to 1999, SAH among those aged 75 and older were also included.
The total incidence among those 25 years and older was 13.3 per 100 000 in men and 24.4 per 100 000 in women. During the 16 years of observation, age standardized incidence in the group aged 25 to 74 years decreased significantly in men (P for trend
PubMed ID
15272133 View in PubMed
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Depressive mood after a cardiac event: gender inequality and participation in rehabilitation programme.

https://arctichealth.org/en/permalink/ahliterature45747
Source
Eur J Cardiovasc Nurs. 2004 Dec;3(4):295-302
Publication Type
Article
Date
Dec-2004
Author
Signild Norrman
Birgitta Stegmayr
Marie Eriksson
Bo Hedbäck
Gunilla Burell
Christine Brulin
Author Affiliation
Department of Cardiology, Heart Center, University Hospital, SE-90185 Umeå, Sweden. signild.norrman@vll.se
Source
Eur J Cardiovasc Nurs. 2004 Dec;3(4):295-302
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Angioplasty, Transluminal, Percutaneous Coronary - psychology - rehabilitation
Coronary Artery Bypass - psychology - rehabilitation
Depressive Disorder - epidemiology - prevention & control
Female
Humans
Male
Middle Aged
Myocardial Infarction - psychology - rehabilitation
Prospective Studies
Research Support, Non-U.S. Gov't
Sex Distribution
Statistics, nonparametric
Sweden - epidemiology
Abstract
BACKGROUND: Depressive mood after a cardiac event is common with serious consequences for the patient. AIMS: To compare gender in depressive mood during the first year after a cardiac event and to evaluate the effect of participating in a multidimensional secondary prevention program on depressive mood. METHODS: 166 men and 54 women,
PubMed ID
15572018 View in PubMed
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Diabetes and obesity in Northern Sweden: occurrence and risk factors for stroke and myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature47321
Source
Scand J Public Health Suppl. 2003;61:70-7
Publication Type
Article
Date
2003
Author
Mats Eliasson
Bernt Lindahl
Vivan Lundberg
Birgitta Stegmayr
Author Affiliation
Medicine, Department of Medicine, Sunderby Hospital, Luleå, Sweden. mats.eliasson@nll.se
Source
Scand J Public Health Suppl. 2003;61:70-7
Date
2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cerebrovascular Accident - complications - epidemiology
Diabetes Complications
Diabetes Mellitus - epidemiology
Female
Humans
Male
Middle Aged
Myocardial Infarction - complications - epidemiology
Obesity - complications - epidemiology
Prevalence
Risk factors
Sweden - epidemiology
Abstract
AIMS: The authors describe the occurrence of diabetes and obesity in the population of Northern Sweden and the role of diabetes in cardiovascular disease. METHODS: Four surveys of the population aged 25 to 64 years were undertaken during a 14-year time span. Stroke events in subjects 35-74 years during 1985-92 and myocardial infarction in subjects 25-64 years 1989-93 were registered. RESULTS: The prevalence of diagnosed diabetes was 3.1 and 2.0% in men and women, respectively, and 2.6 and 2.7% for previously undiagnosed diabetes. During the 13-year observation period, BMI increased 0.96 kg/m(2) in men and 0.87 in women. The proportion of subjects with obesity (BMI>or=30) increased from 10.3% to 14.6% in men and from 12.5% to 15.7% in women. Hip circumference increased substantially more than waist circumference, leading to a decreasing waits-to-hip ratio (WHR). The relative risk for stroke or myocardial infarction was four to six times higher in a person with diabetes than in those without diabetes. The 28-day case fatality for myocardial infarction, but not for stroke, was significantly higher in both men and women with diabetes. Population-attributable risk for diabetes and stroke was 18% in men and 22% in women and for myocardial infarction it was 11% in men and 17% in women. CONCLUSION: Obesity is becoming more common, although of a more distal than central distribution. The burden of diabetes in cardiovascular diseases in Northern Sweden is high.
PubMed ID
14660250 View in PubMed
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53 records – page 1 of 6.