OBJECTIVE. Based on a meta-analysis, it was recently stated that there is no association between coffee consumption and the risk of coronary heart disease. Why then, have studies on the issue shown quite variable results? DESIGN SETTING AND SUBJECTS. A prospective study was performed in the Copenhagen Male Study on 2975 men (53-74 years) without cardiovascular disease at baseline in 1985/1986. They were classified according to self-reported consumption of filter coffee. Some 147 men (5%) were coffee abstainers. Potential confounders were alcohol use, physical activity, smoking, serum cotinine, serum lipids, serum selenium, body mass index, blood pressure, Lewis blood group, hypertension, non-insulin-dependent diabetes mellitus and social class. MAIN OUTCOME MEASURES. The incidence of ischaemic heart disease (IHD) 1985/86-1991. RESULTS. Some 184 men had a first IHD event. There was no significant difference between those consuming 1-4, 5-8 or > or = 9 cups per day after controlling for confounders (P-value of trend test: 0.14). The crude incidence rates were 6.8, 6.7 and 4.6%, respectively; the adjusted rates were 6.8, 6.7 and 4.0%, respectively. Coffee consumption was significantly (P
Knowledge on the genetic risk of peptic ulcer has predominantly been based on hospital materials. To minimize selection bias, we tested the association between some genetic markers and the risk of peptic ulcer in a large-scale epidemiologic design.
Some 3387 white men aged 55-74 years were investigated and reported their history of peptic ulcer. Information about hospitalization and operation was collected from registers.
The lifetime prevalence of peptic ulcer in men with the Lewis phenotype Le(a + b-) and non-secretors of ABH antigen was 15%, significantly higher than others, 11% (P
The association between low back pain and occupational work loads, lifestyle factors and socio-demographic factors was examined in 469 steelplant workers (436 men, 33 women), aged 40 +/- 12 years (mean +/- SD). Fifty-one per cent had experienced low back pain during the preceding year. The strongest associations were found between recent low back pain and domestic recreational activities (> or = 3 h/week vs. 0-2 h/week), and between recent low back pain and work pace (too fast vs. adequate), with odds ratios (95% confidence limits) of 3.0 (1.5-5.8) and 2.3 (1.2-4.2), respectively. We considered a subject to have a particularly severe history of low back pain if, due to low back trouble, he (i) had ever been admitted to a hospital, (ii) had ever had to change work, or (iii) had had more than one week's accumulated sick leave during the preceding year. There was a strong association between a severe low back pain history and lifetime occupational exposure to heavy and frequent lifting at work. Forty-seven per cent of severe low back pain events could be ascribed to heavy and frequent lifting, assuming the associations were causal. We conclude that domestic recreational activities may be an important potential confounder in studies on occupational risk factors for low back pain, and that, based on the results of this and of other studies, a case for prevention still seems to exist regarding lifting of heavy burdens in the work environment.
OBJECTIVE: Misclassification of smokers as non-smokers may bias estimates of the excess morbidity and mortality associated with smoking. The issue has been given little, if any, attention in prospective epidemiological studies. This study examined characteristics of potentially misclassified smokers with respect to mortality, morbidity, and risk factors. METHOD: A prospective study (within The Copenhagen Male Study, Denmark) used serum cotinine as an objective marker of use of tobacco. A serum concentration of 100 ng/ml was regarded as a relevant threshold for active smoking. In all, 3270 males aged 53-74 years who reported their previous and current tobacco habits, including the use of chew tobacco and snuff, were included. Incidence of all causes of mortality (ACM) during 9 years and death due to ischaemic heart disease (IHD) during 8 years of follow-up were the main outcome measures. RESULTS: Overall cumulative incidence rates of ACM and IHD were 19.1% and 4.3%, respectively. Of 1405 men who reported being non-tobacco users, i.e. no current smoking and no use of chewing tobacco or snuff, 1377 had levels
OBJECTIVES: The association of socioeconomic status with the risk of ischaemic heart disease is only partly explained by the uneven distribution of conventional risk factors. We tested the hypothesis that an uneven socioeconomic distribution of ABO phenotypes could contribute to the explanation. DESIGN: A prospective study controlling for age and other relevant potential confounders: smoking, physical activity, wine consumption, height, weight, serum lipids, blood pressure, hypertension, type II diabetes, serum selenium concentration and soldering fumes exposure. SETTING: The Copenhagen Male Study, Denmark. STUDY PARTICIPANTS: Two thousand, nine hundred and ninety-three men aged 53-74 years without overt ischaemic heart disease. MAIN OUTCOME MEASURE: Incidence of ischaemic heart disease in an 8-year follow-up. RESULTS: Two hundred and forty-two men (8.1%) had a first ischaemic heart disease event. There was no association between socioeconomic status and the ABO blood group phenotypes and, in accordance with this, ABO phenotype was not a confounder for the association of socioeconomic status with the risk of ischaemic heart disease. However, ABO blood group was a strong risk or effect modifier. Only among men with the O phenotype was socioeconomic status (social classes IV and V versus social classes I, II and III) associated with a significant excess risk (relative risk 1.7, 95% confidence interval 1.1-2.7 and P = 0.02 after adjustment for confounders; the corresponding relative risks among the A and B/AB phenotypes comparing low social classes with the higher social classes were 1.08 (P = 0.77) and 1.08 (P = 0.89), respectively). CONCLUSION: ABO phenotypes did not contribute directly to the explanation of socioeconomic inequalities in the risk of ischaemic heart disease. However, the finding of ABO phenotypes being effect modifiers for the association of socioeconomic status with the risk of ischaemic heart disease may open up new possibilities of clarifying the roles of socioeconomic status and ABO blood group as cardiovascular disease risk factors.
OBJECTIVE: Large social inequalities exist in risk of ischaemic heart disease (IHD) in Western populations; inequalities which are only little accounted for by established risk factors. We wished to find out if some newly identified cardiovascular risk factors in concert with established factors might contribute further to the explanation. DESIGN AND SETTING: A 6-year follow-up in the Copenhagen Male Study. SUBJECTS: Some 2974 males aged 53-75 years (mean 63) without overt cardiovascular disease were included in the study. Potential confounders included were: alcohol, physical activity, smoking, serum lipids, serum cotinine, serum selenium, lifetime occupational exposure to soldering fumes and organic solvents, body mass index, blood pressure, hypertension, use of sugar in hot beverages, use of diuretics, and Lewis phenotypes. MAIN OUTCOME MEASURES: During the 6-year follow-up period (1985/1986-1991), 184 men (6.2%) had a first IHD event. Compared to higher social classes (classes I, II and III), lower classes (classes IV and V) had a significantly (P