Non insulin dependent diabetes mellitus (NIDDM) and essential hypertension (EH) are two of several manifestations of the insulin resistance syndrome. Although subjects with NIDDM and subjects with EH share a common defect in carbohydrate metabolism, only diabetics are advised to avoid sugar. We tested the theory that an adverse effect of diuretics treatment in men with EH with respect to risk of ischaemic heart disease (IHD) would depend on the intake of dietary sugar using sugar in hot beverages as a marker. The cohort consisted of 2,899 men from the Copenhagen Male Study aged 53-74 years (mean 63) who were without overt cardiovascular disease. Potential confounders were: age, alcohol,smoking, physical activity, body mass index, blood pressure, fasting lipids, cotinine, NIDDM,and social class. A total of 340 men took antihypertensives; 211 took diuretics (95% thiazides and related agents), and 129 used other antihypertensives. During 6 years, 179 men (6.2%) had a first IHD event. Among the 340 men taking antihypertensives, the incidence rate was 11%. Diuretics use was associated with a high risk of IHD in hypertensive men with a relatively high intake of dietary sugar; the cumulative incidence rate was 22%; in diuretics treated men with a low intake of sugar, the rate was 7%. After controlling for potential confounders, relative risk (95% ci.) was 3.1(1.3-7.6), p = 001. Among the 129 men who took other forms of antihypertensive drugs, the IHD incidence rate was 8%, and independent of the intake of sugar. The results indicate that the risk of IHD in hypertensives using diuretics is associated with intake of dietary sugar, which may explain at least some of the discouraging effects of antihypertensive agents on the reduction of risk of IHD.
OBJECTIVES: To test the hypothesis that long-term occupational exposure to airborne pollutants is a stronger risk factor for ischaemic heart disease (IHD) in men with blood type O than in men with other ABO phenotypes. DESIGN: Cross-sectional and prospective study taking into account potential confounders. SETTING: The Copenhagen Male Study. SUBJECTS: 3321 men aged 53-74 years. MAIN OUTCOME MEASURE: Lifetime prevalence of myocardial infarction and incidence of IHD in an 8-year follow-up among men without overt cardiovascular disease. RESULTS: Among men with phenotypes other than O no association was found between airborne pollutant exposure and IHD risk. Among men with blood type O (P = 1417, 42%), 4.7% had a history of myocardial infarction, as compared with 5.7% among men with other phenotypes (P = 1904, 58%). Long-term occupational exposure (> 5 years of exposure) to various airborne pollutants: soldering fumes, welding fumes and plastic fumes was associated with a significantly increased lifetime prevalence of myocardial infarction. Odds ratios (95% confidence limits) for these factors were 3.0 (1.6-5.8), P = 0.002, 2.1 (1.05-4.2), P = 0.05, and 8.3 (2.6-27.0), P = 0.003. In an 8-year follow-up a similar though weaker association was found with a significantly increased risk for those exposed long term to soldering fumes: 1.8 (1.0-3.2), P = 0.05. CONCLUSION: The finding of a quite strong interplay between airborne pollutants, ABO phenotypes, and risk of IHD, may open up new possibilities for clarifying the roles of the ABO blood group and air pollution as cardiovascular risk factors.
OBJECTIVES: To investigate the interplay between use of alcohol, concentration of low density lipoprotein cholesterol, and risk of ischaemic heart disease. DESIGN: Prospective study with controlling for several relevant confounders, including concentrations of other lipid fractions. SETTING: Copenhagen male study, Denmark. SUBJECTS: 2826 men aged 53-74 years without overt ischaemic heart disease. MAIN OUTCOME MEASURE: Incidence of ischaemic heart disease during a six year follow up period. RESULTS: 172 men (6.1%) had a first ischaemic heart disease event. There was an overall inverse association between alcohol intake and risk of ischaemic heart disease. The association was highly dependent on concentration of low density lipoprotein cholesterol. In men with a high concentration (> or = 5.25 mmol/l) cumulative incidence rates of ischaemic heart disease were 16.4% for abstainers, 8.7% for those who drank 1-21 beverages a week, and 4.4% for those who drank 22 or more beverages a week. With abstainers as reference and after adjustment for confounders, corresponding relative risks (95% confidence interval) were 0.4 (0.2 to 1.0; P or = 3.63 mmol/l who abstained from drinking alcohol was 43% (10% to 64%). CONCLUSIONS: In middle aged and elderly men the inverse association between alcohol consumption and risk of ischaemic heart disease is highly dependent on the concentration of low density lipoprotein cholesterol. These results support the suggestion that use of alcohol may in part explain the French paradox.
Comment In: ACP J Club. 1996 Sep-Oct;125(2):51
Comment In: BMJ. 1996 Aug 10;313(7053):365-68760765
A high intake of saturated fat is associated with an increase in serum low density lipoprotein cholesterol (LDL) and an increase in risk of ischaemic heart disease (IHD). In some parts of France a high intake of fat is not associated with increased risk of IHD, an apparent discrepancy named the French paradox. It has been suggested, but never tested prospectively, that regular use of alcohol might explain this low risk. We investigated the interplay between use of alcohol, LDL and risk of IHD in a prospective study controlling for a number of relevant confounders including other lipid fraction, including 2,826 males aged 53-74 years without overt IHD. The incidence of IHD during a six year follow-up period was registered. One hundred and seventy-two men (6.1%) had a first IHD event. There was an overall inverse association between alcohol intake and risk of IHD. The association was highly dependent on LDL. In men with a high LDL (> or = 5.25 mmol/l), cumulative incidence rates of IHD were 16.4% for abstainers, 8.7% for those who drank 1-21 beverages/week and 4.4% for those who drank 22+. Using abstainers as reference, adjusted for confounders, corresponding relative risks (95% CI) were 0.4 (0.2-1.0), p or = 3.63 mmol/l who abstained from drinking alcohol was calculated; AR with 95% confidence limits was 43% (10-64%). To conclude, in middleaged and elderly men the inverse association between alcohol consumption and risk of IHD was highly dependent on the level of LDL. These results support the suggestion that alcohol intake may at least in part explain the French paradox.
In the Copenhagen Male Study we found an increased risk of ischaemic heart disease (IHD) in men with the Lewis phenotype Le(a-b-). This study investigated whether, within the group of Le(a-b-) men, any conventional risk factors modified their increased risk. Three thousand, three hundred and eighty-three men aged 53 to 75 years were examined in 1985/86 and their morbidity and mortality over the next four years recorded. Three hundred and forty-three men with cardiovascular diseases were excluded at baseline. Potential risk factors examined were: alcohol consumption, physical activity, tobacco smoking, serum cotinine, serum lipids, body mass index, blood pressure, hypertension, non-insulin dependent diabetes mellitus and social class. In eligible men with Le(a-b-), N = 280 (9.6%), alcohol was the only risk factor associated with risk of IHD. There was a significant inverse dose-effect relationship between alcohol consumption and risk. The age-adjusted p-values of trend tests were for risk of non-fatal + fatal IHD: p = 0.03; for risk of fatal IHD: p = 0.02. In eligible men with other phenotypes, N = 2,649 (90.4%) only a limited and non-significant negative association with alcohol. In Le(a-b-) men, a group genetically at increased risk of IHD, the risk was strongly and significantly negatively correlated with alcohol consumption.
This study aims to study physiological stress indicators in relation to prevalence of building-related symptoms (BRS) among teachers employed in three selected schools in Copenhagen. Three hypotheses were studied: (i) Perceived psychosocial work environment was associated with BRS; (ii) Perceived psychosocial work environment (job strain) was associated with physiological strain; (iii) BRS was associated with physiological strain. We found a tendency among women of an association between job strain and being BRS positive. Also an association between job strain and physiological strain was observed among women. Being BRS positive was not associated with single physiological stress indicators with the exception of a higher level free testosterone in serum among BRS-positive women.
Including physiological stress indicators may be a supplementary measure to questionnaires when studying the association between the psychosocial work environment and building-related symptoms (BRS). In this study, job strain was associated with physiological strain among women. Being BRS positive was not associated with single physiological stress indicators with the exception of a higher level free testosterone in serum among BRS-positive women. This study should be regarded as a preliminary study because of its small number of participants.
Former studies on the association between snoring and cardiovascular disease (CVD) have only partly taken established CVD risk factors into consideration. In the Copenhagen Male Study, 3323 men aged 54-74 years were classified according to self-reported snoring habits. Eleven CVD risk factors were examined. The prevalence of snoring decreased with age, with a 50% higher frequency of snorers in the youngest quintile than in the oldest, p
In The Copenhagen Male Study, an epidemiological study comprising 3,387 men aged 53 to 75 years, 3,303 men with valid questionnaire answers to questions on occupational organic solvents exposure, four cerebral symptoms and current work status were examined. Two hundred and ninety-five men had been occupationally exposed to mixed organic solvents for a period of five years or more. Among the exposed persons, 178 had retired, while 117 were still gainfully employed. The exposed men in both groups had highly significantly more complaints of decreased concentration and defective memory. Among the exposed retired men a higher prevalence of headache was found. Among the exposed men who were still employed a trend towards a higher prevalence of vertigo was found. This study was conducted within a cardiovascular study with no focus on the relationship between organic solvent exposure and cerebral symptoms, a design reducing the risk of overreporting. If overreporting was responsible for the differences found between solvent exposed and unexposed a similar pattern for reporting of acute and chronic symptoms should be expected. This was not the case. Our results support the hypothesis, that occupational exposure to organic solvents for a period of five years or more increases the risk of developing persistent defective memory and decrease in concentration.
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
INTRODUCTION: Compared with controls, up to six years after their return, Danish Gulf War Veterans have a significantly higher prevalence of self-reported neuropsychological symptoms. Independent associations are found for concentration or memory problems, repeated fits of headache, balance disturbances or fits of dizziness, abnormal fatigue not caused by physical activity, and problems sleeping all night. We investigated whether psychosocial, physical, chemical or biological exposures were associated with these symptoms. METHODOLOGY: This study is a prevalence study using retrospective data on exposure. Some 686 subjects who had been deployed in the Persian Gulf within the period August 2 1990 until December 31 1997 were included; the control group comprised 257 subjects matched according to age, gender and profession. All participants underwent clinical and paraclinical examinations, and were interviewed by a physician based on a completed questionnaire. RESULTS: A clustering of three to five of the above symptoms were found in 21.4% of Gulf War Veterans vs. 6.2% in controls, p