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The Anglo-Scandinavian Cardiac Outcomes Trial: blood pressure-lowering limb: effects in patients with type II diabetes.

https://arctichealth.org/en/permalink/ahliterature154723
Source
J Hypertens. 2008 Nov;26(11):2103-11
Publication Type
Article
Date
Nov-2008
Author
Jan Ostergren
Neil R Poulter
Peter S Sever
Björn Dahlöf
Hans Wedel
Gareth Beevers
Mark Caulfield
Rory Collins
Sverre E Kjeldsen
Arni Kristinsson
Gordon T McInnes
Jesper Mehlsen
Markku Nieminen
Eoin O'Brien
Author Affiliation
Department of Medicine, Karolinska University Hospital Solna, Stockholm, Sweden. jan.ostergren@karolinska.se
Source
J Hypertens. 2008 Nov;26(11):2103-11
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Amlodipine - therapeutic use
Antihypertensive Agents - therapeutic use
Atenolol - therapeutic use
Blood pressure
Cardiovascular Diseases - drug therapy - etiology - mortality
Diabetes Mellitus, Type 2 - complications - drug therapy
Drug Therapy, Combination
Female
Great Britain - epidemiology
Humans
Hypertension - drug therapy - etiology - mortality
Male
Middle Aged
Perindopril - therapeutic use
Peripheral Vascular Diseases - prevention & control
Scandinavia - epidemiology
Stroke - prevention & control
Thiazides - therapeutic use
Abstract
To compare the effects of two antihypertensive treatment strategies for the prevention of coronary heart disease and other cardiovascular events in the large subpopulation (n=5137) with diabetes mellitus in the blood pressure-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial.
Patients had either untreated hypertension or treated hypertension. For those with type II diabetes mellitus, inclusion criteria required at least two additional risk factors. Patients were randomized to amlodipine with addition of perindopril as required (amlodipine-based) or atenolol with addition of thiazide as required (atenolol-based). Therapy was titrated to achieve a target blood pressure of less than 130/80 mmHg.
The trial was terminated early due to significant benefits on mortality and stroke associated with the amlodipine-based regimen. In patients with diabetes mellitus, the amlodipine-based treatment reduced the incidence of the composite endpoint--total cardiovascular events and procedures--compared with the atenolol-based regimen (hazard ratio 0.86, confidence interval 0.76-0.98, P=0.026). Fatal and nonfatal strokes were reduced by 25% (P=0.017), peripheral arterial disease by 48% (P=0.004) and noncoronary revascularization procedures by 57% (P
Notes
Comment In: Expert Rev Cardiovasc Ther. 2009 Mar;7(3):269-7119296764
PubMed ID
18854748 View in PubMed
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Blunted autonomic response in cluster headache patients.

https://arctichealth.org/en/permalink/ahliterature276215
Source
Cephalalgia. 2015 Dec;35(14):1269-77
Publication Type
Article
Date
Dec-2015
Author
Mads Barloese
Louise Brinth
Jesper Mehlsen
Poul Jennum
Helena Inez Sofia Lundberg
Rigmor Jensen
Source
Cephalalgia. 2015 Dec;35(14):1269-77
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Autonomic Nervous System - physiopathology
Blood Pressure - physiology
Cluster Headache - diagnosis - epidemiology - physiopathology
Denmark - epidemiology
Female
Heart Rate - physiology
Humans
Hypothalamus, Posterior - physiopathology
Male
Middle Aged
Smoking - epidemiology - physiopathology
Surveys and Questionnaires
Tilt-Table Test - methods
Young Adult
Abstract
Cluster headache (CH) is a disabling headache disorder with chronobiological features. The posterior hypothalamus is involved in CH pathophysiology and is a hub for autonomic control. We studied autonomic response to the head-up tilt table test (HUT) including heart rate variability (HRV) in CH patients and compared results to healthy controls.
Twenty-seven episodic and chronic CH patients and an equal number of age-, sex- and BMI-matched controls were included. We analyzed responses to HUT in the time and frequency domain and by non-linear analysis.
CH patients have normal cardiovascular responses compared to controls but increased blood pressure. In the frequency analysis CH patients had a smaller change in the normalized low- (LF) (2.89 vs. 13.38, p?
PubMed ID
25769490 View in PubMed
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Echocardiographic indices of left ventricular diastolic dysfunction in 647 individuals with preserved left ventricular systolic function.

https://arctichealth.org/en/permalink/ahliterature51998
Source
Eur J Heart Fail. 2004 Jun;6(4):439-47
Publication Type
Article
Date
Jun-2004
Author
Frants Pedersen
Ilan Raymond
Lene H Madsen
Jesper Mehlsen
Dan Atar
Per Hildebrandt
Author Affiliation
Department of Cardiology and Endocrinology, Frederiksberg University Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg-Copenhagen, Denmark. frants@dadlnet.dk
Source
Eur J Heart Fail. 2004 Jun;6(4):439-47
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Comparative Study
Denmark - epidemiology
Diastole - physiology
Echocardiography
Female
Heart Ventricles - physiopathology - ultrasonography
Humans
Male
Middle Aged
Myocardial Contraction - physiology
Observer Variation
Prevalence
Reproducibility of Results
Research Support, Non-U.S. Gov't
Stroke Volume - physiology
Systole - physiology
Vasodilation - physiology
Ventricular Dysfunction, Left - epidemiology - physiopathology - ultrasonography
Abstract
BACKGROUND: Knowledge about the occurrence of isolated diastolic dysfunction (DD) in the general population is limited. AIMS: This population study was performed to assess the frequency and distribution pattern of echocardiographic indices of left ventricular (LV) DD in an elderly population aged 50-89 years in which LV systolic function is preserved. METHODS AND RESULTS: The study population (n=764) recruited from the background population answered a heart failure questionnaire and underwent echocardiography. Excluding subjects with a LV ejection fraction
PubMed ID
15182769 View in PubMed
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Prevalence of diastolic dysfunction as a possible cause of dyspnea in the elderly.

https://arctichealth.org/en/permalink/ahliterature49637
Source
Am J Med. 2005 Jan;118(1):25-31
Publication Type
Article
Date
Jan-2005
Author
Frants Pedersen
Ilan Raymond
Jesper Mehlsen
Dan Atar
Per R Hildebrandt
Author Affiliation
Frederiksberg University Hospital, Department of Cardiology and Endocrinology, Nordre Fasanvej 57, DK-2000 Frederiksberg-Copenhagen, Denmark. frants@dadlnet.uk
Source
Am J Med. 2005 Jan;118(1):25-31
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Aged
Diagnosis, Differential
Diastole
Dyspnea - etiology
Echocardiography, Doppler
Electrocardiography
Exercise Test
Female
Humans
Magnetic Resonance Imaging
Male
Norway - epidemiology
Prevalence
Research Support, Non-U.S. Gov't
Respiratory Function Tests
Stroke Volume
Ventricular Dysfunction - complications - diagnosis - epidemiology - physiopathology - ultrasonography
Ventricular Dysfunction, Left - complications - diagnosis
Abstract
PURPOSE: Symptoms in patients with heart failure and preserved left ventricular ejection fraction may be caused by isolated diastolic dysfunction. The purpose of this study was to assess the prevalence of diastolic dysfunction as a potential cause of dyspnea in a sample of elderly subjects, as well as of isolated diastolic dysfunction as a potential cause of dyspnea in a subgroup with a preserved left ventricular ejection fraction and normal lung function. METHODS: A total of 152 subjects with dyspnea underwent echocardiography, electrocardiography, and lung function testing. Subjects with normal lung function test results (n = 60) underwent cardiac magnetic resonance imaging, chest radiography, bicycle exercise tests, and blood tests. Left ventricular diastolic function was assessed by a variety of echocardiographic/Doppler techniques. RESULTS: Of 129 subjects with dyspnea, 81 (63%) had signs of lung disease or 'obvious' cardiac disease. In the remaining 48 subjects, 32 (67%) had a potential cardiac/noncardiac cause of dyspnea. In all subjects with dyspnea, 1% to 11% had diastolic dysfunction, and in the 48 remaining subjects, 0% to 10% had isolated diastolic dysfunction, depending on the definition used. CONCLUSION: The frequency of diastolic dysfunction was low in the sample of elderly subjects with dyspnea as well as in the subgroup of persons with no signs of lung disease, left ventricular systolic dysfunction, atrial fibrillation, or valvular heart disease. Diastolic dysfunction was infrequent as a possible cause of dyspnea, and coexisting potential causes of dyspnea were often present.
Notes
Comment In: Am J Med. 2005 Jan;118(1):32-415639207
Comment In: Am J Med. 2005 Nov;118(11):1300-1; author reply 130116271926
Comment In: Am J Med. 2005 Nov;118(11):1301-2; author reply 130216271928
PubMed ID
15639206 View in PubMed
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Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature175728
Source
Drugs. 2004;64 Suppl 2:43-60
Publication Type
Article
Date
2004
Author
Peter S Sever
Björn Dahlöf
Neil R Poulter
Hans Wedel
Gareth Beevers
Mark Caulfield
Rory Collins
Sverre E Kjeldsen
Arni Kristinsson
Gordon T McInnes
Jesper Mehlsen
Markku Nieminen
Eoin O'Brien
Jan Ostergren
Author Affiliation
Imperial College, London, UK.
Source
Drugs. 2004;64 Suppl 2:43-60
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cholesterol - blood
Coronary Disease - mortality - prevention & control
Endpoint Determination
Female
Great Britain
Heptanoic Acids - therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hypertension - complications
Male
Middle Aged
Myocardial Infarction - epidemiology - prevention & control
Proportional Hazards Models
Pyrroles - therapeutic use
Scandinavia
Stroke - mortality - prevention & control
Treatment Outcome
Abstract
The lowering of cholesterol concentrations in individuals at high risk of cardiovascular disease improves outcome. No study, however, has assessed benefits of cholesterol lowering in the primary prevention of coronary heart disease (CHD) in hypertensive patients who are not conventionally deemed dyslipidaemic.
Of 19 342 hypertensive patients (aged 40-79 years with at least three other cardiovascular risk factors) randomised to one of two antihypertensive regimens in the Anglo-Scandinavian Cardiac Outcomes Trial, 10,305 with nonfasting total cholesterol concentrations 6.5 mmol/L or less were randomly assigned additional atorvastatin 10 mg or placebo. These patients formed the lipid-lowering arm of the study. We planned follow-up for an average of 5 years, the primary endpoint being non-fatal myocardial infarction and fatal CHD. Data were analysed by intention to treat.
Treatment was stopped after a median follow-up of 3.3 years. By that time, 100 primary events had occurred in the atorvastatin group compared with 154 events in the placebo group (hazard ratio 0.64 [95% CI 0.50-0.83], p = 0.0005). This benefit emerged in the first year of follow-up. There was no significant heterogeneity among prespecified subgroups. Fatal and non-fatal stroke (89 atorvastatin vs 121 placebo, 0.73 [0.56-0.96], p = 0.024), total cardiovascular events (389 vs 486, 0.79 [0.69-0.90], p = 0.0005), and total coronary events (178 vs 247, 0.71 [0.59-0.86], p = 0.0005) were also significantly lowered. There were 185 deaths in the atorvastatin group and 212 in the placebo group (0.87 [0.71-1.06], p = 0.16). Atorvastatin lowered total serum cholesterol by about 1.3 mmol/L compared with placebo at 12 months, and by 1.1 mmol/L after 3 years of follow-up.
The reductions in major cardiovascular events with atorvastatin are large, given the short follow-up time. These findings may have implications for future lipid-lowering guidelines.
PubMed ID
15765890 View in PubMed
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The prognosis of impaired left ventricular systolic function and heart failure in a middle-aged and elderly population in an urban population segment of Copenhagen.

https://arctichealth.org/en/permalink/ahliterature51971
Source
Eur J Heart Fail. 2004 Aug;6(5):653-61
Publication Type
Article
Date
Aug-2004
Author
Ilan Raymond
Jesper Mehlsen
Frants Pedersen
Jeannett Dimsits
Jørgen Jacobsen
Per Rossen Hildebrandt
Author Affiliation
Department of Cardiology and Endocrinology, H:S Frederiksberg Hospital, University of Copenhagen, Ndr. Fasanvej 57-59, DK-2000 Frederiksberg, Denmark. ilan.raymond@dadlnet.dk
Source
Eur J Heart Fail. 2004 Aug;6(5):653-61
Date
Aug-2004
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cross-Sectional Studies
Denmark - epidemiology
Female
Heart Failure, Congestive - mortality
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Research Support, Non-U.S. Gov't
Survival Analysis
Urban Population
Ventricular Dysfunction, Left - mortality
Abstract
AIMS: To determine the prognosis, total mortality and cardiac morbidity, of patients with left ventricular systolic dysfunction and heart failure (HF) in a general population sample. METHODS AND RESULTS: A total of 764 subjects, 432 females and 332 males, median age (range) 66 years (50-89), participated in this cross sectional survey. The study population was recruited from randomly selected general practitioners and stratified to include a minimum of 150 persons in each age decade stratum. Each participant filled in a heart failure questionnaire and ECG, blood tests and echocardiography were performed. Median (range) follow-up was 1145 (51-1197) days. Subjects with LVEF 0.40. The age and gender adjusted 2-year relative risk of death was 4.6 (95% C.I.=1.6-13.2). No significant difference in mortality was found between subjects with or without heart failure symptoms. CONCLUSION: Significantly higher mortality as well as cardiac morbidity was found in subjects with symptomatic and asymptomatic LV systolic dysfunction compared to those with normal systolic function. These conditions were among the strongest predictors of all-cause mortality and cardiac morbidity.
PubMed ID
15302015 View in PubMed
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Semen Quality as a Predictor of Subsequent Morbidity: A Danish Cohort Study of 4,712 Men With Long-Term Follow-up.

https://arctichealth.org/en/permalink/ahliterature286699
Source
Am J Epidemiol. 2017 Oct 15;186(8):910-917
Publication Type
Article
Date
Oct-15-2017
Author
Tabassam Latif
Tina Kold Jensen
Jesper Mehlsen
Stine Agergaard Holmboe
Louise Brinth
Kirsten Pors
Sven Olaf Skouby
Niels Jørgensen
Rune Lindahl-Jacobsen
Source
Am J Epidemiol. 2017 Oct 15;186(8):910-917
Date
Oct-15-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers
Cardiovascular Diseases - epidemiology
Denmark - epidemiology
Diabetes Mellitus - epidemiology
Follow-Up Studies
Health status
Hospitalization - statistics & numerical data
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Semen
Semen Analysis
Young Adult
Abstract
Semen quality has been suggested to be a biological marker of long-term morbidity and mortality; however, few studies have been conducted on this subject. We identified 5,370 men seen for infertility at Frederiksberg Hospital, Denmark, during 1977-2010, and 4,712 of these men were followed in the Danish National Patient Registry until first hospitalization, death, or the end of the study. We classified patients according to hospitalizations and the presence of cardiovascular disease, diabetes, testicular cancer, or prostate cancer. We found a clear association between sperm concentration below 15 million/mL and all-cause hospitalizations (hazard ratio?=?1.5, 95% confidence interval: 1.4, 1.6) and cardiovascular disease (hazard ratio?=?1.4, 95% confidence interval: 1.2, 1.6), compared with men with a concentration above 40 million/mL. The probabilities for hospitalizations were also higher with a low total sperm count and low motility. Men with a sperm concentration of 195-200 million/mL were, on average, hospitalized for the first time 7 years later than were men with a sperm concentration of 0-5 million/mL. Semen quality was associated with long-term morbidity, and a significantly higher risk of hospitalization was found, in particular for cardiovascular diseases and diabetes mellitus. Our study supports the suggestion that semen quality is a strong biomarker of general health.
PubMed ID
28498890 View in PubMed
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Suspected side effects to the quadrivalent human papilloma vaccine.

https://arctichealth.org/en/permalink/ahliterature269079
Source
Dan Med J. 2015 Apr;62(4):A5064
Publication Type
Article
Date
Apr-2015
Author
Louise Brinth
Ann Cathrine Theibel
Kirsten Pors
Jesper Mehlsen
Source
Dan Med J. 2015 Apr;62(4):A5064
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Child
Cohort Studies
Denmark
Follow-Up Studies
Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 - administration & dosage - adverse effects
Humans
Papillomavirus Infections - prevention & control
Patient Safety
Predictive value of tests
Retrospective Studies
Risk assessment
Syncope - diagnosis - epidemiology - etiology
Vaccination - adverse effects - methods
Young Adult
Abstract
The quadrivalent vaccine that protects against human papilloma virus types 6, 11, 16 and 18 (Q-HPV vaccine, Gardasil) was included into the Danish childhood vaccination programme in 2009. During the past years, a collection of symptoms primarily consistent with sympathetic nervous system dysfunction have been described as suspected side effects to the Q-HPV vaccine.
We present a description of suspected side effects to the Q-HPV vaccine in 53 patients referred to our Syncope Unit for tilt table test and evaluation of autonomic nervous system function.
All patients had symptoms consistent with pronounced autonomic dysfunction including different degrees of orthostatic intolerance, severe non-migraine-like headache, excessive fatigue, cognitive dysfunction, gastrointestinal discomfort and widespread pain of a neuropathic character.
We found consistency in the reported symptoms as well as between our findings and those described by others. Our findings neither confirm nor dismiss a causal link to the Q-HPV vaccine, but they suggest that further research is urgently warranted to clarify the pathophysiology behind the symptoms experienced in these patients and to evaluate the possibility and the nature of any causal link and hopefully establish targeted treatment options.
not relevant.
PubMed ID
25872549 View in PubMed
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8 records – page 1 of 1.