Skip header and navigation

Refine By

36 records – page 1 of 4.

Anticardiolipin antibodies are not an independent risk factor for stroke: an incident case-referent study nested within the MONICA and Västerbotten cohort project.

https://arctichealth.org/en/permalink/ahliterature47865
Source
Stroke. 2000 Jun;31(6):1289-93
Publication Type
Article
Date
Jun-2000
Author
E. Ahmed
B. Stegmayr
J. Trifunovic
L. Weinehall
G. Hallmans
A K Lefvert
Author Affiliation
Immunological Research Unit, Karolinska Institutet, Stockholm, Sweden.
Source
Stroke. 2000 Jun;31(6):1289-93
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Adult
Antibodies, Anticardiolipin - blood
Autoimmune Diseases - epidemiology - immunology
Brain Ischemia - epidemiology - immunology
Case-Control Studies
Cerebral Infarction - epidemiology - immunology
Cerebrovascular Accident - epidemiology - immunology
Cohort Studies
Comorbidity
Diabetes Mellitus - epidemiology
Disease Susceptibility
Enzyme-Linked Immunosorbent Assay
Epidemiologic Research Design
Female
Follow-Up Studies
Humans
Hypertension - epidemiology
Immunoglobulin A - blood - immunology
Immunoglobulin G - blood - immunology
Immunoglobulin M - blood - immunology
Male
Middle Aged
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Abstract
BACKGROUND AND PURPOSE: Anticardiolipin antibodies (aCL) have been proposed to be an independent risk factor for stroke. To test this hypothesis, a nested case-control study was performed to compare aCL with the other known risk factors for stroke. METHODS: Within the framework of the World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) project and the Västerbotten Intervention Program (VIP) health survey, 44 725 men and women were enrolled and followed up from January 1, 1985, through August 31, 1996. Individuals free from cardiovascular events were followed up, and 123 developed stroke (on average, 34.1 months after blood sampling; 21 cerebral hemorrhage and 102 cerebral infarction); they were compared with 241 age- and sex-matched control subjects from the same population. ELISA was used for the analysis of IgG, IgM, and IgA aCL. RESULTS: IgM-aCL were present in 11.4% of patients (14/123) who developed stroke and in 4. 1% of individuals (10/241) who remained healthy (P=0.013, OR 2.97, 95% CI 1.28 to 6.89). The OR for the levels of IgM-aCL was 1.34 (P=0. 01, 95% CI 1.07 to 1.68) without adjustment for other risk factors and 1.24 when adjusted for hypertension, diabetes mellitus, cigarette smoking, and use of smokeless tobacco (P=0.077, 95% CI 0. 98 to 1.56). There was no difference between patients and controls for the prevalence or level of IgG-aCL and IgA-aCL and also no difference between patients with cerebral hemorrhage and cerebral infarction for the prevalence of all 3 isotypes of aCL. CONCLUSIONS: We conclude that aCL are associated with future stroke but do not constitute an independent risk factor.
Notes
Comment In: Stroke. 2001 May;32(5):1234-711340241
PubMed ID
10835446 View in PubMed
Less detail

Can a sustainable community intervention reduce the health gap?--10-year evaluation of a Swedish community intervention program for the prevention of cardiovascular disease.

https://arctichealth.org/en/permalink/ahliterature53844
Source
Scand J Public Health Suppl. 2001;56:59-68
Publication Type
Article
Date
2001
Author
L. Weinehall
G. Hellsten
K. Boman
G. Hallmans
K. Asplund
S. Wall
Author Affiliation
Department of Public Health and Clinical Medicine, Umeå University, Sweden. Lars.Weinehall@epiph.umu.se
Source
Scand J Public Health Suppl. 2001;56:59-68
Date
2001
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - epidemiology - mortality - prevention & control
Community Health Planning - organization & administration
Female
Health Behavior
Health Promotion - organization & administration
Humans
Male
Middle Aged
Pilot Projects
Primary Health Care - organization & administration
Program Evaluation
Public Health Practice
Research Support, Non-U.S. Gov't
Risk factors
Rural Health
Sweden - epidemiology
Abstract
OBJECTIVES: This paper evaluates the 10-year outcomes of a Northern Sweden community intervention program for the prevention of cardiovascular disease (CVD), with special reference to the social patterning of risk development. METHODS: Using a quasi-experimental design, trends in risk factors and predicted mortality in an intervention area (Norsjö municipality) are compared with those in a reference area (Northern Sweden region) by repeated independent cross-sectional surveys. RESULTS: There were significant differences in changes in total cholesterol level and systolic blood pressure between the intervention and reference populations. The predicted coronary heart disease mortality (based on the North Karelia risk equation). after adjustment for age and education, was reduced by 36% in the intervention area and by 1% in the reference area. CONCLUSIONS: We conclude that a long-term community-based CVD prevention program which combines population and individual strategies can substantially promote a health shift in CVD risk in a high risk rural population. When evaluated for different social strata, we found no signs of an increasing health gap between socially privileged and less privileged groups. Socially less-privileged groups benefited the most from the present prevention program.
PubMed ID
11681565 View in PubMed
Less detail

Cardiovascular disease risk factors and dental caries in adolescents: effect of a preventive program in Northern Sweden (the Norsjö project).

https://arctichealth.org/en/permalink/ahliterature72801
Source
Acta Paediatr. 1997 Jan;86(1):63-71
Publication Type
Article
Date
Jan-1997
Author
B. Larsson
I. Johansson
L. Weinehall
G. Hallmans
T. Ericson
Author Affiliation
Department of Cardiology, University of Umeå, Sweden.
Source
Acta Paediatr. 1997 Jan;86(1):63-71
Date
Jan-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Health Services - organization & administration
Body mass index
Cardiovascular Diseases - prevention & control
Cross-Sectional Studies
Dental Caries - prevention & control
Female
Health Surveys
Humans
Male
Parents - education
Prevalence
Preventive Health Services - organization & administration
Program Evaluation
Research Support, Non-U.S. Gov't
Risk factors
Sweden
Abstract
Since 1985 a 10 year prevention programme aiming to reduce cardiovascular diseases (CVD) has been running in the county of Västerbotten in Northern Sweden. The project started in Norsjö. The present investigation is a study on dietary intake, medical CVD risk factors and dental caries in five cross-sectional groups of 15-year-olds during 5 years (1987-1991) of the "Norsjö project". Most of the measured medical and dietary variables followed a similar trend, i.e. a positive trend during the first 3 years (1987-1989) and in the last 2 years (1990-1991) the averages returned towards baseline values. Dental caries prevalence followed a similar trend. Parental educational level did not have a major influence on diet or medical CVD risk factors, but higher caries scores were noted in adolescents with parents with "low" education compared with adolescents where the parents had higher educational levels. The results from the study also point to the fact that dental caries prevalence together with body mass index may indicate adolescents with CVD risk factors at unfavourable levels. Dietary counselling by dental personnel to adolescents with high caries and moderate obesity can be of advantage in reducing caries risk, as well as risk for development of CVD at higher ages.
PubMed ID
9116429 View in PubMed
Less detail

Changing social patterns of risk factors for cardiovascular disease in a Swedish community intervention programme.

https://arctichealth.org/en/permalink/ahliterature67766
Source
Int J Epidemiol. 1993 Dec;22(6):1026-37
Publication Type
Article
Date
Dec-1993
Author
I. Brännström
L. Weinehall
L A Persson
P O Wester
S. Wall
Author Affiliation
Department of Epidemiology and Public Health, University of Umeå, Sweden.
Source
Int J Epidemiol. 1993 Dec;22(6):1026-37
Date
Dec-1993
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Cardiovascular Diseases - epidemiology - etiology - prevention & control
Cross-Sectional Studies
Female
Humans
Hypercholesterolemia - epidemiology
Hypertension - epidemiology
Male
Middle Aged
Obesity - epidemiology
Questionnaires
Research Support, Non-U.S. Gov't
Risk factors
Smoking
Social Class
Sweden - epidemiology
Abstract
Since 1985 a small-scale community-based cardiovascular disease (CVD) preventive programme has been in operation in an inland municipality, Norsjö, in Northern Sweden. The aim of this study was to assess the development of the relationship between social position and CVD risk factors in repeated cross-sectional surveys (1985-1990) among all men and women aged 30, 40, 50 and 60 years in the study area, using an age-stratified random sample from the Northern Sweden MONICA Study of 1986 and 1990 as reference population. These multiple cross-sectional surveys comprised a self-administered questionnaire and a health examination. Of the study population 95% (n = 1499) and 80% of those in the reference area (n = 3208) participated. Subjects were classified with regard to demographic, structural and social characteristics in relation to CVD risk factors and self-reported health status. Time trends in classical risk factor occurrence were assessed in terms of age- and sex- adjusted odds ratios using Mantel-Haenszel procedures. When simultaneously adjusting for several potential confounders we used a logistic regression analysis. Initially, more than half of the study population, both males and females, had and elevated (> or = 6.5 mmol/l) serum cholesterol level. After adjustments had been made for age and social factors it was found that the relative risk of hypercholesterolaemia dropped substantially and significantly among both sexes during the 6 years of CVD intervention in the study area. However, the probability of being a smoker was significantly reduced only in highly educated groups. Among other risk factors no single statistically significant change over time could be found. In the reference area there were no changes over time for the selected CVD risk factors. People in the study area had a less favourable perception of their health than those in the reference area. Social differences were found when perceived good health was measured, especially in variables indicating emotional and social support. When sex, age and social factors had been accounted for there was not clear change over the years in perceived good health.
PubMed ID
8144283 View in PubMed
Less detail

Chlamydia pneumoniae antibodies and high lipoprotein(a) levels do not predict ischemic cerebral infarctions. Results from a nested case-control study in Northern Sweden.

https://arctichealth.org/en/permalink/ahliterature200669
Source
Stroke. 1999 Oct;30(10):2013-8
Publication Type
Article
Date
Oct-1999
Author
C A Glader
B. Stegmayr
J. Boman
H. Stenlund
L. Weinehall
G. Hallmans
G H Dahlén
Author Affiliation
Department of Clinical Chemistry, Umeâ University, Sweden. christine.ahlbeck.glader@klinkemi.umu.se
Source
Stroke. 1999 Oct;30(10):2013-8
Date
Oct-1999
Language
English
Publication Type
Article
Keywords
Antibodies, Bacterial - blood
Cerebral Infarction - blood - diagnosis
Chlamydophila pneumoniae - immunology
Female
Humans
Immunoglobulin A - blood
Immunoglobulin G - blood
Lipoprotein(a) - blood
Male
Middle Aged
Predictive value of tests
Reference Values
Regression Analysis
Sweden
Abstract
An association between high lipoprotein(a) [Lp(a)] levels and positive Chlamydia pneumoniae IgG titers in coronary artery disease has been described. The possibility of predicting ischemic stroke by measurements of plasma Lp(a) and C pneumoniae antibodies was investigated.
This incident case-control study included 101 case subjects (cases) who had suffered ischemic cerebral infarctions and 201 matched control subjects (controls). The study population was nested within the Västerbotten Intervention Program or the WHO MONICA project. Plasma samples were measured for C pneumoniae-specific IgG and IgA antibodies and Lp(a).
A significantly higher mean Lp(a) level was found in female cases than in female controls. However, plasma Lp(a) was unable to predict ischemic cerebral infarctions in either women or men. The proportion of individuals with positive C pneumoniae-specific IgG or IgA titers did not differ between cases and controls. Antibody titers were unable to predict a future stroke. The proportion of individuals with a positive C pneumoniae IgG titer in combination with a high Lp(a) level did not differ significantly between cases and controls.
These data suggest that there is no association between baseline plasma Lp(a) levels, presence of C pneumoniae antibodies, and future ischemic cerebral infarctions. Furthermore, no evidence of an interactive effect between high Lp(a) levels and C pneumoniae IgG titers was found. However, selection bias and a recent C pneumoniae epidemic may have influenced the results.
Notes
Comment In: Stroke. 2000 May;31(5):1194-510797185
PubMed ID
10512900 View in PubMed
Less detail

[Cost-effectiveness analysis of cardiovascular disease prevention: a graded list as aid to the rational distribution of resources]

https://arctichealth.org/en/permalink/ahliterature72345
Source
Lakartidningen. 1999 Jun 9;96(23):2858-63, 2865-6
Publication Type
Article
Date
Jun-9-1999
Author
L. Lindholm
C G Hallgren
K. Boman
K. Markgren
L. Weinehall
J E Ogren
Author Affiliation
Länsutvecklingsenheten, Landstingshuset, Umeå.
Source
Lakartidningen. 1999 Jun 9;96(23):2858-63, 2865-6
Date
Jun-9-1999
Language
Swedish
Publication Type
Article
Keywords
Adult
Aged
Anticholesteremic Agents - administration & dosage - economics
Cardiovascular Diseases - prevention & control
Comparative Study
Cost-Benefit Analysis
Drug Costs
English Abstract
Female
Guidelines
Health Care Rationing
Health Resources
Humans
Male
Middle Aged
Models, Economic
Preventive Health Services - economics
Risk factors
Sweden
Abstract
In a study designed to compare the cost-effectiveness of three cardiovascular disease prevention programmes, subject to a defined budget, a population was subgrouped according to risk levels. Cost per year of life saved and annual budget expenditure were calculated for each subgroup. Budget expenditure was defined in terms of current direct costs. A ranked list was constructed, and the cut-off level of 'acceptable' cost-effectiveness elicited.
PubMed ID
10405534 View in PubMed
Less detail

Cost-effectiveness analysis with defined budget: how to distribute resources for the prevention of cardiovascular disease?

https://arctichealth.org/en/permalink/ahliterature72072
Source
Health Policy. 1999 Sep;48(3):155-70
Publication Type
Article
Date
Sep-1999
Author
L. Lindholm
C G Hallgren
K. Boman
K. Markgren
L. Weinehall
J E Ogren
Author Affiliation
Unit for Community Medicine, County Council of Västerbotten, Västerbotten, Sweden.
Source
Health Policy. 1999 Sep;48(3):155-70
Date
Sep-1999
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Budgets
Cardiovascular Diseases - economics - prevention & control
Cholesterol - blood
Cost-Benefit Analysis
Female
Health Resources - supply & distribution
Humans
Life Style
Male
Middle Aged
Preventive Health Services - economics
Risk factors
Sweden
Value of Life
Abstract
The aim of the study was to undertake cost-effectiveness calculations subject to a defined budget. The setting chosen was the prevention of cardiovascular disease (CVD) by means of three intervention programmes in a Swedish county council. The population in the county was divided into subgroups according to risk level. For each subgroup the cost per years of life saved was calculated, as well as the annual budget claims. The budget available was defined as present direct cost in the programmes. The calculations resulted in a programming solution showing the optimal distribution of resources between the programmes. Also a league table was constructed and the cut-off value for a 'acceptable' cost-effectiveness was shown. The conclusion that can be drawn is that a combination of internationally published intervention results and local data regarding epidemiology and resource improves the accuracy and usefulness of cost-effectiveness ratios. However, the model presented is a first attempt containing only three interventions: the planned next phase is to integrate more interventions in the model.
PubMed ID
11067036 View in PubMed
Less detail

Cost effectiveness and equity of a community based cardiovascular disease prevention programme in Norsjö, Sweden.

https://arctichealth.org/en/permalink/ahliterature72905
Source
J Epidemiol Community Health. 1996 Apr;50(2):190-5
Publication Type
Article
Date
Apr-1996
Author
L. Lindholm
M. Rosén
L. Weinehall
K. Asplund
Author Affiliation
Department of Epidemiology Ume & University, Sweden.
Source
J Epidemiol Community Health. 1996 Apr;50(2):190-5
Date
Apr-1996
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Cardiovascular Diseases - economics - mortality - prevention & control
Cholesterol - blood
Cost-Benefit Analysis
Cross-Sectional Studies
Female
Humans
Logistic Models
Male
Middle Aged
Primary Prevention - economics
Prospective Studies
Risk factors
Sex Factors
Sweden
Abstract
STUDY OBJECTIVE: To evaluate the cost effectiveness and equity of a community based cardiovascular disease prevention programme. DESIGN: A prospective cross sectional design. SETTING: A community based intervention to reduce cardiovascular disease in the district of Norsjö (n = 5500), Sweden. The intervention was aimed at both the general population and at individuals thought to be at special risk, the emphasis being on changing dietary habits and reducing cholesterol concentrations. PARTICIPANTS: The participants were men and women aged 30-60 years. MAIN RESULTS: The mean serum cholesterol concentration in the Norsjö population was reduced by nearly 20% during the first six years of intervention. It was estimated that the programme's overall total societal costs were 363,000 pounds and estimates of the cost per year of life saved ranged from 14,900 pounds to net savings, according to different assumptions. Taking only health care costs and savings into account, the cost per year of life saved ranged from 1100 pounds to 4050 pounds. The results varied between different sex and age groups, but not between social classes. Even if a causal relationship exists between low cholesterol concentrations and excess mortality, the estimated side effects of lowering cholesterol values in Norsjö were negligible in comparison with the expected benefits. CONCLUSIONS: The community based intervention in Norsjö seems to be cost effective even under conservative assumptions. The approach used seems to have benefited all social classes. Cost effectiveness analyses that take consequences for equity into account are valuable tools in decision making.
PubMed ID
8762387 View in PubMed
Less detail

Design issues in the combination of international data from two rural community cardiovascular intervention programs.

https://arctichealth.org/en/permalink/ahliterature71826
Source
Scand J Public Health Suppl. 2001;56:33-9
Publication Type
Article
Date
2001
Author
A N Nafziger
L. Weinehall
C. Lewis
P L Jenkins
T A Erb
T A Pearson
S. Wall
Author Affiliation
Clinical Pharmacology Research Center & Department of Medicine and The Research Institute, Bassett Healthcare, Cooperstown, New York 13326-1394, USA. nafziger@iex.net
Source
Scand J Public Health Suppl. 2001;56:33-9
Date
2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Cardiovascular Diseases - epidemiology - prevention & control
Community Health Planning - organization & administration
Comparative Study
Cross-Cultural Comparison
Data Interpretation, Statistical
Female
Health Behavior
Health Promotion - organization & administration
Health Surveys
Humans
Male
Middle Aged
New York - epidemiology
Pilot Projects
Program Evaluation
Public Health Practice
Risk factors
Rural Health
Sweden - epidemiology
Abstract
OBJECTIVES: To compare and contrast two rural cardiovascular community intervention programs (CCIP) in northern Sweden and the US by discussing the methods used to select and combine similar data from two separately designed and implemented CCIP in order to describe and evaluate their effectiveness in reducing cardiovascular risk. METHODS: Two rural intervention populations and their reference populations were compared. A comparison was made of the intensity and duration of the intervention programs using an overall intervention intensity score. Population-based surveys were conducted at 5-year intervals in both countries. The methods used for data pooling and comparison are described. A description of statistical analyses using a mixed analysis of variance model is provided. RESULTS: The data were pooled. taking into consideration comparable ages. New variables were created in order to define the relationship between similar data that did not permit direct comparison. CONCLUSIONS: Combination and comparison of international data from two programs allowed evaluation of community intervention programs that were developed independently for similar communities. The effectiveness of interventions can be compared using such methods.
PubMed ID
11681561 View in PubMed
Less detail

Different outcomes for different interventions with different focus!--A cross-country comparison of community interventions in rural Swedish and US populations.

https://arctichealth.org/en/permalink/ahliterature67408
Source
Scand J Public Health Suppl. 2001;56:46-58
Publication Type
Article
Date
2001
Author
L. Weinehall
C. Lewis
A N Nafziger
P L Jenkins
T A Erb
T A Pearson
S. Wall
Author Affiliation
Department of Public Health and Clinical Medicine, Umeå University, Sweden. Lars.Weinehall@epiph.umu.se
Source
Scand J Public Health Suppl. 2001;56:46-58
Date
2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cardiovascular Diseases - epidemiology - prevention & control
Community Health Planning - organization & administration
Comparative Study
Cross-Cultural Comparison
Female
Health Behavior
Health Promotion - organization & administration
Health Surveys
Humans
Male
Middle Aged
New York - epidemiology
Outcome Assessment (Health Care)
Pilot Projects
Program Evaluation
Public Health Practice
Research Support, Non-U.S. Gov't
Risk factors
Rural Health
Sweden - epidemiology
Abstract
OBJECTIVES: There is a need among healthcare providers to acquire more knowledge about small-scale and low budget community intervention programmes. This paper compares risk factor outcomes in Swedish and US intervention programmes for the prevention of cardiovascular disease (CVD). The aim was to explore how different intervention programme profiles affect outcome. METHODS: Using a quasi-experimental design, trends in risk factors and estimated CVD risk in two intervention areas (Norsjö. Sweden and Otsego-Schoharie County, New York state) are compared with those in reference areas (Northern Sweden region and Herkimer County, New York state) using serial cross-sectional studies and panel studies. RESULTS: The programmes were able to achieve significant changes in CVD risk factors that the local communities recognized as major concerns: changing eating habits in the Swedish population and reducing smoking in the US population. For the Swedish cross-sectional follow-up study cholesterol reduction was 12%, compared to 5% in the reference population (p for trend differences 10% decline in smoking prevalence in the intervention population, while it increased slightly in the reference population. When pooling the serial cross-sectional studies the estimated risk reduction (using the Framingham risk equation) was significantly greater in the intervention populations compared to the reference populations. CONCLUSIONS: The overall pattern of risk reduction is consistent and suggests that the two different models of rural county intervention can contribute to significant risk reduction. The Swedish programme had its greatest effect on reduction of serum cholesterol levels whereas the US programme had its greatest effect on smoking prevention and cessation. These outcomes are consistent with programmatic emphases. Socially less privileged groups in these rural areas benefited as much or more from the interventions as those with greater social resources.
PubMed ID
11681563 View in PubMed
Less detail

36 records – page 1 of 4.