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The 1-month prevalence of generalized anxiety disorder according to DSM-IV, DSM-V, and ICD-10 among nondemented 75-year-olds in Gothenburg, Sweden.

https://arctichealth.org/en/permalink/ahliterature124775
Source
Am J Geriatr Psychiatry. 2012 Nov;20(11):963-72
Publication Type
Article
Date
Nov-2012
Author
Nilsson, J
Östling, S
Waern, M
Karlsson, B
SigstrÖm, R
Xinxin Guo
Ingmar Skoog
Author Affiliation
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Source
Am J Geriatr Psychiatry. 2012 Nov;20(11):963-72
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Aged
Alzheimer Disease - diagnosis - epidemiology - psychology
Anxiety Disorders - diagnosis - epidemiology - psychology
Chronic Disease - epidemiology - psychology
Comorbidity
Cross-Sectional Studies
Depressive Disorder, Major - diagnosis - epidemiology - psychology
Diagnostic and Statistical Manual of Mental Disorders
Female
Geriatric Assessment - statistics & numerical data
Health Behavior
Health Surveys
Humans
International Classification of Diseases
Interview, Psychological
Life Style
Male
Obsessive-Compulsive Disorder - diagnosis - epidemiology - psychology
Phobic Disorders - diagnosis - epidemiology - psychology
Sweden
Abstract
To examine the 1-month prevalence of generalized anxiety disorder (GAD) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Diagnostic and Statistical Manual of Mental, Fifth Edition (DSM-V), and International Classification of Diseases, Tenth Revision (ICD-10), and the overlap between these criteria, in a population sample of 75-year-olds. We also aimed to examine comorbidity between GAD and other psychiatric diagnoses, such as depression.
During 2005-2006, a comprehensive semistructured psychiatric interview was conducted by trained nurses in a representative population sample of 75-year-olds without dementia in Gothenburg, Sweden (N = 777; 299 men and 478 women). All psychiatric diagnoses were made according to DSM-IV. GAD was also diagnosed according to ICD-10 and DSM-V.
The 1-month prevalence of GAD was 4.1% (N = 32) according to DSM-IV, 4.5% (N = 35) according to DSM-V, and 3.7% (N = 29) according to ICD-10. Only 46.9% of those with DSM-IV GAD fulfilled ICD-10 criteria, and only 51.7% and 44.8% of those with ICD-10 GAD fulfilled DSM-IV/V criteria. Instead, 84.4% and 74.3% of those with DSM-IV/V GAD and 89.7% of those with ICD-10 GAD had depression. Also other psychiatric diagnoses were common in those with ICD-10 and DSM-IV GAD. Only a small minority with GAD, irrespective of criteria, had no other comorbid psychiatric disorder. ICD-10 GAD was related to an increased mortality rate.
While GAD was common in 75-year-olds, DSM-IV/V and ICD-10 captured different individuals. Current definitions of GAD may comprise two different expressions of the disease. There was greater congruence between GAD in either classification system and depression than between DSM-IV/V GAD and ICD-10 GAD, emphasizing the close link between these entities.
PubMed ID
22549369 View in PubMed
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Adherence to diagnostic guidelines and quality indicators in asthma and COPD in Swedish primary care.

https://arctichealth.org/en/permalink/ahliterature89646
Source
Pharmacoepidemiol Drug Saf. 2009 May;18(5):393-400
Publication Type
Article
Date
May-2009
Author
Weidinger Paolina
Nilsson J Lars G
Lindblad Ulf
Author Affiliation
Department of Clinical Sciences, Lund University, Malmö, Sweden. paolina.weidinger@vgregion.se
Source
Pharmacoepidemiol Drug Saf. 2009 May;18(5):393-400
Date
May-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Asthma - diagnosis
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Practice Guidelines as Topic
Primary Health Care
Pulmonary Disease, Chronic Obstructive - diagnosis
Sweden
Abstract
PURPOSE: To study the clinical evaluation and treatment of patients with asthma and COPD in primary care in Sweden, with a focus on adherence to recommended guidelines and quality indicators. METHODS: All visits at health care centres in Skaraborg, Sweden, are documented in computerized medical records constituting the Skaraborg Primary Care Database (SPCD). In a register-based retrospective observational study, all patients diagnosed with asthma or COPD during 2000-2005 (n = 12,328) were identified. In a 5% random sample (n = 623), information on performed investigations at initial visits and at follow-up during 2004-2005 was collected. Compliance with procedures as recommended by national guidelines was used for quality assessment. RESULTS: Among 499 patients with asthma, 167 (33%) were investigated with spirometry or Peak Expiratory Flow (PEF) during initial visits in agreement with guidelines. Correspondingly, 40 out of 124 patients with COPD (32%) were investigated with spirometry. During follow-up, evaluation in agreement with guidelines was performed in 130 (60%) of patients with asthma and in 35 patients out of 77 (45%) with COPD. Prescribing of ICS reached quality target, still every second patient made an acute visit during follow-up. CONCLUSION: Adherence to recommended guidelines in asthma/COPD was low. Acute visits were common and despite the prescribing of ICS according to recommendations, patients still seem uncontrolled in their disease. There is a need for quality improvement in the clinical evaluation and treatment of patients with asthma and COPD.
PubMed ID
19288473 View in PubMed
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An outbreak of mumps in Sweden, February-April 2004.

https://arctichealth.org/en/permalink/ahliterature83115
Source
Euro Surveill. 2005 Sep;10(9):191-3
Publication Type
Article
Date
Sep-2005
Author
Sartorius B.
Penttinen P.
Nilsson J.
Johansen K.
Jönsson K.
Arneborn M.
Löfdahl M.
Giesecke J.
Author Affiliation
European Programme for Intervention Epidemiology Training, Department of Epidemiology, Swedish Institute for Infectious Disease Control, Solna, Sweden.
Source
Euro Surveill. 2005 Sep;10(9):191-3
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Child
Child, Preschool
Demography
Disease Outbreaks
Female
Hospitalization
Humans
Male
Middle Aged
Mumps - diagnosis - epidemiology - physiopathology - prevention & control
Mumps Vaccine
Serologic Tests
Sex Distribution
Sweden - epidemiology
Treatment Outcome
Vaccination
Abstract
Between 24 February and 26 April 2004, Västra Götaland county in Sweden reported 42 cases of suspected mumps. A descriptive study of the cases was undertaken. A questionnaire was administered by telephone and vaccine effectiveness was calculated using the screening method. Seventy four per cent (31/42) of the suspected cases were interviewed by telephone. Eight out of the 42 serum samples were positive or equivocal for mumps IgM by ELISA. Mumps virus genome was identified in 21/42 (50%) saliva samples. Eleven were selected for sequencing and all were confirmed to be mumps virus. Cases were predominantly from 2 small towns. Eighteen out of 19 cases that developed bilateral swelling could be linked to one small town. The median age of interviewed cases was 43 years (range 5 to 88). Six cases were admitted to hospital, 5 of which were older than 30 years. The highest incidence occurred in the 35 to 44 years age group. Vaccine effectiveness was estimated to be 65% for 1 dose and 91% for 2 doses. This descriptive study shows the increasing age of mumps cases with increasing vaccine coverage. Vaccine effectiveness was particularly high for 2 doses. Second-dose uptake must be ensured, as primary vaccine failure is well documented in mumps. Stronger precautions must be taken to avoid pools of susceptible older individuals accumulating due to the increased risk of complications.
PubMed ID
16280614 View in PubMed
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Clinical course and prognosis of never-smokers with severe alpha-1-antitrypsin deficiency (PiZZ).

https://arctichealth.org/en/permalink/ahliterature92621
Source
Thorax. 2008 Dec;63(12):1091-5
Publication Type
Article
Date
Dec-2008
Author
Tanash H A
Nilsson P M
Nilsson J-A
Piitulainen E.
Author Affiliation
Department of Respiratory Medicine, Malmö University Hospital, Entrance 35, S-205 02, Malmö, Sweden. hanan.tanash@med.lu.se
Source
Thorax. 2008 Dec;63(12):1091-5
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cause of Death
Female
Forced Expiratory Volume - physiology
Humans
Liver Diseases - complications - mortality - physiopathology
Male
Middle Aged
Prognosis
Respiratory Tract Diseases - complications - mortality - physiopathology
Survival Analysis
Sweden - epidemiology
Vital Capacity - physiology
Young Adult
alpha 1-Antitrypsin Deficiency - complications - mortality - physiopathology
Abstract
BACKGROUND: Previous studies of non-smoking individuals with severe alpha(1)-antitrypsin deficiency (PiZZ) have been sparse and included only a limited number of individuals, mostly identified by respiratory symptoms. The aim of this study was to estimate the prognosis of non-smoking PiZZ individuals and to analyse the most common causes of death by including a large number of individuals who had been identified by other means than respiratory symptoms. METHODS: The study included 568 non-smoking PiZZ subjects who were selected from the Swedish National AAT Deficiency Registry and followed up from 1991 to September 2007. Of these, 156 (27%) were identified by respiratory symptoms (respiratory cases) and 412 were identified by extrapulmonary symptoms or screening (non-respiratory cases). RESULTS: 93 subjects (16%) died during the follow-up period. The specific standardised mortality rate (SMR) for the whole study population was 2.32 (95% CI 1.87 to 2.83) with no significant difference between men and women. The SMR was 2.55 (95% CI 1.91 to 2.83) for the respiratory cases and 2.07 (95% CI 1.49 to 2.81) for the non-respiratory cases. Further calculation of SMR for subgroups in the non-respiratory cases showed that the SMR was 0.70 (95% CI 0.14 to 2.04) for individuals identified by family/population screening. Emphysema and liver cirrhosis were the most common causes of death (45% and 28%, respectively). Malignant transformation was found in 38% of the cases with cirrhosis. CONCLUSION: Non-smoking PiZZ individuals identified by screening do not have an increased mortality risk compared with the Swedish general population.
PubMed ID
18682522 View in PubMed
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Correlation of drug utilisation and morbidity at the municipality level. High use of antibiotics associated with low use of antihypertensives.

https://arctichealth.org/en/permalink/ahliterature81549
Source
Eur J Clin Pharmacol. 2006 Aug;62(8):675-80
Publication Type
Article
Date
Aug-2006
Author
Nilsson J Lars G
Lindberg Gunnar
Johansson Hans
Melander Arne
Author Affiliation
NEPI Foundation, 118 81 Stockholm, Sweden. lars.nilsson@nepi.net
Source
Eur J Clin Pharmacol. 2006 Aug;62(8):675-80
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adult
Anti-Bacterial Agents - administration & dosage
Antihypertensive Agents - administration & dosage
Drug Utilization - statistics & numerical data
Female
Humans
Male
Middle Aged
Morbidity
Pharmacoepidemiology
Sweden - epidemiology
Abstract
OBJECTIVE: The aim of the study was to explore the relationship between Swedish drug sales data per municipality and morbidity per municipality. The morbidity was expressed as "sickness numbers" which are assumed to function as proxy for morbidity. METHODS: Sickness numbers per municipality were correlated to volumes of drug sales per municipality in 2003. In addition, the sales volumes of antibiotics were correlated to the sales volumes of other drugs. RESULTS: We found significant positive correlations between municipality sickness numbers and sales volumes for most drug groups, except for antibiotics where the correlations were negative in all age groups. When the volumes of antibiotics were related to the volumes of other drug groups it was observed that municipalities with volumes of antibiotics above the national average had reduced volumes of cardiovascular drugs, especially of diuretics, beta blockers and calcium antagonists, all primarily used as antihypertensives. For ACE inhibitors and statins, no such relationship was found. CONCLUSION: The findings might suggest a link between infection and hypertension, but a cause-effect relation is not established.
PubMed ID
16823583 View in PubMed
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Dispensed volumes of anti-asthmatic drugs related to the prevalence of asthma and COPD in Sweden.

https://arctichealth.org/en/permalink/ahliterature86518
Source
Pharmacoepidemiol Drug Saf. 2008 May;17(5):461-7
Publication Type
Article
Date
May-2008
Author
Haupt Dan
Wettermark Björn
Nilsson J Lars G
Author Affiliation
Department of Health Sciences, Luleå Technical University, Luleå, Sweden.
Source
Pharmacoepidemiol Drug Saf. 2008 May;17(5):461-7
Date
May-2008
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Anti-Asthmatic Agents - administration & dosage - therapeutic use
Asthma - drug therapy - epidemiology
Commerce - statistics & numerical data
Databases, Factual - statistics & numerical data
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Prevalence
Pulmonary Disease, Chronic Obstructive - drug therapy - epidemiology
Sweden - epidemiology
Abstract
PURPOSE: To explore the possibility of using dispensed volumes asthma/COPD drugs as a proxy for the combined prevalence of asthma plus COPD. METHODS: The proportions of the Swedish population with inhalation drugs for asthma/COPD 2004 were obtained using three different databases. A pharmacy record database gave the volumes of dispensed drugs (defined daily doses, DDDs of R03A + R03B drugs) for each patient, 20 years and older. The X-plain database of Apoteket AB gave drug sales data for Sweden and Swedish population data were obtained from Swedish statistics. RESULTS: The sales volumes of asthma/COPD drugs were much higher for older than for younger people. The volumes increased from 18 DDD/TID for the 20-29 year group up to 124 DDD/TID for patients 70-79 years, or about seven times. The average volumes per patient in the different age groups corresponded to one DDD/day in only three of the age groups (50-79 years). In the youngest group the average drug volume per patient corresponded to one DDD every second day, which may indicate undermedication. The percentages of the Swedish population with asthma/COPD drugs increased from 4.0% for 20-29 years old to 14.5% for 80+ years old, or 3.6 times. When head-to-head comparisons could be made between reported prevalence data of asthma and COPD and our data the two sets of data were in a reasonable agreement. CONCLUSION: The prevalence of drug treatment, i.e. the proportion of the population with dispensed asthma/COPD drugs, could function as a proxy for the disease prevalence of asthma plus COPD.
PubMed ID
18302301 View in PubMed
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"I don't know how many of these [medicines] are necessary.." - a focus group study among elderly users of multiple medicines.

https://arctichealth.org/en/permalink/ahliterature91698
Source
Patient Educ Couns. 2009 Feb;74(2):135-41
Publication Type
Article
Date
Feb-2009
Author
Moen Janne
Bohm Anna
Tillenius Therese
Antonov Karolina
Nilsson J Lars G
Ring Lena
Author Affiliation
Department of Pharmacy, Uppsala University, Uppsala, Sweden. moen.janne@gmail.com
Source
Patient Educ Couns. 2009 Feb;74(2):135-41
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Aged - psychology
Aged, 80 and over
Attitude to Health
Communication
Drug Interactions
Drug Prescriptions
Drug Therapy, Combination
Female
Focus Groups
Health Knowledge, Attitudes, Practice
Health services needs and demand
Humans
Male
Nonprescription Drugs - adverse effects - therapeutic use
Patient Education as Topic
Physician-Patient Relations
Phytotherapy - adverse effects - psychology
Polypharmacy
Qualitative Research
Sweden
Trust
Abstract
OBJECTIVE: The growing prevalence of multiple medicine use among elderly challenges health care. The aim was to conduct an exploratory study describing multiple medicine use from the elderly patient's perspective. METHODS: Twelve focus groups of 29 men and 30 women 65 years of age or older, using five or more medicines were analysed qualitatively. RESULTS: Initially the participants reported no problems with using multiple medicines; they felt fortunate that medicines existed and kept them alive. However, negative attitudes were also revealed, both similar to those presented in studies on lay experience of medicine-taking and some that appear more specific to users of multiple medicines. The foremost of these was that acceptance of medicines depends on not experiencing adverse effects and worrying whether multiple medicine use is 'good' for the body. Furthermore, participants' perception of their medicines depended on interaction with doctors, i.e. trusting 'good' doctors. CONCLUSION: The participants revealed co-existing accounts of both immediate gratitude and problems with using multiple medicines. Furthermore, the patient-doctor relationship coloured their attitudes towards their medicines. PRACTICE IMPLICATIONS: Importance of the patient-doctor relationship for treatment success is highlighted. Moreover, to be able to capture both accounts of the elderly in this study an appropriate consultation length is needed.
PubMed ID
18845412 View in PubMed
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Improved outcome in Wegener's granulomatosis and microscopic polyangiitis? A retrospective analysis of 95 cases in two cohorts.

https://arctichealth.org/en/permalink/ahliterature90455
Source
J Intern Med. 2009 Apr;265(4):496-506
Publication Type
Article
Date
Apr-2009
Author
Eriksson P.
Jacobsson L.
Lindell A.
Nilsson J-A
Skogh T.
Author Affiliation
Division of Rheumatology, Faculty of Health Sciences, Linköping University Hospital, Linköping, Sweden. per.eriksson@lio.se
Source
J Intern Med. 2009 Apr;265(4):496-506
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Cohort Studies
Cyclophosphamide - therapeutic use
Female
Humans
Immunosuppressive Agents - therapeutic use
Incidence
Kidney Failure, Chronic - epidemiology
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Survival Analysis
Sweden - epidemiology
Vasculitis - drug therapy - mortality
Wegener Granulomatosis - drug therapy - mortality
Abstract
OBJECTIVES: Mortality rates for Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA) have decreased after the introduction of cyclophosphamide. Standardized mortality ratio (SMR) expresses the overall mortality of patients compared with the general population. The aims of this study were to compare survival in an old and a recent cohort of patients with WG and MPA using SMR and to determine predictors for death in both groups combined. DESIGN: Survival analyses were performed by Kaplan-Meier survival curves, SMR and proportional hazards regression models. SETTING: The nephrology and rheumatology clinics at Linköping University Hospital, Sweden. SUBJECTS: All patients diagnosed with WG or MPA in the catchment area during 1978-2005 were divided into two cohorts; patients diagnosed before (n=32, old cohort) and after (n=63, recent cohort) December 31, 1996. RESULTS: The two cohorts differed regarding the proportion of WG (75% vs. 56%, P=0.03) and a tendency for more pronounced kidney involvement in the old cohort: 266 micromol L(-1) (16% dialysis-dependent) vs. 192 micromol L(-1) (5% dialysis-dependent), but were comparable regarding disease severity. SMR at 1 and 5 years were 2.1 (95% CI: 0.43-6.09) and 1.6 (95% CI: 0.6-3.2) in the recent cohort and 5.2 (95% CI: 1.07-15.14) and 2.5 (95% CI: 0.93-5.52) in the old cohort. Five-year survival was 87% and 81%. Serum creatinine, age, end-stage renal disease, diagnosis before 1997 and first relapse were independent predictors for death. CONCLUSION: Patient survival in WG and MPA analysed with SMR may be better than previously believed. Severe renal disease and disease relapse were the major predictors of reduced survival.
PubMed ID
19141094 View in PubMed
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Medication persistence among patients with asthma/COPD drugs.

https://arctichealth.org/en/permalink/ahliterature93683
Source
Pharm World Sci. 2008 Oct;30(5):509-14
Publication Type
Article
Date
Oct-2008
Author
Haupt Dan
Krigsman Kristin
Nilsson J Lars G
Author Affiliation
Health Sciences, Luleå Tecnical University, 971 87 Lulea, Sweden.
Source
Pharm World Sci. 2008 Oct;30(5):509-14
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Anti-Asthmatic Agents - therapeutic use
Asthma - drug therapy
Databases, Factual
Female
Glucocorticoids - therapeutic use
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Pulmonary Disease, Chronic Obstructive - drug therapy
Sweden - epidemiology
Treatment Outcome
Young Adult
Abstract
OBJECTIVE: To determine medication possession ratio (MPR) of patients with asthma/COPD drugs. METHOD: Individual patient's volumes of asthma/COPD drugs (ATC-code R03) for 2000-2004 were obtained from a pharmacy record database. For each patient the MPR was calculated as the percentage of the treatment time that the patient had drugs available. MAIN OUTCOME MEASURE: Medication possession ratio (MPR). RESULTS: A total of 1,812 patients, 20 years and older, with dispensed asthma/COPD drugs were registered in the database, 928 patients (51%) had acquired drugs less than once per year (68% for 20-29 years old) during the 5-year study. Only 13% of the patients had steroids and steroid combinations available to allow continuous treatment. Eight percent of the patients 20-29 years old had MPR > or = 80% of all the included drugs and 5% when only steroids and steroid combinations were considered. About 25% of the patients had acquired 80% of the total volume of asthma/COPD drugs. CONCLUSION: The majority of the patients, and particularly those in the youngest age group used asthma/COPD drugs only sporadically. This may indicate undermedication which is likely to have a negative impact on patient outcome.
PubMed ID
18247154 View in PubMed
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Population-attributable risk of coronary heart disease risk factors during long-term follow-up: the Malmö Preventive Project.

https://arctichealth.org/en/permalink/ahliterature81243
Source
J Intern Med. 2006 Aug;260(2):134-41
Publication Type
Article
Date
Aug-2006
Author
Nilsson P M
Nilsson J-A
Berglund G.
Author Affiliation
Department of Clinical Sciences Medicine, University Hospital, Malmö, Sweden. peter.nilsson@med.lu.se
Source
J Intern Med. 2006 Aug;260(2):134-41
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adult
Coronary Disease - epidemiology - prevention & control
Epidemiologic Methods
Female
Health Surveys
Humans
Male
Middle Aged
Registries
Smoking - adverse effects
Sweden - epidemiology
Time Factors
Abstract
AIMS: To calculate the population-attributable risk (PAR) of coronary events (CE) from 10 risk factors, during long-term follow-up. METHODS: We used both case-cohort and case-control analyses for calculation of PAR in relation to 10 baseline risk factors. First CE (fatal or nonfatal, n=3072) in 22,444 males and 10,902 females was recorded during a mean follow-up of 20 years by use of national registers. RESULTS: Using a Cox regression analysis in a case-cohort design, smoking (prevalence in men 49%, women 37%) was the strongest risk factor, RR 2.29 (95% CI 2.09-2.52; PAR 39%), followed by hypercholesterolaemia, RR 1.70 (95% CI 1.56-1.86; PAR 18%), and diabetes, RR 1.67 (95% CI 1.41-1.99; PAR 3%). For women the strongest risk factors were smoking, RR 3.16 (95% CI 2.50-3.98; PAR 44%), diabetes, RR 2.59 (95% CI 1.78-3.76; PAR 6%), and hypertension, RR 2.47 (95% CI 1.94-3.14; PAR 23%). In men, smoking was the strongest predictor both after 10 years [RR 2.69 (95% CI 2.23-3.24)] and 20 years [RR 2.45 (95% CI 2.15-2.79)], followed by hypercholesterolaemia (RR 2.16-1.63), hypertension (RR 2.04-1.51), and diabetes (RR 1.85 -1.47). The case-control design gave very similar results. Total PAR varied from 74% (fully adjusted Cox regression, case-control, in men) to 116% in women (case-cohort). CONCLUSION: Smoking is the most important long-term risk factor for CE in both genders, based on data from a population with a high proportion of smokers. Ten measured variables explained almost all variation in risk and could be used as a basis for intervention programmes.
PubMed ID
16882277 View in PubMed
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13 records – page 1 of 2.