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Body composition and body fat distribution in relation to later risk of acute myocardial infarction: a Danish follow-up study.

https://arctichealth.org/en/permalink/ahliterature137399
Source
Int J Obes (Lond). 2011 Nov;35(11):1433-41
Publication Type
Article
Date
Nov-2011
Author
J G Stegger
E B Schmidt
T. Obel
T L Berentzen
A. Tjønneland
T I A Sørensen
K. Overvad
Author Affiliation
Department of Cardiology, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. Jakob.Stegger@rn.dk
Source
Int J Obes (Lond). 2011 Nov;35(11):1433-41
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Body Composition
Body Fat Distribution
Body mass index
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology - etiology - physiopathology
Obesity - complications - epidemiology - physiopathology
Predictive value of tests
Proportional Hazards Models
Prospective Studies
Questionnaires
Risk factors
Abstract
Obesity is a modifiable risk factor for acute myocardial infarction (MI), but lean body mass (LBM) may also be an important factor. Low LBM may increase the risk of MI and LBM may modify the effect of obesity on MI. Thus, the inability of the classical anthropometric measures to evaluate LBM may lead to misclassification of MI risk in both lean and obese persons. We investigated the associations between incident MI and bioelectrical impedance analyses (BIA) derived measures of body composition in combination with body mass index (BMI) and anthropometric measures of body fat distribution.
From 1993 to 1997, 27?148 men and 29?863 women, aged 50 to 64 year, were recruited into the Danish prospective study Diet, Cancer and Health. During 11.9 years of follow-up we identified 2028 cases of incident MI (1487 men and 541 women). BMI, waist circumference (WC), hip circumference and BIA of body composition including body fat mass (BFM), body fat percentage and LBM were measured at baseline. We used Cox proportional hazard models with age as time axis and performed extensive control for confounding. Weight, BMI, classical estimates of abdominal obesity and BIA estimates of obesity showed significant positive associations with incident MI. However, BFM adjusted for WC showed no association. Low LBM was associated with a higher risk of incident MI in both genders, and high LBM was associated with a higher risk in men.
Obesity was positively associated with MI. Estimates of obesity achieved by BIA seemed not to add additional information to classical anthropometric measures regarding MI risk. Both high and low LBM may be positively associated with MI.
PubMed ID
21285940 View in PubMed
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Control of blood pressure and risk of first acute myocardial infarction: Skaraborg hypertension project.

https://arctichealth.org/en/permalink/ahliterature54916
Source
BMJ. 1994 Mar 12;308(6930):681-6
Publication Type
Article
Date
Mar-12-1994
Author
U. Lindblad
L. Råstam
L. Rydén
J. Ranstam
S O Isacsson
G. Berglund
Author Affiliation
Department of Community Health Sciences, Lund University, Malmö, Sweden.
Source
BMJ. 1994 Mar 12;308(6930):681-6
Date
Mar-12-1994
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Pressure - physiology
Diastole
Electrocardiography
Female
Humans
Hypertension - complications - epidemiology - physiopathology
Longitudinal Studies
Male
Middle Aged
Myocardial Infarction - epidemiology - etiology - physiopathology
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Systole
Abstract
OBJECTIVE--To analyse the relation between treated blood pressure and concomitant risk factor and morbidity from acute myocardial infarction. DESIGN--Prospective longitudinal study. Treated blood pressures and other variables were used to predict acute myocardial infarction. SETTING--Primary health care in Skaraborg, Sweden. SUBJECTS--1121 men and 1453 women aged 40-69 years at registration at outpatient clinics, 1977-81, with no evidence of previous myocardial infarction were followed up for an average of 7.4 years. Subjects were undergoing treatment with drugs to lower blood pressure or had blood pressure that exceeded the systolic or diastolic limits, or both, for diagnosis (> 170/> 105 mm Hg (patients aged 40-60 years) and > 180/> 110 mm Hg (older than 60 years)) on three different occasions, or both. MAIN OUTCOME MEASURES--First validated event of fatal or non-fatal acute myocardial infarction. RESULTS--In men but not in women there was a negative relation between treated diastolic blood pressure and risk of acute myocardial infarction. Left ventricular hypertrophy and smoking were contributory risk factors in both sexes, as was serum cholesterol concentration in men. In men with normal electrocardiograms (n = 345) risk increased with increasing diastolic blood pressure (P = 0.047), whereas the opposite was found in men with electrocardiograms suggesting ischaemia or hypertrophy, or both (n = 499, P = 0.009). In those with a reading of 95-99 mm Hg the relative risk was 0.30 (P = 0.034); at > or = 100 mm Hg it was 0.37 (P = 0.027). No similar relations were seen in women or for systolic blood pressure. CONCLUSION--It may be hazardous to lower diastolic blood pressure below 95 mm Hg in hypertensive men with possible ischaemia or hypertrophy, or both. Electrocardiographic findings should be considered when treatment goals are decided for men with hypertension.
Notes
Comment In: BMJ. 1994 May 14;308(6939):1301-28205034
Comment In: BMJ. 1994 May 14;308(6939):13028054030
PubMed ID
8142790 View in PubMed
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The role of cold in ischaemic heart disease: a review.

https://arctichealth.org/en/permalink/ahliterature226378
Source
Public Health. 1991 May;105(3):205-15
Publication Type
Article
Date
May-1991
Author
E L Lloyd
Author Affiliation
Department of Anaesthetics, Princess Margaret Rose Hospital, Fairmilehead, Edinburgh.
Source
Public Health. 1991 May;105(3):205-15
Date
May-1991
Language
English
Publication Type
Article
Keywords
Blood Pressure - physiology
Cholesterol - blood
Cold Temperature - adverse effects
Coronary Disease - epidemiology - etiology - physiopathology
Finland - epidemiology
Great Britain - epidemiology
Humans
Italy - epidemiology
Myocardial Infarction - epidemiology - etiology - physiopathology
Rain
Risk factors
Smoking - adverse effects
Wind
Abstract
A review of the literature suggests that the geographical and social class distribution of ischaemic heart disease (IHD) could be partly explained by variations in degrees of cold exposure, which includes wind and rain as well as temperature, with frequent exposure to cold being more harmful than steady exposure. Blood pressure (BP) and serum cholesterol are raised in response to acute and chronic exposure to cold. Smoking and cold produce similar physiological changes which increase the risk of IHD, while regular exercise blunts the physiological effects of cold and other stresses. There are many acute responses to cold which could trigger a myocardial infarction (MI) and therefore cold is probably a major precipitating factor in many cases of MI. Public health measures to improve domestic housing and the working environment may produce a significant impact on the incidence of IHD.
PubMed ID
2062993 View in PubMed
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Smoking in relation to ST-segment elevation acute myocardial infarction: findings from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions.

https://arctichealth.org/en/permalink/ahliterature88902
Source
Heart. 2009 Jun;95(12):1006-11
Publication Type
Article
Date
Jun-2009
Author
Björck L.
Rosengren A.
Wallentin L.
Stenestrand U.
Author Affiliation
Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy University of Gothenburg, Göteborg, Sweden. lena.m.bjorck@vgregion.se
Source
Heart. 2009 Jun;95(12):1006-11
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Electrocardiography
Epidemiologic Methods
Female
Humans
Intensive Care - statistics & numerical data
Male
Middle Aged
Myocardial Infarction - epidemiology - etiology - physiopathology
Sex Distribution
Smoking - adverse effects - epidemiology
Sweden - epidemiology
Abstract
OBJECTIVES: In the past few decades, clinical presentation in AMI has been reported to be changing, with milder cases and less ST-elevation myocardial infarction, the most serious form of AMI. The better outcome may be due to improved medical and interventional management, as well as more sensitive methods for detecting AMI. However, changes in risk factors have also been documented, especially lower tobacco-smoking rates. Therefore, the relation between smoking and ST-elevation AMI in a large observational cohort was analysed. METHODS: Data were derived from 93 416 consecutive patients aged 25 to 84 years and admitted to hospital between 1996 and 2004 with a first AMI. RESULTS: Tobacco smoking was more prevalent in younger patients (ie, or =65 years), the corresponding ORs were 1.33 (99% CI 1.20 to 1.48) and 1.14 (99% CI 1.04 to 1.25), respectively. CONCLUSION: Tobacco smoking is a major determinant for presenting with STEMI compared with non-STEMI, particularly among younger patients and among women. These results indicate that smoking is one of the major risk factors for presenting with more severe AMIs.
PubMed ID
19478111 View in PubMed
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