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Alcohol and coronary heart disease risk--is there an unknown confounder?

https://arctichealth.org/en/permalink/ahliterature173661
Source
Addiction. 2005 Aug;100(8):1150-7
Publication Type
Article
Date
Aug-2005
Author
Kari Poikolainen
Jussi Vahtera
Marianna Virtanen
Anne Linna
Mika Kivimäki
Author Affiliation
Finnish Foundation for Alcohol Studies, Helsinki, Finland. kari.poikolainen@stakes.fi
Source
Addiction. 2005 Aug;100(8):1150-7
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alcohol Drinking - adverse effects - epidemiology
Confounding Factors (Epidemiology)
Coronary Disease - epidemiology
Cross-Sectional Studies
Female
Finland - epidemiology
Humans
Life Style
Male
Middle Aged
Regression Analysis
Risk factors
Abstract
To evaluate whether confounding by several known or suspected coronary heart disease risk factors are likely to explain the lower coronary heart disease risk among light alcohol drinkers compared with never-drinkers.
A population-based cross-sectional study.
Hypertension, body mass index (BMI), diabetes, depression, sleep disturbances, smoking, physical activity, life satisfaction, psychological distress, trait anxiety, independent and dependent life events, length of working hours, job control, job strain and effort-reward imbalance were compared between never-drinkers and light drinkers (
PubMed ID
16042645 View in PubMed
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Cigarette smoking as risk factor for late fetal and early neonatal death.

https://arctichealth.org/en/permalink/ahliterature60031
Source
BMJ. 1988 Jul 23;297(6643):258-61
Publication Type
Article
Date
Jul-23-1988
Author
S. Cnattingius
B. Haglund
O. Meirik
Author Affiliation
Uppsala University Hospital, Sweden.
Source
BMJ. 1988 Jul 23;297(6643):258-61
Date
Jul-23-1988
Language
English
Publication Type
Article
Keywords
Female
Fetal Death
Humans
Infant mortality
Infant, Newborn
Maternal Age
Parity
Pregnancy
Pregnancy, Multiple
Prospective Studies
Regression Analysis
Risk factors
Smoking - adverse effects
Sweden
Abstract
Risk factors for late fetal death and early neonatal mortality were examined in a population based prospective study. Practically all Swedish births between 1983 and 1985 were included, 281,808 births in all. The overall rates of late fetal death and early neonatal mortality were 3.5 and 3.1 per 1000, respectively. About 30% of the pregnant women were recorded as being daily smokers. Logistic regression analyses showed significant relative risks for late fetal death for high maternal age (1.4), nulliparity (1.4), multiparity (greater than or equal to 2) (1.3), smoking (1.4), and multiple births (2.8). Significant relative risks for early neonatal mortality were found for multiple births (4.9) and smoking (1.2). Smokers aged under 35 faced a relative risk of late fetal death ranging from 1.1 to 1.6, while the risk for late fetal death was doubled if the mothers were aged 35 years or more and smoked. In countries like Sweden, where maternal cigarette smoking is prevalent, smoking may be the most important preventable risk factor for late fetal death.
PubMed ID
3416144 View in PubMed
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Delayed childbearing and risk of adverse perinatal outcome. A population-based study.

https://arctichealth.org/en/permalink/ahliterature59589
Source
JAMA. 1992 Aug 19;268(7):886-90
Publication Type
Article
Date
Aug-19-1992
Author
S. Cnattingius
M R Forman
H W Berendes
L. Isotalo
Author Affiliation
Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892.
Source
JAMA. 1992 Aug 19;268(7):886-90
Date
Aug-19-1992
Language
English
Publication Type
Article
Keywords
Adult
Comparative Study
Female
Fetal Death
Humans
Infant mortality
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Maternal Age
Odds Ratio
Parity
Population Surveillance
Pregnancy
Pregnancy outcome
Regression Analysis
Risk factors
Sweden
Abstract
OBJECTIVE--To investigate the effect of advancing maternal age on pregnancy outcome among healthy nulliparous women, after adjustment for demographic characteristics, smoking, history of infertility, and other medical conditions. DESIGN--A population-based cohort study was conducted with prospectively collected data from the Swedish Medical Birth Register. PATIENTS--Nulliparous Nordic women (N = 173,715), aged 20 years and above, who delivered single births at Swedish hospitals from 1983 through 1987. OUTCOME MEASURES--Late fetal and early neonatal death rates; rates of very low birth weight (VLBW, less than 1500 g), moderately low birth weight (MLBW, 1500 through 2499 g), very preterm delivery (less than or equal to 32 weeks), moderately preterm delivery (33 through 36 weeks), and small-for-gestational-age (SGA) infants (less than -2 SDs). RESULTS--Compared with women aged 20 to 24 years, women aged 30 to 34 years had significantly higher adjusted odds ratios (ORs) of late fetal deaths (OR = 1.4); VLBW (OR = 1.2); MLBW (OR = 1.4); very preterm birth (OR = 1.2); and SGA infants (OR = 1.4). Among women aged 35 to 39 years, the adjusted OR was significantly higher for VLBW (OR = 1.9); MLBW (OR = 1.7); very preterm birth (OR = 1.7); moderately preterm birth (OR = 1.2); and SGA infants (OR = 1.7). Among women 40 years old and older, the adjusted OR was significantly higher for VLBW (OR = 1.8); MLBW (OR = 2.0); very preterm birth (OR = 1.9); moderately preterm birth (OR = 1.5); and SGA infants (OR = 1.4). CONCLUSIONS--Delayed childbearing is associated with an increased risk of poor pregnancy outcomes after adjustment for maternal complications and other risk factors.
Notes
Comment In: JAMA. 1993 Feb 10;269(6):745-6; author reply 746-78423649
Comment In: JAMA. 1993 Feb 10;269(6):746; author reply 746-78423650
Comment In: JAMA. 1993 Feb 10;269(6):746; author reply 746-78423651
PubMed ID
1640617 View in PubMed
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Do psychological attributes matter for adherence to antihypertensive medication? The Finnish Public Sector Cohort Study.

https://arctichealth.org/en/permalink/ahliterature154722
Source
J Hypertens. 2008 Nov;26(11):2236-43
Publication Type
Article
Date
Nov-2008
Author
Hermann Nabi
Jussi Vahtera
Archana Singh-Manoux
Jaana Pentti
Tuula Oksanen
David Gimeno
Marko Elovainio
Marianna Virtanen
Timo Klaukka
Mika Kivimaki
Author Affiliation
Department of Epidemiology and Public Health, University College London, London, UK. H.Nabi@public-health.ucl.ac.uk
Source
J Hypertens. 2008 Nov;26(11):2236-43
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Adult
Antihypertensive Agents - therapeutic use
Comorbidity
Female
Finland
Humans
Hypertension - drug therapy - psychology
Male
Middle Aged
Odds Ratio
Patient Compliance - psychology - statistics & numerical data
Prospective Studies
Regression Analysis
Treatment Refusal - psychology - statistics & numerical data
Abstract
Psychological factors may be important determinants of adherence to antihypertensive medication, as they have been repeatedly found to be associated with an increased risk of hypertension, coronary heart disease, and health-damaging behaviours. We examined the importance of several psychological attributes (sense of coherence, optimism, pessimism, hostility, anxiety) with regard to antihypertensive medication adherence assessed by pharmacy refill records.
A total of 1021 hypertensive participants, aged 26-63 years, who were employees in eight towns and 12 hospitals in Finland were included in the analyses.
We found 60% of patients to be totally adherent, 36% partially adherent, and 4% totally nonadherent. Multinomial regression analyses revealed high sense of coherence to be associated with lower odds of being totally nonadherent in contrast of being totally adherent (odds ratio=0.55; 95% confidence interval: 0.31-0.96). This association was independent of factors that influenced adherence to antihypertensive medication, such as sociodemographic characteristics, health-related behaviours, self-reported medical history of doctor-diagnosed comorbidity, and anteriority of hypertension status. The association was not specific to certain types of antihypertensive drugs.
High sense of coherence may influence antihypertensive medication-adherence behaviour. Aspects characterizing this psychological attribute, such as knowledge (comprehensibility), capacity (manageability), and motivation (meaningfulness) may be important determinants of adherence behaviour for asymptomatic illnesses, such as hypertension, in which patients often do not feel or perceive the immediate consequences of skipping medication doses.
Notes
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PubMed ID
18854766 View in PubMed
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Effect of age, parity, and smoking on pregnancy outcome: a population-based study.

https://arctichealth.org/en/permalink/ahliterature59544
Source
Am J Obstet Gynecol. 1993 Jan;168(1 Pt 1):16-21
Publication Type
Article
Date
Jan-1993
Author
S. Cnattingius
M R Forman
H W Berendes
B I Graubard
L. Isotalo
Author Affiliation
Division of Epidemiology, Statistics and Preventive Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892.
Source
Am J Obstet Gynecol. 1993 Jan;168(1 Pt 1):16-21
Date
Jan-1993
Language
English
Publication Type
Article
Keywords
Adult
Female
Humans
Infant mortality
Infant, Low Birth Weight
Infant, Newborn
Infant, Small for Gestational Age
Maternal Age
Odds Ratio
Parity - physiology
Pregnancy
Pregnancy outcome
Regression Analysis
Smoking - adverse effects
Sweden
Abstract
OBJECTIVES: The purpose of our study was to investigate the combined interactive effects of maternal age, parity, and smoking on pregnancy outcome. STUDY DESIGN: This was a population-based Swedish study (n = 538,829). RESULTS: Multiple logistic regression analysis showed that the smoking-related effect on the relative increase in the odds ratio of low birth weight and preterm delivery was significantly greater among multiparous patients than nulliparous; among multiparas, smoking increased the odds ratios for low birth weight and preterm delivery by 2.4 and 1.6; the corresponding relative increases in the odds ratios among nulliparas were 1.7 and 1.1, respectively. With advancing maternal age there was a smoking-related relative increase in the odds ratios for small-for-gestational-age births. Moreover, the age effect on the relative increase of low birth weight, preterm delivery, and small-for-gestational-age births was greater among nulliparas than multiparas. CONCLUSIONS: Older smokers are at an especially high risk for small-for-gestational-age births, and parous smokers are at an especially high risk for low birth weight and preterm delivery.
PubMed ID
8420320 View in PubMed
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Effects of maternal age, parity, and smoking on the risk of stillbirth.

https://arctichealth.org/en/permalink/ahliterature48467
Source
Br J Obstet Gynaecol. 1994 Apr;101(4):301-6
Publication Type
Article
Date
Apr-1994
Author
E G Raymond
S. Cnattingius
J L Kiely
Author Affiliation
Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland.
Source
Br J Obstet Gynaecol. 1994 Apr;101(4):301-6
Date
Apr-1994
Language
English
Publication Type
Article
Keywords
Abortion, Spontaneous - epidemiology - etiology
Adult
Cohort Studies
Female
Fetal Death - epidemiology - etiology
Fetal Growth Retardation - etiology
Gestational Age
Humans
Maternal Age
Odds Ratio
Parity
Population Surveillance
Pregnancy
Pregnancy, High-Risk
Regression Analysis
Risk factors
Smoking - adverse effects
Sweden - epidemiology
Abstract
OBJECTIVE: To examine the effects of advanced maternal age, nulliparity, and smoking on risk of stillbirth as gestation advances, and to explore possible clinical mediators of these effects. DESIGN: A population based cohort study. SETTING: Sweden, 1983 to 1989. SUBJECTS: All singleton pregnancies of 28 weeks gestation or greater in Nordic citizens at least 20 years old (n = 638,242). MAIN OUTCOME MEASURES: Crude and adjusted risks of stillbirth; gestational age specific risks of stillbirth. RESULTS: Older women (35 years or older), smokers, and nulliparas had elevated risks of stillbirth. The elevated stillbirth risk in smokers was eliminated when women with intrauterine growth retardation, placental abruption, and placenta previa were excluded from the analysis. However, the higher risks in older women and nulliparas persisted even when the analysis excluded women with hypertension, diabetes, placental complications, or growth retardation. Over the course of the third trimester, the age related risk of stillbirth increased, the smoking related risk decreased, and the higher risk in nulliparas showed no clear trend with gestational age. CONCLUSIONS: The association between smoking and stillbirth is explained entirely by the higher incidence of growth retardation and placental complications in smokers. The clinical mediators of the associations of maternal age and parity with stillbirth remain unexplained. Gestational age is an important modifier of the effects of advanced maternal age and smoking on stillbirth risk.
PubMed ID
8199075 View in PubMed
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Factors associated with birth weight in Sweden: the study of men born in 1913.

https://arctichealth.org/en/permalink/ahliterature64364
Source
J Epidemiol Community Health. 1997 Feb;51(1):19-23
Publication Type
Article
Date
Feb-1997
Author
M. Eriksson
S. Cnattingius
K. Svärdsudd
G. Tibblin
Author Affiliation
University of Uppsala, Clinical Epidemiology Unit, Department of Family Medicine, Sweden.
Source
J Epidemiol Community Health. 1997 Feb;51(1):19-23
Date
Feb-1997
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Birth weight
Cohort Studies
Female
Gestational Age
Humans
Male
Maternal Age
Parity
Pregnancy
Pregnancy Complications
Proteinuria
Regression Analysis
Research Support, Non-U.S. Gov't
Retrospective Studies
Rural Health
Socioeconomic Factors
Sweden
Urban health
Abstract
STUDY OBJECTIVE: To analyse factors associated with birth weight and to evaluate the validity of obstetrical data. DESIGN: Obstetrical data were retrieved for singleton men born in 1913 and living in Gothenburg, Sweden in 1963. Information on birth weight, maternal age, marital status, parity, social class, proteinuria, gestational age, and place of birth (home or hospital) was obtained from these birth records. SETTING: Sweden. PARTICIPANTS: Fifty year old men living in Gothenburg, Sweden, in 1963. MAIN RESULTS: Obstetrical records were obtained for 524 men (65%). Place of birth, gestational age, maternal age, parity, proteinuria, and marital status were all significantly correlated to birth weight. In multivariate analyses, place of birth, gestational age, parity, and proteinuria influenced birth weight. There was a substantial difference in mean birth weight between hospital deliveries (3352 g) and home deliveries (3817 g), which could be explained only partly by sociodemographic variables. Birth weight increased with parity and gestational age in home delivered babies as well as those delivered in a hospital. CONCLUSIONS: The validity of obstetrical records from 1913 was good. The place of birth (home or hospital) is strongly associated with birth weight and may be a confounding factor in studies of the implications of birth weight for future risk of disease or death.
PubMed ID
9135783 View in PubMed
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Labor market trajectories and health: a four-year follow-up study of initially fixed-term employees.

https://arctichealth.org/en/permalink/ahliterature175178
Source
Am J Epidemiol. 2005 May 1;161(9):840-6
Publication Type
Article
Date
May-1-2005
Author
Pekka Virtanen
Jussi Vahtera
Mika Kivimäki
Virpi Liukkonen
Marianna Virtanen
Jane Ferrie
Author Affiliation
Medical School, University of Tampere, FN-33014 Tampere, Finland. pekka.virtanen@uta.fi
Source
Am J Epidemiol. 2005 May 1;161(9):840-6
Date
May-1-2005
Language
English
Publication Type
Article
Keywords
Adult
Career Mobility
Confidence Intervals
Employment - classification - psychology - trends
Female
Finland
Health status
Humans
Marital status
Occupations
Prospective Studies
Regression Analysis
Stress, Psychological
Abstract
With the growth of atypical employment, there is increasing concern about the potential health-damaging effects of unstable employment. This prospective study of Finnish public-sector employees in 1998-2002 examined labor market trajectories and changes in health. At entry, all participants had a fixed-term job contract. Trajectories were measured by exposure to unstable employment during follow-up, destination employment status at the end of follow-up, and the way in which these elements were combined. Nonoptimal self-rated health at baseline was associated with high exposure to unstable employment and unemployment as the destination. After adjustment for health and psychological distress at baseline, a trajectory with stable employment as the destination was associated with a decreased risk of psychological distress at follow-up (odds ratio = 0.68, 95% confidence interval: 0.46, 0.98), whereas a trajectory toward the labor market periphery was related to increased risk of nonoptimal health (odds ratio = 2.54, 95% confidence interval: 1.47, 4.39) when compared with remaining in fixed-term employment. A significant dose-response relation was seen between the measure combining exposure to instability with destination employment status and nonoptimal health. This longitudinal study provides evidence of health-related selection into employment trajectories and suggests that the trajectories themselves carry different health risks.
PubMed ID
15840616 View in PubMed
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Living alone and antidepressant medication use: a prospective study in a working-age population.

https://arctichealth.org/en/permalink/ahliterature125884
Source
BMC Public Health. 2012;12:236
Publication Type
Article
Date
2012
Author
Laura Pulkki-Råback
Mika Kivimäki
Kirsi Ahola
Kaisla Joutsenniemi
Marko Elovainio
Helena Rossi
Sampsa Puttonen
Seppo Koskinen
Erkki Isometsä
Jouko Lönnqvist
Marianna Virtanen
Author Affiliation
Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland. laura.pulkki-raback@helsinki.fi
Source
BMC Public Health. 2012;12:236
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Antidepressive Agents - therapeutic use
Cluster analysis
Drug Utilization
Educational Status
Employment - psychology
Female
Finland
Follow-Up Studies
Health Behavior
Humans
Male
Marital status
Middle Aged
Prospective Studies
Psychosocial Deprivation
Questionnaires
Regression Analysis
Residence Characteristics - statistics & numerical data
Socioeconomic Factors
Abstract
An increasing proportion of the population lives in one-person households. The authors examined whether living alone predicts the use of antidepressant medication and whether socioeconomic, psychosocial, or behavioral factors explain this association.
The participants were a nationally representative sample of working-age Finns from the Health 2000 Study, totaling 1695 men and 1776 women with a mean age of 44.6 years. In the baseline survey in 2000, living arrangements (living alone vs. not) and potential explanatory factors, including psychosocial factors (social support, work climate, hostility), sociodemographic factors (occupational grade, education, income, unemployment, urbanicity, rental living, housing conditions), and health behaviors (smoking, alcohol use, physical activity, obesity), were measured. Antidepressant medication use was followed up from 2000 to 2008 through linkage to national prescription registers.
Participants living alone had a 1.81-fold (CI = 1.46-2.23) higher purchase rate of antidepressants during the follow-up period than those who did not live alone. Adjustment for sociodemographic factors attenuated this association by 21% (adjusted OR = 1.64, CI = 1.32-2.05). The corresponding attenuation was 12% after adjustment for psychosocial factors (adjusted OR = 1.71, CI = 1.38-2.11) and 9% after adjustment for health behaviors (adjusted OR = 1.74, CI = 1.41-2.14). Gender-stratified analyses showed that in women the greatest attenuation was related to sociodemographic factors and in men to psychosocial factors.
These data suggest that people living alone may be at increased risk of developing mental health problems. The public health value is in recognizing that people who live alone are more likely to have material and psychosocial problems that may contribute to excess mental health problems in this population group.
Notes
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PubMed ID
22443226 View in PubMed
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Maternal age modifies the effect of maternal smoking on intrauterine growth retardation but not on late fetal death and placental abruption.

https://arctichealth.org/en/permalink/ahliterature64361
Source
Am J Epidemiol. 1997 Feb 15;145(4):319-23
Publication Type
Article
Date
Feb-15-1997
Author
S. Cnattingius
Author Affiliation
Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden.
Source
Am J Epidemiol. 1997 Feb 15;145(4):319-23
Date
Feb-15-1997
Language
English
Publication Type
Article
Keywords
Abruptio Placentae - etiology
Adolescent
Adult
Age Factors
Birth Certificates
Case-Control Studies
Female
Fetal Death - etiology
Fetal Growth Retardation - etiology
Humans
Maternal Age
Pregnancy
Pregnancy Complications
Registries
Regression Analysis
Smoking - adverse effects
Sweden
Abstract
To investigate whether the effect modification of smoking by maternal age previously reported for small for gestational age births was also obtained for late fetal death and placental abruption, the author analyzed single births in Sweden (n = 1,057,711) from 1983 to 1992. An effect modification of smoking by maternal age was obtained only with regard to fetal growth: Compared with nonsmokers aged 40-44 years, the risk of small for gestational age births among women smoking at east 10 cigarettes per day in the same age group was 4.5, whereas the corresponding risk increase among teenagers was only 2.0. The present results support the hypothesis that smoking actually influences fetal growth more among older smokers.
PubMed ID
9054235 View in PubMed
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22 records – page 1 of 3.