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Maris L, Ghitea TC. Can Cardiometabolic Risk Be Reduced in the Elderly? Comprehensive Epidemiological Study. Geriatrics (Basel) 2023; 8:73. [PMID: 37489321 PMCID: PMC10366737 DOI: 10.3390/geriatrics8040073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/16/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023] Open
Abstract
Through these epidemiological studies, which are based on statistical and observational calculations, without visual appeal, we tracked the incidence of public health problems. In this study, our research objective was to determine and evaluate the health patterns present in a population, along with identifying the factors that contribute to the risks or provide protection against specific diseases or conditions. The progression of cardiometabolic diseases is closely linked to various chronic conditions, such as diabetes, hypertension, dyslipidemia, and chronic kidney disease. This research study involved 578 patients, who were divided into six-year cohorts ranging from 2017 to 2022. The study examined parameters related to cardiometabolic diseases, including alcoholic hepatopathies, non-alcoholic hepatopathy, chronic kidney disease, hypertension, myocardial infarction, other forms of chronic coronary syndrome, peripheral vascular disease, microvascular diseases, macrovascular diseases, and hypercholesterolemia, while considering age and physical activity levels. The study concluded that individuals in the age group of 41-50 years exhibited the highest propensity for cardiometabolic damage. Additionally, the promotion of a healthy and active lifestyle is increasingly gaining traction among elderly patients.
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Affiliation(s)
- Lavinia Maris
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania
| | - Timea Claudia Ghitea
- Faculty of Medicine and Pharmacy, Medicine Department, University of Oradea, 410068 Oradea, Romania
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Persson CU, Collén AC, Rosengren A, Mandalenakis Z, Zverkova Sandström T, Fu M, Dellborg M, Johansson S, Hansson PO. Secular trends in cardiovascular risk factors among women aged 45-54 years in Gothenburg, Sweden, from 1980 to 2014. BMC Public Health 2020; 20:1042. [PMID: 32611406 PMCID: PMC7329532 DOI: 10.1186/s12889-020-09098-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/12/2020] [Indexed: 11/20/2022] Open
Abstract
Background A declining trend in mean cholesterol levels and smoking has been observed in high-income western countries during the last few decades, whereas obesity rates have increased. Simultaneously, mortality from coronary heart disease has decreased. The aim of the present study was to determine whether the trends in cardiovascular risk factors have continued in successive cohorts of middle-aged women over a period of 34 years. Methods Six population-based, cross-sectional samples of women (n = 2294) mean age: 49.8 years (range: 45–54), living in Gothenburg, Sweden, were investigated between 1980 and 2014. Results Body mass index (BMI) increased over time, with a mean BMI of 24.7 kg/m2 in 1980 to 25.7 kg/m2 in 2013–2014, corresponding to a weight gain of 4.5 kg, together with an increase in the proportion of obese individuals (BMI ≥ 30 kg/m2) from 10.4 to 16.6% (p = 0.0012). The proportion of smokers and women with hypertension decreased from 34.5 to 12.8% (p = 0.0006) and from 37.7 to 24.5% (p < 0.0001) respectively. Mean total serum cholesterol levels decreased from 6.23 (SD 1.09) mmol/L in 1980 to 5.43 (SD 0.98) mmol/L in 2013–2014 (p < 0.0001). Self-reported leisure time regular exercise increased from 7.8% in 1980 to 35.6% in 2013–2014 (p < 0.0001). For women born in 1963, the prevalence ratio of not having any of five major cardiovascular risk factors was 1.82 (95% confidence interval (CI) 1.38–2.41), compared with women born in 1925–1934. Conclusion The trend towards increasing obesity, more leisure-time physical activity and less smoking remains, while the decrease in serum cholesterol appears to have abated.
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Affiliation(s)
- Carina U Persson
- Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Region Västra Götaland, Department of Physiotherapy, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
| | - Anna-Clara Collén
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine Geriatric and Emergency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine Geriatric and Emergency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Zacharias Mandalenakis
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine Geriatric and Emergency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tatiana Zverkova Sandström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine Geriatric and Emergency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Michael Fu
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine Geriatric and Emergency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mikael Dellborg
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine Geriatric and Emergency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Saga Johansson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Per-Olof Hansson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine Geriatric and Emergency, Sahlgrenska University Hospital, Gothenburg, Sweden
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Bu S, Ruan D, Yang Z, Xing X, Zhao W, Wang N, Xie L, Yang W. Sex-Specific Prevalence of Diabetes and Cardiovascular Risk Factors in the Middle-Aged Population of China: A Subgroup Analysis of the 2007-2008 China National Diabetes and Metabolic Disorders Study. PLoS One 2015; 10:e0139039. [PMID: 26406982 PMCID: PMC4583471 DOI: 10.1371/journal.pone.0139039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/07/2015] [Indexed: 01/19/2023] Open
Abstract
The sex difference in the prevalence rates of diabetes and cardiovascular diseases (CVDs) among the middle-aged population in China remain largely unknown. Therefore, we analyzed differences in the prevalence of diabetes, self-reported CVDs, and some CVD risk factors among men and women in the middle-aged population (30-49 years) and in individuals aged 50 years and older using data from the China National Diabetes and Metabolic Disorders Study of 2007-2008. Middle-aged men appeared to have significantly a higher prevalence of diabetes and self-reported CVDs than middle-aged women (8.07% vs 5.06% for diabetes, P < 0.001; 0.64% vs 0.22% for CVDs, P < 0.001). Men also showed higher rates of central obesity, hypertension, and dyslipidemia than women (all P < 0.01). Compared with women, men were more likely to drink alcohol and smoke cigarettes but less likely to be under diet control. The sex-specific differences in prediabetes, CVD, and CVD risk factors between men and women were diminished or even reversed in the population aged 50 years and older. No sex-specific differences were found in the prevalences of a family history of diabetes, coronary heart disease, and hypertension (P > 0.05) in middle-aged population. Specific strategies to reduce modifiable risk factors for the prevention and control of diabetes and CVD may be warranted in this population.
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Affiliation(s)
- Shi Bu
- Department of Endocrinology, China–Japan Friendship Hospital, Beijing 100029, PR China
| | - Danjie Ruan
- Department of Endocrinology, the 1 Hospital of Huairou District, Beijing 101400, PR China
| | - Zhaojun Yang
- Department of Endocrinology, China–Japan Friendship Hospital, Beijing 100029, PR China
| | - Xiaoyan Xing
- Department of Endocrinology, China–Japan Friendship Hospital, Beijing 100029, PR China
| | - Wenhui Zhao
- Department of Endocrinology, China–Japan Friendship Hospital, Beijing 100029, PR China
| | - Na Wang
- Department of Endocrinology, China–Japan Friendship Hospital, Beijing 100029, PR China
| | - Lingding Xie
- Department of Endocrinology, China–Japan Friendship Hospital, Beijing 100029, PR China
| | - Wenying Yang
- Department of Endocrinology, China–Japan Friendship Hospital, Beijing 100029, PR China
- * E-mail:
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Ekblom Ö, Ekblom-Bak E, Rosengren A, Hallsten M, Bergström G, Börjesson M. Cardiorespiratory Fitness, Sedentary Behaviour and Physical Activity Are Independently Associated with the Metabolic Syndrome, Results from the SCAPIS Pilot Study. PLoS One 2015; 10:e0131586. [PMID: 26120842 PMCID: PMC4486454 DOI: 10.1371/journal.pone.0131586] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 06/02/2015] [Indexed: 12/23/2022] Open
Abstract
Background Previous studies on the relation between lifestyle and the metabolic syndrome lack one or several aspects of the physical activity pattern in the analyses or cardiorespiratory fitness. Likewise, both uni- and triaxial accelerometry have been used, though, the predictive validity of these two modes has not been compared. Objectives The aims of the present study were firstly to investigate the independent relation between cardiorespiratory fitness and physical activity pattern to the metabolic syndrome (MetS) and secondly to examine the predictive validity of uni- and triaxial accelerometry, respectively. Methods Data was extracted from the SCAPIS pilot study (n=930, mean age 57.7 yrs). Physical activity pattern was assessed by accelerometry. Cardiorespiratory fitness was estimated using cycle ergometry. MetS was defined per the Adult Treatment Panel III from the National Cholesterol Education Program definition. Results Time spent sedentary (OR: 2.38, 95% CI: 1.54-4.24 for T3 vs T1), in light intensity (OR: 0.50, 95% CI: 0.28-0.90) and in moderate-to-vigorous activity (OR: 0.33, 95% CI: 0.18-0.61), as well as cardiorespiratory fitness (OR: 0.24, 95% CI:0.12-0.48), were all independently related to the prevalence of MetS after adjustment for potential confounders, fitness and/or the other aspects of the physical activity pattern. In addition, we found that triaxial analyses were more discriminant, with ORs farther away from the reference group and additional significant ORs. Conclusion The finding that several aspects of the physical activity pattern reveal independent relations to the MetS makes new possible targets for behaviour change of interest, focusing on both exercise and everyday life. When assessing the risk status of a patient, it is advised that triaxial accelerometry is used.
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Affiliation(s)
- Örjan Ekblom
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- * E-mail:
| | - Elin Ekblom-Bak
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mattias Hallsten
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Centre for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Centre for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mats Börjesson
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Karolinska University Hospital, Stockholm, Sweden
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Persson LG, Lingfors H, Nilsson M, Mölstad S. Lifestyle, Biological Risk Markers, Morbidity and Mortality in a Cohort of Men 33 - 42 Years Old at Baseline, after 24-Year Follow-Up of a Primary Health Care Intervention. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojpm.2015.53011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
OBJECTIVE To analyse whether poor breakfast habits in adolescence predict the metabolic syndrome and its components in adulthood. Previous studies suggest that regular breakfast consumption improves metabolic parameters. DESIGN Prospective. Breakfast habits and other lifestyle variables at age 16 years were assessed from questionnaires. Poor breakfast habits were defined as skipping breakfast or only drinking or eating something sweet. At age 43 years, the effective sample consisted of 889 participants defined as having the metabolic syndrome or not, using the International Diabetes Federation criteria. Logistic regression was used to calculate odds ratios and confidence intervals. SETTING The Northern Swedish Cohort, a longitudinal population-based cohort with 27-year follow-up. SUBJECTS Adolescents (age 16 years). RESULTS Prevalence of the metabolic syndrome at age 43 years was 27·0 %. Of the participants, 9·9 % were classified with poor breakfast habits at age 16 years. Adjusted odds for the metabolic syndrome at age 43 years was OR = 1·68 (95 % CI 1·01, 2·78) for those with poor breakfast habits at age 16 years compared with breakfast eaters. Looking at the metabolic syndrome components, poor breakfast habits at age 16 years were associated with central obesity (OR = 1·71; 95 % CI 1·00, 2·92) and high fasting glucose (OR = 1·75; 95 % CI 1·01, 3·02) at age 43 years, even after multivariate adjustments. CONCLUSIONS Poor breakfast habits in adolescence predicted the metabolic syndrome in adulthood. Of the metabolic syndrome components, poor breakfast habits in adolescence predicted central obesity and high fasting glucose in adulthood. Further research is needed to fully understand the relationship between early breakfast habits and adult metabolic syndrome.
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Saha S, Carlsson KS, Gerdtham UG, Eriksson MK, Hagberg L, Eliasson M, Johansson P. Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study. PLoS One 2013; 8:e80672. [PMID: 24244703 PMCID: PMC3828270 DOI: 10.1371/journal.pone.0080672] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 10/07/2013] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Lifestyle interventions affect patients' risk factors for metabolic syndrome (MeSy), a pre-stage to cardiovascular diseases, diabetes and related complications. An effective lifestyle intervention is the Swedish Björknäs intervention, a 3-year randomized controlled trial in primary care for MeSy patients. To include future disease-related cost and health consequences in a cost-effectiveness analysis, a simulation model was used to estimate the short-term (3-year) and long-term (lifelong) cost-effectiveness of the Björknäs study. METHODOLOGY/ PRINCIPAL FINDINGS A Markov micro-simulation model was used to predict the cost and quality-adjusted life years (QALYs) for MeSy-related diseases based on ten risk factors. Model inputs were levels of individual risk factors at baseline and at the third year. The model estimated short-term and long-term costs and QALYs for the intervention and control groups. The cost-effectiveness of the intervention was assessed using differences-in-differences approach to compare the changes between the groups in the health care and societal perspectives, using a 3% discount rate. A 95% confidence interval (CI), based on bootstrapping, and sensitivity analyses describe the uncertainty in the estimates. In the short-term, costs are predicted to increase over time in both groups, but less in the intervention group, resulting in an average cost saving/reduction of US$-700 (in 2012, US$1=six point five seven SEK) and US$-500, in the societal and health care perspectives. The long-term estimate also predicts increased costs, but considerably less in the intervention group: US$-7,300 (95% CI: US$-19,700 to US$-1,000) in the societal, and US$-1,500 (95% CI: US$-5,400 to US$2,650) in the health care perspective. As intervention costs were US$211 per participant, the intervention would result in cost saving. Furthermore, in the long-term an estimated 0.46 QALYs (95% CI: 0.12 to 0.69) per participant would be gained. CONCLUSIONS/ SIGNIFICANCE The Swedish Björknäs study appears to reduce demands on societal and health care resources and increase health-related quality of life.
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Affiliation(s)
- Sanjib Saha
- Centre for Primary Healthcare Research, Skåne University Hospital, Malmö, Lund University/Region Skåne, Malmö, Sweden
- Health Economics and Management, Institute of Economic Research, Lund University, Lund, Sweden
| | - Katarina Steen Carlsson
- Centre for Primary Healthcare Research, Skåne University Hospital, Malmö, Lund University/Region Skåne, Malmö, Sweden
| | - Ulf-G Gerdtham
- Centre for Primary Healthcare Research, Skåne University Hospital, Malmö, Lund University/Region Skåne, Malmö, Sweden
- Health Economics and Management, Institute of Economic Research, Lund University, Lund, Sweden
- Economics Department, Lund University, Lund, Sweden
| | - Margareta K. Eriksson
- Department of Public Health and Department of Research, Norrbotten County Council, Luleå, Sweden
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Lars Hagberg
- Centre for Healthcare Science, Örebro County Council and Örebro University, Örebro, Sweden
| | - Mats Eliasson
- Department of Public Health and Clinical Medicine, Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Pia Johansson
- Centre for Health Economics, Informatics and Healthcare Research, Stockholm County Council, Stockholm, Sweden
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Nilsson A, Tovar J, Johansson M, Radeborg K, Björck I. A diet based on multiple functional concepts improves cognitive performance in healthy subjects. Nutr Metab (Lond) 2013; 10:49. [PMID: 23855966 PMCID: PMC3720285 DOI: 10.1186/1743-7075-10-49] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 07/11/2013] [Indexed: 01/01/2023] Open
Abstract
Background Disorders such as the metabolic syndrome (MetS), impaired glucose tolerance and diabetes, are associated with increased risk of cognitive decline. Also several of the individual key features that define the MetS, e.g. hypertension, impaired glucose regulation, dyslipidemia, obesity, and inflammation, are related to an increased risk of cognitive decline. Consequently, a diet that prevents metabolic disorders might be expected to prevent cognitive decline. The purpose of the present study was to, in overweight but otherwise healthy subjects, investigate effects on cognitive functions of a dietary regime combining multiple functional concepts potentially beneficial to risk markers associated with MetS. The purpose was in addition to evaluate cognitive performance in relation to results on cardiometabolic risk variables (BMI, blood pressure, glucose, insulin, cholesterol, triglycerides, free fatty acids, lipoprotein A-1 and B, hs-CRP, HbA1c, interleukin-6, TNF-α, and PAI-1). Methods Fourty-four healthy women and men (50–73 years, BMI 25–33, fasting glycemia ≤ 6.1 mmol/L) participated in a randomized, controlled crossover intervention, comparing a multifunctional diet (active diet (AD)) including foods with a potential anti-inflammatory action, with a control diet (CD) devoid of the “active” components. Both diets were composed in close agreement with the Nordic dietary recommendations. Each diet was consumed during 4 wk, separated by a 4 wk washout period. Cognitive tests were performed at fasting and in the postprandial period after a standardized breakfast, after each diet period. Results In comparison with the CD, the AD improved performance in the Rey Auditory-Verbal Learning test (recognition test, p < 0.05, ANOVA, n = 42) and significantly improved performance in test of selective attention, which also included aspects of working memory (p < 0.05, n = 40). Performance in cognitive tests was inversely associated with plasma concentrations of cardiometabolic risk markers (fasting cholesterol, blood glucose, blood pressure) and cardiovascular risk scores (Framingham and Reynols), and positivly associated with apolipoprotein A1 (p < 0.05). Conclusions The results indicate that diet characteristics may modulate cognitive performance. A relationship seems to exist between cardiometabolic risk markers and cognitive performance in apparently healthy subjects. The results provide additional motives for diet based prevention of metabolic disturbances related to the MetS.
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Affiliation(s)
- Anne Nilsson
- Department of Applied Nutrition and Food Chemistry, Lund University, P.O. Box 124, Lund, SE-221 00, Sweden
| | - Juscelino Tovar
- Antidiabetic Food Centre, Lund University, Lund, SE-221 00, Sweden
| | - Maria Johansson
- Antidiabetic Food Centre, Lund University, Lund, SE-221 00, Sweden
| | - Karl Radeborg
- Department of Psychology, Lund University, Lund, Sweden
| | - Inger Björck
- Department of Applied Nutrition and Food Chemistry, Lund University, P.O. Box 124, Lund, SE-221 00, Sweden ; Antidiabetic Food Centre, Lund University, Lund, SE-221 00, Sweden
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Song A, Liang Y, Yan Z, Sun B, Cai C, Jiang H, Qiu C. Highly prevalent and poorly controlled cardiovascular risk factors among Chinese elderly people living in the rural community. Eur J Prev Cardiol 2013; 21:1267-74. [PMID: 23598595 DOI: 10.1177/2047487313487621] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Aiqin Song
- School of Public Health, Jining Medical University, China
| | - Yajun Liang
- School of Public Health, Jining Medical University, China
| | - Zhongrui Yan
- Department of Neurology, Jining First People’s Hospital, China
| | - Binglun Sun
- Xing Long Zhuang Coal Mine Hospital, Yankuang Group, China
| | - Chuanzhu Cai
- Xing Long Zhuang Coal Mine Hospital, Yankuang Group, China
| | - Hui Jiang
- Xing Long Zhuang Coal Mine Hospital, Yankuang Group, China
| | - Chengxuan Qiu
- Aging Research Center, Karolinska Institutet-Stockholm University, Sweden
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Yang TK, Hsieh JT, Chen SC, Chang HC, Yang HJ, Huang KH. Metabolic syndrome associated with reduced lower urinary tract symptoms in middle-aged men receiving health checkup. Urology 2013; 80:1093-7. [PMID: 23107400 DOI: 10.1016/j.urology.2012.08.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 07/29/2012] [Accepted: 08/03/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the impact of metabolic syndrome on lower urinary tract symptoms in a sample of middle-aged men receiving a health checkup. METHODS Subjects aged 45 years or older who voluntarily underwent a medical checkup were enrolled. Participant demographics and health history were collected by a self-administered questionnaire. All participants were stratified into 2 groups by the presence of metabolic syndrome, as defined according to the updated National Cholesterol Education Program's Adult Treatment Panel III. Prostate volume and prostate-specific antigen levels were used for subgroup analysis. RESULTS During January through December of 2010, 708 subjects with a mean age of 55.6 ± 9.72 years were enrolled into the study. Compared to the nonmetabolic syndrome group, the metabolic syndrome group had lower total international prostatic symptoms score (7.89 ± 6.63 vs 6.85 ± 6.52, P = .05) and lower severity of weak urinary stream (1.24 ± 1.60 vs 0.95 ± 1.50, P = .021). In the higher prostate volume group (prostate volume ≥ 30 mL), total international prostatic symptoms score, storage score, and urinary frequency, urgency and incomplete emptying were lower in men vs those without metabolic syndrome (all P < .05). The negative association between voiding score, severity of lower urinary tract symptoms, and metabolic syndrome became particularly pronounced as the number of metabolic syndrome factors increased (P for trend < .01). CONCLUSION We confirmed that metabolic syndrome had favorable effects on lower urinary tract symptoms, including voiding and storage symptoms in healthy middle-aged men. This beneficial effect was most significant in men with enlarged prostate and/or high prostate specific antigen levels.
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Affiliation(s)
- Teng-Kai Yang
- Division of Urology, Department of Surgery, Cardinal Tien Hospital, Yonghe Branch, New Taipei City, Taiwan
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Pyleris E, Giamarellos-Bourboulis EJ, Tzivras D, Koussoulas V, Barbatzas C, Pimentel M. The prevalence of overgrowth by aerobic bacteria in the small intestine by small bowel culture: relationship with irritable bowel syndrome. Dig Dis Sci 2012; 57:1321-9. [PMID: 22262197 DOI: 10.1007/s10620-012-2033-7] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 01/04/2012] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Many studies have linked irritable bowel syndrome (IBS) with small intestinal bacterial overgrowth (SIBO), although they have done so on a qualitative basis using breath tests even though quantitative cultures are the hallmark of diagnosis. The purpose of this study was to underscore the frequency of SIBO in a large number of Greeks necessitating upper gastrointestinal (GI) tract endoscopy by using quantitative microbiological assessment of the duodenal aspirate. METHODS Consecutive subjects presenting for upper GI endoscopy were eligible to participate. Quantitative culture of aspirates sampled from the third part of the duodenum during upper GI tract endoscopy was conducted under aerobic conditions. IBS was defined by Rome II criteria. RESULTS Among 320 subjects enrolled, SIBO was diagnosed in 62 (19.4%); 42 of 62 had IBS (67.7%). SIBO was found in 37.5% of IBS sufferers. SIBO was found in 60% of IBS patients with predominant diarrhea compared with 27.3% without diarrhea (P = 0.004). Escherichia coli, Enterococcus spp and Klebsiella pneumoniae were the most common isolates within patients with SIBO. A step-wise logistic regression analysis revealed that IBS, history of type 2 diabetes mellitus and intake of proton pump inhibitors were independently and positively linked with SIBO; gastritis was protective against SIBO. CONCLUSIONS Using culture of the small bowel, SIBO by aerobe bacteria is independently linked with IBS. These results reinforce results of clinical trials evidencing a therapeutic role of non-absorbable antibiotics for the management of IBS symptoms.
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Affiliation(s)
- Emmannouil Pyleris
- Department of Gastroenterology, Sismanogleion General Hospital, Athens, Greece
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Tovar J, Nilsson A, Johansson M, Ekesbo R, Åberg AM, Johansson U, Björck I. A diet based on multiple functional concepts improves cardiometabolic risk parameters in healthy subjects. Nutr Metab (Lond) 2012; 9:29. [PMID: 22472183 PMCID: PMC3361470 DOI: 10.1186/1743-7075-9-29] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 04/02/2012] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Different foods can modulate cardiometabolic risk factors in persons already affected by metabolic alterations. The objective of this study was to assess, in healthy overweight individuals, the impact of a diet combining multiple functional concepts on risk markers associated with cardiometabolic diseases (CMD). METHODS Fourty-four healthy women and men (50-73 y.o, BMI 25-33, fasting glycemia ≤ 6.1 mmol/L) participated in a randomized crossover intervention comparing a multifunctional (active) diet (AD) with a control diet (CD) devoid of the "active" components. Each diet was consumed during 4 wk with a 4 wk washout period. AD included the following functional concepts: low glycemic impact meals, antioxidant-rich foods, oily fish as source of long-chain omega-3 fatty acids, viscous dietary fibers, soybean and whole barley kernel products, almonds, stanols and a probiotic strain (Lactobacillus plantarum Heal19/DSM15313). RESULTS Although the aim was to improve metabolic markers without promoting body weight loss, minor weight reductions were observed with both diets (0.9-1.8 ± 0.2%; P < 0.05). CD did not modify the metabolic variables measured. AD promoted significant changes in total serum cholesterol (-26 ± 1% vs baseline; P < 0.0001), LDL-cholesterol (-34 ± 1%; P < 0.0001), triglycerides (-19 ± 3%; P = 0.0056), LDL/HDL (-27 ± 2%; P < 0.0001), apoB/apoA1 (-10 ± 2%; P < 0.0001), HbA1c (-2 ± 0.4%; P = 0.0013), hs-CRP (-29 ± 9%; P = 0.0497) and systolic blood pressure (-8 ± 1%¸ P = 0.0123). The differences remained significant after adjustment for weight change. After AD, the Framingham cardiovascular risk estimate was 30 ± 4% (P < 0.0001) lower and the Reynolds cardiovascular risk score, which considers CRP values, decreased by 35 ± 3% (P < 0.0001). CONCLUSION The improved biomarker levels recorded in healthy individuals following the multifunctional regime suggest preventive potential of this dietary approach against CMD.
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Affiliation(s)
- Juscelino Tovar
- Antidiabetic Food Centre, Lund University, P.O. Box 121, SE-221 00 Lund, Sweden
| | - Anne Nilsson
- Department of Applied Nutrition and Food Chemistry, Lund University, SE-221 00 Lund, Sweden
| | - Maria Johansson
- Antidiabetic Food Centre, Lund University, P.O. Box 121, SE-221 00 Lund, Sweden
| | | | | | | | - Inger Björck
- Antidiabetic Food Centre, Lund University, P.O. Box 121, SE-221 00 Lund, Sweden
- Department of Applied Nutrition and Food Chemistry, Lund University, SE-221 00 Lund, Sweden
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Antonopoulou A, Baziaka F, Tsaganos T, Raftogiannis M, Koutoukas P, Spyridaki A, Mouktaroudi M, Kotsaki A, Savva A, Georgitsi M, Giamarellos-Bourboulis EJ. Role of tumor necrosis factor gene single nucleotide polymorphisms in the natural course of 2009 influenza A H1N1 virus infection. Int J Infect Dis 2012; 16:e204-8. [DOI: 10.1016/j.ijid.2011.11.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 01/04/2011] [Accepted: 11/30/2011] [Indexed: 10/14/2022] Open
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Gender differences in the prevalence of metabolic syndrome in 50-year-old Swedish men and women with hypertension born in 1953. J Hum Hypertens 2011; 27:56-61. [PMID: 22129609 DOI: 10.1038/jhh.2011.106] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To investigate potential gender differences in the role of hypertension as a risk factor for metabolic syndrome (MetS) we used a random population sample of 50-year-old men (n=595) and women (n=667; all born in 1953) who were examined in 2003-2004. Systolic (SBP) and diastolic (DBP) blood pressure values were dichotomized at ≥ 140 mm Hg and ≥ 90 mm Hg, respectively. MetS was defined using NCEP (National Cholesterol Education Programme) and IDF (International Diabetes Federation) criteria. MetS was more prevalent in men than in women (NCEP 16% versus 10%, P=0.003; IDF 26% versus 16%, P=0.000) and systolic hypertension was more common in men than in women (high SBP 24% versus 18%, P=0.003; high DBP 29% versus 24%, P=0.074). Women with high SBP had about a seven-fold increased NCEP risk compared with normotensive women (odds ratio (OR) 6.91, confidence interval (CI) 2.90-16.42), whereas high SBP in men was associated with about a three-fold increased NCEP risk (OR 2.72, CI 1.69-4.38). A similar pattern was observed for the IDF criterion of MetS. All interaction terms (sex × hypertension) were significant at P<0.01. At middle age, despite that fewer women had hypertension or MetS than men, hypertension carries a relatively greater risk for MetS in women than in men.
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Schult A, Eriksson H, Wallerstedt S, Kaczynski J. Overweight and hypertriglyceridemia are risk factors for liver cirrhosis in middle-aged Swedish men. Scand J Gastroenterol 2011; 46:738-44. [PMID: 21561285 DOI: 10.3109/00365521.2011.560679] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Hyperlipidemia, overweight, insulin resistance and hypertension are associated with non-alcoholic fatty liver disease. The knowledge about these conditions as etiologic factors in liver cirrhosis is, however, limited. In this study, we examined the relation between overweight and hypertriglyceridemia, and development of liver cirrhosis in a general population. MATERIAL AND METHODS An epidemiological, longitudinal study was conducted involving men at the age of 50 with 40 years of follow-up. Baseline data were collected in 1963 and 1967. Cases of liver cirrhosis were identified by searching the Swedish Hospital Discharge Register and death certificates of the Central Bureau of Statistics. The independent effect of BMI, triglyceride levels and alcohol habits for cirrhosis of the liver was calculated by using multiple logistic regression analysis. RESULTS Elevated BMI and triglycerides were significant independent risk factors for the development of liver cirrhosis (OR 1.27 and 1.99, respectively, p < 0.01). CONCLUSIONS Overweight and hypertriglyceridemia are independent risk factors for liver cirrhosis in Swedish men.
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Affiliation(s)
- Andreas Schult
- Department of Medicine, Sahlgrenska University Hospital Östra, Gothenburg, Sweden.
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Welin C, Wilhelmsen L, Welin L, Johansson S, Rosengren A. Perceived Health in 50-Year-Old Women and Men and the Correlation With Risk Factors, Diseases, and Symptoms. ACTA ACUST UNITED AC 2011; 8:139-49. [DOI: 10.1016/j.genm.2011.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2011] [Indexed: 11/16/2022]
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17
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Engström S, Berne C, Gahnberg L, Svärdsudd K. Efficacy of screening for high blood pressure in dental health care. BMC Public Health 2011; 11:194. [PMID: 21450067 PMCID: PMC3079645 DOI: 10.1186/1471-2458-11-194] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 03/30/2011] [Indexed: 11/17/2022] Open
Abstract
Background There is consensus on the importance of early detection and treatment of high blood pressure. Dental care is one of few medical services to which a considerable proportion of the general population comes for regular check-ups. We tested the effects of blood pressure screening in dental care centres with subsequent work-up of subjects screening positive in primary health care (PHCC). Methods Altogether 1,149 subjects 40-65 years old or 20-39 years old with body mass index >25, and with no previously known hypertension, who came for a dental examination had their blood pressure measured with an Omron M4® automatic blood pressure reading device. Subjects with systolic blood pressure readings above 160 mmHg or diastolic above 90 mmHg were referred to their PHCC for a check up. Outcome data were obtained by scrutiny of PHCC and hospital patient records for hypertension diagnoses during the three years following screening. Results 237 (20.6%) subjects screened positive. Of these, 230 (97.1%) came to their PHCC within the 3-year follow-up period, as compared with 695 (76.2%) of those who screened negative (p < 0.0001). Of those who screened positive, 76 (32.1%) received a diagnosis of hypertension, as compared with 26 (2.9%) of those who screened negative. Sensitivity was 79.1%, specificity 84.8% and positive predictive value 30.1%. The number of subjects needed to screen to find one case of hypertension was 18. Conclusions Co-operation between dental and primary care for blood pressure screening and work-up appears to be an effective way of detecting previously unknown hypertension.
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Affiliation(s)
- Sevek Engström
- Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Section, Uppsala, Sweden.
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18
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Johansson S, Wilhelmsen L, Welin C, Eriksson H, Welin L, Rosengren A. Obesity, smoking and secular trends in cardiovascular risk factors in middle-aged women: data from population studies in Göteborg from 1980 to 2003. J Intern Med 2010; 268:594-603. [PMID: 21091809 DOI: 10.1111/j.1365-2796.2010.02278.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND To study the trends in cardiovascular risk factors in middle-aged city-dwelling Swedish women from 1980 to 2003. METHODS Using cross-sectional population-based surveys, five random population samples of a total of 1915 women aged between 45 and 54 years, participating in the BEDA study in 1980, WHO MONICA studies in 1985, 1990 and 1995, and a study of 50-year-old women in 2003 were measured for the following parameters: anthropometry, serum cholesterol and triglyceride levels, smoking habits, blood pressure, physical activity and stress. RESULTS Over almost 25 years, middle-aged women gained on average 4.4 kg in weight, with a net increase in body mass index (BMI) from 24.7 to 25.6 kg m⁻². The proportion of participants classified as obese (≥30 kg m⁻²) increased by 50% from 10.4% to 15.1%. Women who were smokers in 2003 did not have lower BMI values than nonsmokers. Mean serum cholesterol concentrations decreased markedly, whereas smoking habits did not significantly change. The prevalence of hypertension decreased by 8%, whereas that of diabetes remained stable at around 2%. Optimal risk factor status - no smoking, normotension and serum cholesterol <5 mmol l⁻¹ - was present in less than one in six women in 2003, and similar across BMI categories. CONCLUSION The favourable decline in cholesterol levels and hypertension and the increase in leisure time physical activity were offset by an increase in obesity, triglyceride levels and experience of stress, with only a minority of participants (less than one in six) having an optimal level of risk factors with respect to smoking, serum cholesterol and hypertension in 2003. This applied also to overweight and obese women. In earlier cohorts, subjects with low BMI values were more often smokers, whereas the opposite is observed in recent cohorts. Thus, women who smoke no longer have the advantage of lower weight.
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Affiliation(s)
- S Johansson
- Department of Emergency and Cardiovascular Medicine, Sahlgrenska University Hospital/Östra, Göteborg, Sweden.
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First nationwide survey on cardiovascular risk factors in Grand-Duchy of Luxembourg (ORISCAV-LUX). BMC Public Health 2010; 10:468. [PMID: 20698957 PMCID: PMC2925827 DOI: 10.1186/1471-2458-10-468] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 08/10/2010] [Indexed: 11/10/2022] Open
Abstract
Background The ORISCAV-LUX study is the first baseline survey of an on-going cardiovascular health monitoring programme in Grand-Duchy of Luxembourg. The main objectives of the present manuscript were 1) to describe the study design and conduct, and 2) to present the salient outcomes of the study, in particular the prevalence of the potentially modifiable and treatable cardiovascular disease risk factors in the adult population residing in Luxembourg. Method ORISCAV-LUX is a cross-sectional study based on a random sample of 4496 subjects, stratified by gender, age categories and district, drawn from the national insurance registry of 18-69 years aged Luxembourg residents, assuming a response rate of 30% and a proportion of 5% of institutionalized subjects in each stratum. The cardiovascular health status was assessed by means of a self-administered questionnaire, clinical and anthropometric measures, as well as by blood, urine and hair examinations. The potentially modifiable and treatable risk factors studied included smoking, hypertension, dyslipidemia, diabetes mellitus, and obesity. Both univariate and multivariate statistical analyses used weighted methods to account for the stratified sampling scheme. Results A total of 1432 subjects took part in the survey, yielding a participation rate of 32.2%. This figure is higher than the minimal sample size of 1285 subjects as estimated by power calculation. The most predominant cardiovascular risk factors were dyslipidemia (69.9%), hypertension (34.5%), smoking (22.3%), and obesity (20.9%), while diabetes amounted 4.4%. All prevalence rates increased with age (except smoking) with marked gender differences (except diabetes). There was a significant difference in the prevalence of hypertension and of lipid disorders by geographic region of birth. The proportion of subjects cumulating two or more cardiovascular risk factors increased remarkably with age and was more predominant in men than in women (P<0.0001). Only 14.7% of men and 23.1% of women were free of any cardiovascular risk factor. High prevalence of non-treated CVRF, notably for hypertension and dyslipidemia, were observed in the study population. Conclusion The population-based ORISCAV-LUX survey revealed a high prevalence of potentially modifiable and treatable cardiovascular risk factors among apparently healthy subjects; significant gender and age-specific differences were seen not only for single but also for combined risk factors. From a public health perspective, these preliminary findings stress the urgent need for early routine health examinations, preventive interventions and lifestyle behavioural changes, even in young asymptomatic adults, to decrease cardiovascular morbidity and mortality in Luxembourg.
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Phillips AC, Carroll D, Thomas GN, Gale CR, Deary I, Batty GD. The influence of multiple indices of socioeconomic disadvantage across the adult life course on the metabolic syndrome: the Vietnam Experience Study. Metabolism 2010; 59:1164-71. [PMID: 20045139 DOI: 10.1016/j.metabol.2009.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 11/05/2009] [Accepted: 11/06/2009] [Indexed: 10/20/2022]
Abstract
Few studies have explored the relationship between individual and combined multiple indicators of socioeconomic status across the life course and the metabolic syndrome, or attempted to understand the mechanisms underlying any associations. The present study examined the associations between 4 indicators of socioeconomic status, individually and in combination, and metabolic syndrome risk in a study of male US veterans and examined the influence of health behaviors, intelligence, and psychologic distress on these associations. Participants (N = 4253) were drawn from the Vietnam Experience Study. From military service files, telephone interviews, and a medical examination, occupational, sociodemographic, health behavior, intelligence, psychologic, and health data were collected. The 4 indices of socioeconomic status were as follows: education achieved, early adulthood income, household income in midlife, and occupational prestige in midlife. Metabolic syndrome was diagnosed from the following: body mass index, fasting blood glucose or a diagnosis of diabetes, blood pressure-a diagnosis of hypertension or taking antihypertensives, high-density lipoprotein cholesterol, and triglyceride levels. In models that adjusted for age, men in the lower 2 groups on the combined measure of socioeconomic status experienced a higher risk of metabolic syndrome. This association was accounted for mainly by education achieved, household income in midlife, and occupational prestige in midlife. Intelligence appeared to explain much of this association. Combined socioeconomic status measures across the life course were related to metabolic syndrome but in a threshold rather than dose-response manner. Intelligence appeared to mediate this relationship.
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Affiliation(s)
- Anna C Phillips
- School of Sport and Exercise Sciences, University of Birmingham, UK.
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Harmsen P, Wilhelmsen L, Jacobsson A. Stroke Incidence and Mortality Rates 1987 to 2006 Related to Secular Trends of Cardiovascular Risk Factors in Gothenburg, Sweden. Stroke 2009; 40:2691-7. [DOI: 10.1161/strokeaha.109.550814] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Per Harmsen
- From Institute of Clinical Neuroscience (P.H.), Department of Internal Medicine (L.W.), Sahlgrenska University Hospital, Gothenburg, Sweden; Sahlgren’s Academy (A.J.), University of Gothenburg, Gothenburg, Sweden, and Centre for Epidemiology, the National Board of Health and Welfare, Stockholm, Sweden
| | - Lars Wilhelmsen
- From Institute of Clinical Neuroscience (P.H.), Department of Internal Medicine (L.W.), Sahlgrenska University Hospital, Gothenburg, Sweden; Sahlgren’s Academy (A.J.), University of Gothenburg, Gothenburg, Sweden, and Centre for Epidemiology, the National Board of Health and Welfare, Stockholm, Sweden
| | - Anders Jacobsson
- From Institute of Clinical Neuroscience (P.H.), Department of Internal Medicine (L.W.), Sahlgrenska University Hospital, Gothenburg, Sweden; Sahlgren’s Academy (A.J.), University of Gothenburg, Gothenburg, Sweden, and Centre for Epidemiology, the National Board of Health and Welfare, Stockholm, Sweden
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