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Biomedical subjects

A Ahlbom

Publications and source records attributed to A Ahlbom.

At least 145 records · Page 8Linked to original sources
PubMed1982

Incidence of myocardial infarction among male Finnish immigrants in relation to length of stay in Sweden.

In Finland, the incidence of coronary heart disease is reported to be about twice as high as in the neighbouring country of Sweden. The aim of this study was to find out what happens to this excess risk among Finnish immigrants to Sweden. A geographically defined population in Stockholm County was followed up in the in-patient care registry and the cause-of-death registry in order to find cases for a case-control study. All episodes of myocardial infarction (ICD numbers 410.00 and 410.99) that had occurred in men born between 1911 and 1935 during the period 1974-76 were recorded. An age-matched control group was randomly selected from the population. By means of the civil registration system it was possible to identify country of birth and length of stay in Sweden. Of the 356 cases, 32 (9%) had been born in Finland compared with 55 (6%) of the 887 controls. The overall relative risk for the Finnish immigrants compared with native Swedes was 1.7. For the group of Finnish immigrants who had been in Sweden for 20 years or more the relative risk was 1.3. It was concluded that since the relative risk decreases during the stay in Sweden the environmental factors dominate the explanation of the difference in the relative risk of developing myocardial infarction between Finland and Sweden.

Age Factors↗
PubMed1981

Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men.

The association between specific job characteristics and subsequent cardiovascular disease was tested using a large random sample of the male working Swedish population. The prospective development of coronary heart disease (CHD) symptoms and signs was analyzed using a multivariate logistic regression technique. Additionally, a case-controlled study was used to analyze all cardiovascular-cerebrovascular (CHD-CVD) deaths during a six-year follow-up. The indicator of CHD symptoms and signs was validated in a six-year prospective study of CHD deaths (standardized mortality ratio 5.0; p less than or equal to .001). A hectic and psychologically demanding job increases the risk of developing CHD symptoms and signs (standardized odds ratio 1.29, p less than 0.25) and premature CHD-CVD death (relative risk 4.0, p less than .01). Low decision latitude-expressed as low intellectual discretion and low personal schedule freedom-is also associated with increased risk of cardiovascular disease. Low intellectual discretion predicts the development of CHD symptoms and signs (SOR 1.44, p less than .01), while low personal schedule freedom among the majority of workers with the minimum statutory education increases the risk of CHD-CVD death (RR 6.6, p less than .0002). The associations exist after controlling for age, education, smoking, and overweight.

Cardiovascular Diseases↗
PubMed1981

Increased mortality among persons with rheumatoid arthritis, but where RA does not appear on death certificate. Eleven-year follow-up of an epidemiological study.

We have performed an 11-year follow-up study on mortality in rheumatoid arthritis (RA). The population was selected by random sampling and consisted of 293 persons with RA fulfilling two sets of relevant criteria and a contrast group of 453 healthy persons. The mortality in the RA group was found elevated, when compared with both the contrast group and the general Stockholm population. The mortality was correlated with the severity of the disease, as defined by the numbers of criteria for RA fulfilled, the Steinbrocker functional grading, and serological titres. The differences in the distribution of causes of death between RA and contrast groups were not large enough to warrant special consideration. Only 9 out of 84 death certificates in the RA group mentioned rheumatic disease, and 4 of these had RA as underlying cause of death.

Adult↗
PubMed1980

Impact of psychological stress on ischemic heart disease when controlling for conventional risk indicators.

Fifty men with clinically manifest ischemic heart disease (IHD), fifty men with risk indicators of IHD and fifty healthy men were interviewed about experiences of psychological stress in work, family life and education. They were also examined for the presence of hypertension, hyperlipidemia, hyperglycemia, hyperuricemia, obesity, impaired pulmonary function, smoking and alcohol consumption. The relative risk of developing clinical IHD associated with the experience of psychological stress during the five years prior to onset of symptoms was calculated. It was found to be six times greater with than without such experience. This relative risk was not reduced when controlling for conventional risk indicators by means of a multivariate confounder score. When the IHD group was compared to the group with merely risk indicators, the relative risk related to stress was statistically significant, but not when the latter group was compared to the control group. The results indicate that the experience of stress as it is defined in this study may contribute to the development of clinical manifestations of IHD, irrespective of the presence of conventional risk indicators.

Adult↗
PubMed1980

Impact of Pattern A behavior on ischemic heart disease when controlling for conventional risk indicators.

The presence of Pattern A behavior was assessed by means of the Structured Interview in three groups of Swedish men, 50 with manifest ischemic heart disease (IHD), 50 with risk indicators for IHD and fifty healthy men. They were also examined for presence of hypertension, hyperlipidemia, hyperglycemia, obesity, impaired pulmonary function, smoking and alcohol consumption. The relative risk of having developed clinical IHD, associated with the presence of Pattern A behavior was found to be four times greater with than without such behavior. When conventional risk indicators were controlled for, by means of a multivariate confounder score, this relative risk was reduced to 2.7.

Adult↗
PubMed1979

Occurrence of acute myocardial infarction in Stockholm studied by two different methods.

Two studies on the occurrence of acute myocardial infarction (AMI) in Stockholm have been made. In one, the study population consisted of patients who attended a health-control station; cases of AMI were detected retrospectively by a mail questionnaire and by the official cause-of-death register. In the other study, the population comprised the total population of Stockholm county; cases of AMI were detected from routine information on hospital care, and from the official cause-of-death register. The aims of the present study were to compare the two methods for detection of AMI cases and to compare the AMI morbidity of the two populations. The mail questionnaire method missed a small number of cases but, on the other hand, the register method included some cases in which the diagnostic criteria were not fulfilled. The AMI morbidity in the two populations did not differ significantly.

Acute Disease↗
PubMed1979

Application of diagnostic criteria in the diagnosis of myocardial infarction.

A random sample of all patients with a registered diagnosis of acute myocardial infarction (AMI) was selected from the hospitalisation register of Stockholm County in 1973. The sample consisted of 269 patients. The medical records of these patients were scrutinized concerning the fulfilment of criteria of a diagnosis of AMI. The criteria of AMI chosen were those established in a Sweden cooperative study (6). 33 patients did not fulfil the diagnosis of AMI, corresponding to an estimated proportion of 10%. In 4% this was due to more technical reasons such as the use of incorrect code numbers, and in 6% the diagnosis had been made without the criteria being fulfilled.

Acute Disease↗
PubMed1979

Seasonal variations in the incidence of acute myocardial infarction in Stockholm.

The aim of the present paper was to ascertain whether or not there is a seasonal trend in the incidence of acute myocardial infarction (AMI) in Stockholm. The material consisted of hospitalized patients with a diagnosis of AMI, recorded in a medical information system, and of deaths recorded in the cause-of-death register. The hospital stays and the deaths together totalled 4020 cases of AMI occurring in 1973. In contrast to the results of other studies, no seasonal trend was found.

Aged↗
PubMed1978

Acute myocardial infarction in Stockholm--a medical information system as an epidemiological tool.

The objects of the present study were to perform an epidemiological study of acute myocardial infarction in Stockholm County and to investigate and develop the methods by which the medical information system in Stockholm can be used as an epidemiological tool. The possible sources of error were enumerated and their importance assessed. It is concluded that the available routinely collected computer data are useful for estimation of incidence, mortality, and case fatality. Incidence, and case fatality rates are shown to be similar to results from other Swedish studies.

Acute Disease↗
PubMed1978

Acute myocardial infarction in Stockholm - an area comparison.

Stockholm county is divided into 13 catchment areas, which differ in the respect of social and economical structure. There are also differences in the organisation of medical care. These areas were compared with respect to incidence and lethality of acute myocardial infarction (AMI). The proportions of deaths from AMI taking place outside hospital were also compared. The study was based on the impatient-care register in Stockholm and on the cause-of-death register. It was concluded that differences in incidence between the catchment areas exist, most of which might be explained by socio-economic characteristics of the populations. No differences were found in lethality. Particularly, there was no difference in lethality between catchment areas with and without coronary-care units. For older people some small differences were found in the proportion of deaths outside hospital.

Acute Disease↗
PubMedDate not supplied

Acute myeloid leukemia among petrol station attendants.

The risk of acute myeloid leukemia (AML) within different occupations was studied, using occupational information obtained from the Swedish 1970 census. Follow-up in the Swedish Cancer Register was carried out from 1971 to 1984. Among male petrol station attendants, 10 cases were observed versus 2.8 expected (observed/expected = 3.6, 95% confidence interval 1.7-6.6). For several decades, Swedish petrol has contained 3-5% of benzene. Thus, a hypothesis was that benzene had contributed to the excess risk. The work histories of the 10 cases were reconstructed through interviews with surviving relatives and were compatible with the hypothesis. However, because the air benzene exposures at petrol stations always have been lower than benzene exposures associated previously with an increased risk of AML, the leukemogenic effect of benzene may have been potentiated by other petrol or vehicle exhaust components.

Adult↗
PubMedDate not supplied

Do episodes of anger trigger myocardial infarction? A case-crossover analysis in the Stockholm Heart Epidemiology Program (SHEEP).

OBJECTIVE: Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility. METHODS: This study was a case-crossover study within the Stockholm Heart Epidemiology Program. Exposure in the period immediately preceding MI was compared with exposure during a control period for each case. From April 1993 to December 1994, 699 patients admitted to coronary care units in Stockholm County were interviewed. RESULTS: During a period of 1 hour after an episode of anger, with an intensity of at least "very angry," the relative risk of MI was 9.0 (95% CI, 4.4-18.2). In patients with premonitory symptoms, the time of disease initiation may be misclassified. When restricting the analyses to those without such symptoms, the trigger risk was 15.7 (95% CI, 7.6-32.4). The possibility of examining effect modification was limited by a lack of statistical power (eight exposed cases). Results of the analyses suggested, however, an increased trigger effect among subjects reporting nonhostile usual behavior patterns, nonovert strategies of coping with aggressive situations (not protesting when being treated unfairly), and nonuse of beta-blockers. CONCLUSIONS: The hypothesis that anger may trigger MI is further supported, with an increased risk lasting for approximately 1 hour after an outburst of anger. It is suggested that the trigger risk may be modified by personal behavior patterns.

Adult↗