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A Rosengren

Publications and source records attributed to A Rosengren.

At least 19 recordsLinked to original sources
PubMed2001

Heart failure in the general population of men--morbidity, risk factors and prognosis.

AIMS: To analyse the prevalence, aetiology and prognosis of heart failure. METHODS AND RESULTS: A random population sample of men (n=7495) was examined at baseline in 1970-73 and followed until 1996. During up to 27 years, 937 men were hospitalized for heart failure. For the statistical analysis, odds ratios and 95% confidence intervals, multivariate logistic regression and time-dependent Cox analysis were used. The incidence rate was 2.1, 9.1 and 11.5 per 1000 person-years in the age groups 55-64, 65-74 and 75-79, and the prevalences were 0.6, 2.8 and 6.2%, respectively. Valvular heart disease was the aetiology in 5.8%, coronary heart disease only or in combination with hypertension in 58.8%, and hypertension only in 20.3%, and various combinations with diabetes in 4.5%. Of the remaining 12.1%, 96% were smokers and 64% were registered for alcohol abuse. Risk factors were increasing age, myocardial infarction in the family, diabetes mellitus, chest pain, tobacco smoking, high coffee consumption, alcohol abuse, high body mass index, high blood pressure as well as treatment for hypertension, but not high total cholesterol or psychological stress. Mortality after the diagnosis was increased eight times. CONCLUSIONS: Coronary heart disease and hypertension were the most common concomitant diseases. Risk factors were similar to those in coronary heart disease, and also alcohol abuse, but not high total cholesterol, low physical activity or psychological stress. Mortality was high.

Alcohol Drinking↗
PubMed2001

Optimal risk factors in the population: prognosis, prevalence, and secular trends; data from Göteborg population studies.

AIMS: To assess the prognosis and prevalence of optimal risk factors in the population. METHODS AND RESULTS: Data from several Göteborg population studies were used. Optimal risk factors were defined as serum cholesterol <5 mmol x l(-1), blood pressure <140/90 without treatment and being a non-smoker. In a 20-year follow-up of 7130 men aged 47 to 55 at baseline a group of 117 men who were optimal with respect to cholesterol, blood pressure and smoking were identified. In this group there was only one death from coronary disease, corresponding to 0.4 deaths per 1000 years, whereas the overall risk of coronary death in the study was 4.8 per 1000 years. Among men and women aged 25 to 34 in the Göteborg MONICA study 1995, less than half were optimal on all three scores, and in men and women aged 55 to 64, only 7% and 6%, respectively, were optimal. If body mass index below 25 was included only 34% and 37%, respectively, of men and women aged 25 to 34 were optimal, and 11% and 22% among men and women aged 35 to 44. In an analysis of secular trends over 30 years in four successive cohorts of men aged 50 the prevalence of optimal risk factors with respect to cholesterol, blood pressure and smoking increased from 1963 to 1993 but was still only 11% in 1993. CONCLUSIONS: As expected, optimal risk factors with respect to serum cholesterol, blood pressure and smoking confers a very low risk of coronary death. However, the prevalence of optimal risk factor status in the Swedish population is still low.

Adult↗
PubMed2001

Sex differences in survival after myocardial infarction in Sweden; data from the Swedish National Acute Myocardial Infarction Register.

AIMS: Women, particularly younger women, hospitalized with acute myocardial infarction have been found to have poorer prognosis than men. A large proportion of deaths due to myocardial infarction, however, occur in the pre-hospital phase. We set out to analyse age-specific sex differences in survival after myocardial infarction at different time intervals from the onset of acute myocardial infarction, including pre-hospital deaths and 1-year overall survival. METHODS AND RESULTS: The National Acute Myocardial Infarction Register in Sweden was used to analyse age-specific sex differences in mortality outside hospital, 28-day mortality and 1-year mortality in 353 905 cases occurring between 1987 and 1995 in Swedish men and women aged 30 to 89 years. Overall, one in four of all myocardial infarction victims died outside hospital. At all ages, except in individuals younger than 50 years, men had higher pre-hospital mortality. The odds of dying within 28 days for women below 50 years of age, compared to men, was 1.84 (1.56--2.18) in hospitalized patients and 1.31 (1.18--1.46) in all infarction patients. Above the age of 65, in the total population with myocardial infarction, women had a better prognosis, with odds ratios ranging from 0.83 to 0.89. In patients surviving the first 28 days, 4.0% of the women and 2.9% of the men below the age of 50 were dead within a year after the infarction, odds ratio 1.37 (1.06--1.76). This excess mortality was mainly due to diabetes and non-cardiac causes. Only women younger than 50 years had a significantly poorer overall 1-year survival than men of the same age. At the age of 70 or more, women had a small survival advantage. CONCLUSION: In the total acute myocardial infarction population, only women under 50 years of age have a consistently worse prognosis than men. Much of the excess mortality in young women seems to be associated with diabetes.

Aged↗
PubMed2001

Neutrophil-associated activation markers in healthy smokers relates to a fall in DL(CO) and to emphysematous changes on high resolution CT.

Smoking is a risk factor for developing chronic obstructive pulmonary disease (COPD), but there are no good indicators for early identification of subjects who will develop symptomatic COPD. The aim of this study was to investigate inflammatory mechanisms related to changes in lung function and emphysematous changes on high resolution computed tomography (HRCT) in 'healthy' smokers. Subjects were 60-year-old men from a population study. Bronchoscopy was performed in 30 smokers and 18 who had never smoked. Blood tests, lung function measurements and HRCT were carried out in 58 and 34 subjects, respectively. In comparison with never-smokers, smokers had higher levels of myeloperoxidase (MPO), human neutrophil lipocalin (HNL), eosinophil cationic protein (ECP) and lysozyme in blood, higher levels of MPO, interleukin-8 (IL-8) and HNL in bronchial lavage (BL), and of IL-8, HNL and interleukin-lbeta (IL-1beta) in bronchoalveolar lavage (BAL). Smokers also had lower levels of Clara cell protein 16 (CC-16) in blood. HNL in BL and BAL showed strong correlations to other inflammatory markers (MPO, IL-8, IL-1beta). The variations in MPO in BL were explained by variations in HNL (R2 =0.69), while these variations in BAL were explained by variations in HNL and IL-1beta (R2 = 0.76). DL(CO) was the lung function variable most closely related to MPO and IL-8 in BL and BAL and to IL-1beta in BAL. In a multiple regression analysis, MPO, IL-1beta, IL-8 and CC-16 in BL and MPO in BAL contributed to the explanation of variations in DL(CO) to 41% and 22%. respectively, independent of smoking habits. In smokers with emphysematous lesions on HRCT, HNL in BAL correlated to emphysema score (r(s) = 0.71). We conclude that 'healthy' smoking men with a near normal FEV1 show signs of inflammation in the lower airways that are related to a decrease in DL(CO) and to emphysematous lesions on HRCT. This inflammation seems to be the result of both monocyte/macrophage and neutrophil activation.

Acute-Phase Proteins↗
PubMed2000

[Prognosis is often poor in chest pain not interpreted as angina pectoris. Simultaneous occurrence of cardiovascular risk factors increases the risk of premature death].

BACKGROUND: Typical angina pectoris is easy to recognize, but coronary insufficiency may present with nonspecific chest discomfort. AIMS OF STUDY: We wanted to investigate long-term prognosis in men with different types of chest pain. METHODS: A random population sample comprising 5,773 men aged 51-57 years at baseline were followed for 16 years. RESULTS: Mortality due to coronary heart disease was 8.0% among men without chest pain, 19.5% (total mortality 44%) among those with non-specific chest pain, 24.8% (total mortality 45%) among those with typical angina and 48.5% among those with a history of myocardial infarction at baseline. CONCLUSION: Non-specific chest pain is associated with poor prognosis, and coronary risk factors have strong predictive value.

Angina Pectoris↗
PubMed2000

Secular changes in cardiovascular risk factors over 30 years in Swedish men aged 50: the study of men born in 1913, 1923, 1933 and 1943.

OBJECTIVES: To study secular trends in cardiovascular risk factors in men aged 50 over a period of 30 years. DESIGN: Cross-sectional studies of successive cohorts of men from 1963 to 1993. SETTING: City of Göteborg, Sweden. SUBJECTS: Four random population samples of men born in 1913, 1923, 1933 and 1943, aged 50 when they were examined in 1963, 1973, 1983, and 1993 (n = 855, 226, 776, and 798, respectively). MAIN OUTCOME MEASURES: Anthropometric measurements, blood pressure, serum cholesterol and triglycerides and smoking habits over three decades. RESULTS: Over 30 years, men increased in weight from a mean (SD) of 75.9 (11.0) kg to 82.8 (12.1) kg and gained 3.4 cm in height, with a net increase in body mass index from 24.8 (3.2) to 26.0 (3.4) kg m-2 (P < 0.0001), and a concomitant increase in waist circumference. The proportion of men who were overweight but not obese (BMI = 25-30 kg m-2) increased from 38 to 47%, whereas the prevalence of frank obesity (more than 30 kg m-2) increased from 6% in 1963 to 11% in 1993. Despite the increase in weight, mean systolic blood pressure fell by almost 10 mmHg (P < 0.0001). Mean serum cholesterol concentration decreased from 6.42 (1.12) to 5.88 (1.04) (P < 0.0001). Serum triglycerides increased from 1.26 (0.77) to 1.69 (1.04) mmol L-1 (P = 0.001). The proportion of men who smoked decreased from 56% in 1963 to 30% in 1993 (P < 0.0001). This was due more to an increase in smoking cessation rates than to an increase in the proportion of men who had never smoked. In particular, smokers and former smokers are now more obese than the corresponding categories 30 years ago and smokers are no longer leaner than men who have never smoked. CONCLUSIONS: Over a period of 30 years, serum cholesterol as well as systolic blood pressure and the prevalence of smoking decreased. This favourable decline in coronary risk factors was offset by an appreciable increase in body mass index and waist circumference.

Aged↗
PubMed2000

Does immigration contribute to decreasing CHD incidence? Coronary risk factors among immigrants in Göteborg, Sweden.

OBJECTIVES: To investigate if an increasing proportion of immigrants may have contributed to the decreasing trend in coronary heart disease (CHD) in Sweden during the last few decades and to analyse the cardiovascular risk factor pattern in immigrants compared to Swedish-born subjects. POPULATION AND METHODS: CVD risk factors were investigated within the framework of the WHO MONICA project. A random sample of 1618 men and women aged 25-64 years responded to the invitation to a screening procedure including questionnaires and physical and laboratory examination. Data on myocardial infarctions (MI) were collected from the Göteborg Myocardial Infarction Register. Data from the City Council secretariat were used to estimate the number of immigrants in the total population. RESULTS: In 1995, immigrants constituted 22.4% of the population between 25 and 64 years of age in Göteborg. The incidence of MI in immigrants, 21.7%, was similar to that in Swedish-born subjects. Non-Finnish immigrants reported more unemployment, low physical activity during leisure time and psychological stress than Swedish subjects. Immigrant men also smoked more. BMI and WHR were significantly higher in immigrant women and Finnish immigrants had higher blood pressure than Swedes. Total- and LDL-cholesterol were higher in Finnish men. HDL-cholesterol was significantly lower and s-triglycerides significantly higher in non-Finnish immigrants of both genders. CONCLUSION: The decreasing trend in CHD in Sweden during the last few decades is not due to an increasing number of immigrants from 'low-risk countries'. On the contrary, the immigrants in the present study seem to have a worse CVD risk factor profile than Swedes.

Adult↗
PubMed2000

Calcaneal ultrasound measurements are determined by age and physical activity. Studies in two Swedish random population samples.

AIM: To present reference values and correlations with body composition, blood variables and lifestyle factors. SUBJECTS: Two random population samples from Göteborg, Sweden, one comprising 184 men and 455 women aged 25-64 years (MONICA) and the other 860 women aged 55-82 years (BEDA) were studied. METHODS: Calcaneal ultrasound measurement (LUNAR Achilles) and bioimpedance were measured. Smoking habits, coffee consumption, physical activity, psychological stress, education and marital status, as well as blood lipids, blood pressure, and fractures were studied. RESULTS: Broadband ultrasound attenuation and stiffness were higher in men than in women (P < 0. 001), but speed of sound did not differ between sexes. Speed of sound, broadband ultrasound attenuation and stiffness decreased with age (P < 0.001). In both sexes speed of sound, broadband ultrasound attenuation and stiffness correlated positively to body size variables, and negatively with smoking in women after adjustment for age. Speed of sound, broadband ultrasound attenuation and stiffness were positively related to physical activity in both sexes, and these relationships were the only ones that remained in multivariate analyses in addition to age (negative). Osteoporotic fractures increased with age. Speed of sound, broadband ultrasound attenuation and stiffness were lower amongst women with osteoporotic fractures. CONCLUSION: Speed of sound, broadband ultrasound attenuation and stiffness decreased with age and increased with physical activity, but body weight and height were not correlated in multivariate analyses. Osteoporotic fractures increased with age and were associated with lower calcaneal ultrasound values.

Adult↗
PubMed2000

Improved long-term prognosis for patients with unstable coronary syndromes 1988-1995.

AIMS: A more aggressive approach to unstable coronary syndromes has developed over the last decade. We set out to examine the long-term outcome among patients with acute coronary syndromes with respect to period of admission since 1988. METHODS: 3918 patients with unstable angina or a non-Q wave myocardial infarction who were admitted to the coronary care unit at Ostra Hospital in the period 1988-1997 were included. Standardized criteria were used to define a non-Q wave myocardial infarction and included fulfilment of the following: (1) typical enzyme changes (serial serum aspartate aminotransferase above 0.7 microkat x l(-1), serial creatine kinase above 3.3 microkat x l(-1) or serial creatine kinaseMB subunit mass concentration above 15 microg x l(-1)), and at least one of the following: (2) chest pain, shock, syncope or pulmonary oedema suggestive of a myocardial infarction, (3) development of electrocardiographic changes with serial ST-T changes without Q waves. The standardized criteria for unstable angina pectoris were fulfilment of at least one of the following: (1) a clear worsening of a previous stable pattern of angina pectoris, (2) chest pain at rest or minimal effort with transient ST-segment elevation or depression on electrocardiogram or elevation of cardiac enzymes not reaching the criteria for myocardial infarction. Information on vital status and cause of death after discharge was collected from the national cause-specific mortality register. RESULTS: Two-year mortality decreased from 30% in 1988 to 19% in 1995 (relative risk per year 0.94 (0.90-0.97), 95% confidence interval). The improvement was consistent regardless of differences in age, prior myocardial infarction, diabetes mellitus, hypertension, development of non-Q wave myocardial infarction, treatment with heparin or thrombolytics or performance of acute coronary angiograms. The cumulative survival at 10 years was 53% in the unstable angina group and 36% in the non-Q wave myocardial infarction group (P<0.0001). CONCLUSION: Against a background of a more aggressive approach to acute coronary syndromes a decrease in long-term mortality is seen between 1988 and 1995.

Aged↗
PubMed2000

Social gradients in cardiovascular risk factors and symptoms of Swedish men and women: the Göteborg MONICA Study 1995.

BACKGROUND: Even though coronary mortality in middle and old age is decreasing, social gradients may be increasing; but they need not necessarily be the same for men and women. In order to develop efficient preventive strategies more knowledge of the current distributions of risk factors both for men and for women is needed. OBJECTIVE: To investigate and to compare the socio-economic gradients for coronary risk factors of men and women. DESIGN: A cross-sectional study. METHODS: We studied 686 men and 825 women aged 25-64 years from a random population sample. Socio-economic status (SES) was classified according to the occupation-based Swedish Socio-economic Index. RESULTS: For women, high SES was associated with lower levels of total and low-density lipoprotein cholesterol, lower serum levels of triglycerides, higher levels of high-density lipoprotein cholesterol and lower blood pressure. For men, no relation between occupational status and levels of lipids and blood pressure was found. Obesity was associated with low SES both for men and for women. Socioeconomic differences in smoking habits were more pronounced for women than they were for men. The proportion of post-menopausal women was higher among the unskilled workers, despite there being no differences in age. Optimal risk factor status (non-smoker, total cholesterol level < 5 mmol/l, blood pressure < 140/90 mmHg without treatment and body mass index < 25 kg/m2) was unusual both among men and among women, but 34% of the higher officials among the women had optimal risk factor status, compared with 10% of the unskilled workers. Corresponding values for the men were 16 and 9% (P for interaction 0.09). The relation between low SES and level of low-density lipoprotein cholesterol was independent of smoking, post-menopausal state, use of oestrogen and waist:hip ratio (P = 0.04) and so was the relation between systolic blood pressure and low SES (P = 0.0003). CONCLUSIONS: In Sweden, low SES exerts a stronger adverse influence on cardiovascular risk factors of women than it does on those of men.

Adult↗
PubMed1999

Reactive capsule formation around soft-tissue implants is related to cell necrosis.

Low-density polethylene disks with smooth or course surfaces were implanted in the abdominal wall of rats, and the tissue response was evaluated after 1, 6, or 12 weeks. Cell damage was detected by two different methods. Cells with increased membrane permeability could be identified using fluorescence microscopy by injection of propidium iodide prior to the killing of the rats. Second, cell death was verified by detection of DNA fragmentation. At 1 week a considerable number of the interfacial cells was stained with propidium iodide. Propidium-iodide-positive cells also were enriched at the edges of the disks irrespective of surface texture. The numbers of positive interfacial cells decreased markedly over time. Cells with DNA fragmentation initially displayed a scattered distribution; at later time points they appeared mainly in the outer portion of the enveloping capsule. The reactive capsule was thicker for the smooth surface, and there was a positive correlation between capsule thickness and propidium-iodide-positive cells at earlier implantation periods. The results suggest that the thickness of the reactive capsule is related to the extent of cell necrosis. It is suggested that the major initiator for this cell necrosis is mechanical shear since cell necrosis was found mainly in areas where mechanical shear could be expected.

Abdominal Muscles↗
PubMed1999

Coronary risk factors, diet and vitamins as possible explanatory factors of the Swedish north-south gradient in coronary disease: a comparison between two MONICA centres.

OBJECTIVE: To investigate whether differences in serum lipids, diet, plasma vitamins or other risk factors explain the higher incidence of cardiovascular disease in the northern parts of Sweden, compared to Göteborg on the west coast. DESIGN: A comparison between the two Swedish MONICA populations in northern Sweden (NSW) and in Göteborg (GOT) in 1990. SETTING: Norrbotten and Västerbotten counties in the north of Sweden and the city of Göteborg on the west coast. SUBJECTS: In the north 1583 men and women aged 25-64 years were investigated, and in Göteborg 1574 men and women. Plasma vitamins were examined in a subsample of men aged 40-49 (n = 259). MAIN OUTCOME MEASURES: Serum lipids, blood pressure, anthropometric measurements, smoking habits, physical activity, diet, education, and plasma vitamins. RESULTS: NSW men and women had mean serum total cholesterol of 6.30 (standard deviation 1.23) mmol L-1 and 6.12 (1. 33) mmol L-1, compared to 5.75 (1.14) mmol L-1 and 5.67 (1.24) mmol L-1 in GOT men and women (P = 0.0001). NSW men and women were shorter and had higher body mass index than in Göteborg. Cigarette smoking was slightly more prevalent amongst GOT men and women. Göteborg men and women more often had more than compulsory school education, compared to NSW men and women, whereas there were no differences in physical activity during leisure time. There were no differences in vegetable consumption, whereas fruit was consumed more frequently by NSW women compared to GOT women, with a higher intake of fibre and ascorbate. Consumption of wine and total alcohol consumption were higher in Göteborg, whereas NSW men and women drank significantly more coffee. In the subsample of men (aged 40-49) who had plasma vitamins measured, men in Göteborg had slightly higher mean retinol concentrations (P = 0.005) and lutein and zeaxanthine levels (P = 0.006 and 0.009, respectively) compared to northern men, but there were no differences with respect to alpha- or beta-carotene, ascorbic acid or lipid-adjusted vitamin E. NSW men had slightly higher plasma iron and magnesium concentrations (P = 0.005 and 0.001, respectively). CONCLUSION: The largest and most consistent differences between Göteborg and northern Sweden were found for serum cholesterol, probably reflecting differences in intake of saturated fat. The differences in serum cholesterol may explain a substantial part of the differences in coronary heart disease morbidity and mortality. We found no consistent differences concerning vegetable and fruit consumption. More alcohol was consumed in Göteborg. Differences in education and childhood conditions, as reflected in differences in height, may contribute to the north-south gradient with respect to CHD incidence and mortality.

Adult↗
PubMed1999

Relative importance of improved hospital treatment and primary prevention. Results from 20 years of the Myocardial Infarction Register, Göteborg, Sweden.

OBJECTIVE: To analyse to what extent declines in incidence and mortality of coronary artery disease can be attributed to improved hospital and post-hospital treatment in contrast to how much is due to primary prevention. DESIGN: A register for non-fatal and fatal myocardial infarction and sudden coronary death registered in in-hospital as well as out-of-hospital events between 1975 and 1994. SETTING: City of Göteborg, Sweden, with 450,000 inhabitants. RESULTS: Seventy-one per cent of the decline in attacks could be attributed to a decline in first infarctions. Of the decrease in coronary deaths, 63% was due to a decline in out-of-hospital mortality. Previous registrations for myocardial infarction were considerably more common amongst people who died in hospital (29%) than amongst those who died out-of-hospital (11-16%) or who survived an infarction (11-13%). Out-of-hospital resuscitation contributed to about half of the reduction in out-of-hospital mortality. Thus, most of the decline in incidence and about half of the decline in sudden coronary deaths was due to primary preventive measures. Population data on risk factors indicate a decline of 37% between 1963 and 1995 in coronary risk amongst consecutive cohorts of 50-year-old men in the community. CONCLUSION: Out-of-hospital resuscitation, treatment in coronary care units and post-infarct treatment improved considerably, but changes in primary risk factors were also of major importance for the decline in incidence and mortality.

Adult↗
PubMed1999

Time-trends in thrombolytics: women are catching up.

Reports on gender differences in the management of acute coronary syndromes indicate that women do not receive as much active treatment as men. Other conflicting findings have also been published. To investigate whether previously reported gender differences in the treatment of acute myocardial infarction (AMI) still persist, we included all patients admitted to our coronary care unit (CCU) in 1984-1995, and discharged with a diagnosis of AMI, in a retrospective study. A total of 1991 female admissions was compared with 4067 male admissions. The time-span was divided into two-year periods comprising approximately 1000 patients each. During one period, 1988 to 1989, women received significantly less thrombolytic therapy which, however, could reflect that women admitted with AMI were older than men. Analysis of time-trends showed a significant increase in the use of thrombolytic treatment in women and elderly men. In clinical praxis there has been a gender-gap in acute treatment of AMI, but age-dependent or not, this is now no longer apparent.

Age Factors↗
PubMed1999

Job control, job demands and social support at work in relation to cardiovascular risk factors in MONICA 1995, Göteborg.

BACKGROUND: Job control and work environment are related to risk of coronary heart disease (CHD), but there is limited understanding of the independent risks associated with these factors. OBJECTIVE: To investigate the association between psychosocial work characteristics and biological risk factors for both sexes for a random population sample in Göteborg, Sweden. DESIGN: A cross-sectional study. METHODS: We used an age-stratified random sample of men and women aged 25-64 years comprising 1200 men and 1412 women, from which 746 men and 872 women responded to the invitation for screening, which included questionnaires and physical/laboratory investigations in 1995. RESULTS: Women had lower job control than did men (P=0.00001); job demands were equal and social support at work slightly higher among women (P=0.04). Job control was positively related to education and social group. Smoking women had low job control and high job demands. Women with high grades of psychological stress had low job control and low social support at work (P=0.001 and P=0.01). For both sexes job demands were high (P=0.0001) among those who reported high psychological stress. Men with high job control and high social support at work were more physically active during leisure time. Subjects with job strain had low social support (P=0.01). Job-stress factors were not related to biological coronary risk factors. CONCLUSIONS: Women had lower job control than did men. Job control was positively related to education, social class and physical activity. Psychosocial factors were not related to biological coronary risk factors.

Adult↗
PubMed1999

Body weight and weight gain during adult life in men in relation to coronary heart disease and mortality. A prospective population study.

AIMS: To assess the risk of death from coronary disease, and all causes associated with body mass index and weight gain from age 20 to middle age. METHODS AND RESULTS: In this study, 6874 men aged 47 to 55 years at baseline and free of a history of myocardial infarction were followed with respect to mortality from coronary disease and from all causes over an average follow-up of 19.7 years, and with respect to non-fatal myocardial infarction for 11.8 years. High body mass index predicted death from coronary disease, but only at levels above 27.5 m.kg-2. Men with stable weight (defined as +/- 4% change from age 20) had the lowest death rate from coronary disease and the lowest risk of non-fatal myocardial infarction. Relative risk of coronary death increased with increasing weight gain, from 1.57 (1.14-2.15) (after adjustment for age, physical activity, and smoking) in the group who gained 4 to 10%, to 2.76 (1.97-3.85) in men with a weight gain of more than 35% (P for trend 0.0001), compared to men who remained stable. After further adjustment for serum cholesterol, systolic blood pressure, and diabetes, relative risks were reduced but still significantly elevated in all weight gain groups (P for trend 0.004). Data concerning non-fatal myocardial infarction were available for the first 11.8 years and showed a relative risk of 3.35 (2.05-5.47) after adjustment for age, physical activity, and smoking in men with a weight gain of more than 35%. CONCLUSION: Weight gain from age 20, even a very moderate increase, is strongly associated with an increased risk of coronary death and non-fatal myocardial infarction.

Adult↗