This report presents data on antecedents of Type 2 (non-insulin-dependent) diabetes mellitus in a homogeneous sample of randomly selected 54-year-old men from an urban Swedish population with a diabetes incidence of 6.1% during 13.5 years of follow-up. The increased risk leading to diabetes for those in the top quintile compared to the lowest quintile of the distribution of statistically significant risk factors were: body mass index = 21.7, triglycerides = 13.5, waist-to-hip circumference ratio = 9.6, diastolic blood pressure = 6.7, uric acid = 5.8, glutamic pyruvic transaminase = 3.9, bilirubin = 3.2, blood glucose = 2.7, lactate = 2.4 and glutamic oxaloacetic transaminase = 2.0. Those with a positive family history of diabetes had 2.4-fold higher risk for developing diabetes than those without such a history. In a multivariate analysis glutamic pyruvic transaminase, blood glucose, body mass index, bilirubin, systolic blood pressure, uric acid and a family history of diabetes were all significantly associated with the development of diabetes. Our study demonstrates the great importance of adiposity and body fat distribution for the risk of diabetes. A number of established risk factors for coronary heart disease are risk factors for diabetes as well. Disturbed liver function and increased levels of lactate are early risk factors for diabetes - presumably indicators of the presence of impaired glucose tolerance and/or hyperinsulinaemia.

Alanine Transaminase↗

PubMed1988

Quality of life in early heart failure. The study of men born in 1913.

To see whether well-being and quality-of-life are affected in congestive heart failure (CHF), a number of health variables, self-assessed and objectively measured, were estimated among 67-year-old men sampled from the general population of Gothenburg, Sweden. Based on history, physical examination and drug treatment, 407 men were studied and grouped into 4 stages of CHF, ranging from no signs or symptoms of CHF to advanced CHF. Men with CHF had more of other cardiovascular disease manifestations, utilized more health care, and reported less well-being and a higher rate of self-assessed disability than men with no CHF. These quality-of-life changes were found not only in the overt cases but also in early CHF. Regardless of CHF stage, quality-of-life seemed more affected in men on drug treatment, compared with those not treated.

Clinical Protocols↗

PubMed1987

Analysis of risk factors for stroke in a cohort of men born in 1913.

We analyzed parental death from stroke and other potential risk factors in relation to the incidence of stroke among 789 men, all 54 years old at the base-line examination. During 18.5 years of follow-up, 57 men (7.2 percent) had strokes. In univariate analyses, the following characteristics correlated significantly with the incidence of stroke: increased systolic (P = 0.004) and diastolic blood pressure (P = 0.0001), larger waist circumference (P = 0.007), higher waist:hip ratio (P = 0.0004), increased plasma fibrinogen level (P = 0.01), and lower vital capacity (P = 0.03). In addition, men whose mothers had died of stroke had a threefold increase in their incidence of stroke as compared with men without such a maternal history (P = 0.0005). Potential risk factors for stroke that were not confirmed were body-mass index, serum cholesterol level, hematocrit, blood glucose level, smoking, coronary heart disease, electrocardiographic signs of left ventricular hypertrophy, and a paternal history of death from stroke. In multivariate analyses, increased blood pressure, abdominal obesity, increased plasma fibrinogen level, and maternal history still correlated significantly with the risk of stroke. A maternal history of stroke should probably be added to the list of risk factors for stroke among middle-aged men.

Abdomen↗

PubMed1987

Diabetes mellitus in Swedish middle-aged men. The study of men born in 1913 and 1923.

As part of a study of the epidemiology of diabetes mellitus in middle-aged Swedish men, the present paper reports the prevalence and incidence of diabetes and the prevalence of impaired glucose tolerance. Two cohorts of 50-year-old men, representative of the corresponding male population of Gothenburg, Sweden, were examined in 1963 and 1973, respectively, and then followed until 1980. In the cohort of men born in 1913 (n = 855) the diabetes prevalence (WHO criteria), based on a questionnaire and fasting blood glucose, increased from 1.5% at age 50 to 7.6% at age 67. In the cohort of men born in 1923 (n = 226) the prevalence was 3.7% at age 50 and 4.0% at age 57. The overall prevalence of diabetes and impaired glucose tolerance was 25% among men born in 1913 (age 67) and 18% among men born in 1923 (age 57). The cumulative risk of developing diabetes from age 50 to 67 was 7.8%. Variables associated with impaired glucose tolerance and newly found diabetes, when degree of obesity was considered, were systolic blood pressure and triglycerides, well known risk factors for both coronary heart disease and diabetes. Uric acid, fasting insulin and glutamic puruvic transaminase, recently discussed as possible risk factors, were also associated with impaired glucose tolerance and newly found diabetes. Thus, both impaired glucose tolerance and newly found diabetes were associated with a clustering of risk factors, not only for diabetes but also for coronary heart disease.

Blood Glucose↗

PubMed1987

Dyspnoea in a cross-sectional and a longitudinal study of middle-aged men: the Study of Men Born in 1913 and 1923.

In a longitudinal population study, 855 men, born in 1913 and initially examined when 50 years old, were followed for 17 years with measurements of dyspnoea and other variables performed at ages 50, 54, and 67 years. In addition a sample of 226 men born in 1923 was followed from 50 to 57 years of age. At the latest examination, four different methods for measuring dyspnoea were used, one based on questionnaire, one on interview, and two on visual analogue scales. The estimates from these methods were highly intercorrelated, and correlated with measures of cardiopulmonary function as well. The prevalence of dyspnoea grade 2 (shortness of breath when walking with someone of the same age on the level) or more, not counting the mildest form of dyspnoea in these populations, was 2.8%, 3.0%, 5.2% and 10.3% at 50, 54, 57 and 67 years of age, respectively. Dyspnoea grade 1 (shortness of breath when walking quickly on the level or uphill) was less well related to age. A scoring system to differentiate various possible causes of dyspnoea was applied. About one third of the dyspnoeic men had signs and symptoms of cardiac disease, one quarter had pulmonary disease, and a quarter had a combination of both causes. The remaining 20% had no signs or symptoms indicating cardiopulmonary disease but in the majority of the cases other plausible causes were found.

Aged↗

PubMed1987

Prevalence of subjectively experienced symptoms in a population sample of women with special reference to women with arterial hypertension.

Women, participants in a population study and representative of middle-aged women in the general population, were asked to complete a questionnaire containing 30 questions about prevalence or absence of 30 specified complaints during the last three months prior to the investigation. As a whole, complaints were common. E.g. more than 30% reported sleep disturbances, 40% general fatigue and 40% depressive symptoms. There were some differences between the different age groups studied with respect to different complaints but the total number of stated complaints were similar in the different ages. A special analysis was made concerning antihypertensive drugs and blood pressure levels. The most obvious finding with respect to these variables was that symptoms were common in women with low blood pressure (below 120 mmHg).

Adult↗

PubMed1987

The mortality in an age cohort followed from birth to age 70.

The Study of Men Born in 1913 is a prospective population study of cardiovascular diseases in Gothenburg, Sweden, that started in 1963. To describe survival curves and mortality pattern, all boy-children born alive in 1913 in the city of Gothenburg, were identified. This birth cohort was followed from birth to age 70 for residence, vital status and cause of death. At the age of 50 years, 25% of the birth cohort were dead and at age 70, 43% had died. The high infant mortality and the great impact of infectious diseases in the beginning of this century is illustrated. The death rate for the cohort was almost identical to national figures for men in the same age group. Men who migrated from Gothenburg had a death rate very similar to those who stayed. It can therefore be concluded that the men in the Study of Men Born in 1913 is a representative sample not only of men in Gothenburg but also of men in Sweden as far as mortality is concerned. Special attention was paid to death from otitis media complications, congestive heart failure, and diabetes. Few persons died from these diseases before age 50 when the prospective study started and therefore did not influence the study of the natural history for these conditions to any great extent. Otitis media infections might be studied retrospectively from this age.

Aged↗

PubMed1987

Heavy alcohol drinking and related symptoms in a population study of urban men.

An age-stratified random sample of 228 men was selected from the urban districts of Solna and Sundbyberg in Stockholm. Two hundred of these men (90%) underwent a health survey comprising a general medical examination, taking of a medical and social history, blood and urine tests, roentgenography of the heart and lungs, ECG, electroneurography and computed tomography of the brain. The purpose of the present study was to determine alcohol consumption levels and their correlation with symptoms of heavy drinking and with age. The subjects were collected according to a rectangular age distribution, with age ranges of 20-29, 30-39, 40-49, 50-59 and 60-65 years. Quartiles were used in order to obtain homogeneous strata and to group the sample concerning alcohol consumption. Two measures of alcohol consumption were used--the amount of alcohol consumed in the previous week in g of absolute alcohol per day, and the typical peak consumption in the last six months. Three symptoms related to heavy drinking were studied: (1) inability to cut down or stop drinking, referred to here as subjective, relative loss of control over drinking; (2) morning shakes and malaise relieved by drinking, termed morning drinks; (3) amnesia induced by alcohol, referred to as blackouts. Ten per cent of the men had all three alcohol symptoms and 52% had no alcohol symptoms at all. Twenty-nine per cent had lost control over the amount they drank. Blackouts were noted for 33% and morning drinks for 25%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

The multifactor primary prevention trial in Göteborg, Sweden.

The effect of a multifactorial intervention programme on coronary heart disease (CHD), stroke incidence and total mortality was determined in a random sample of men, 47-55 years old at entry. The intervention group comprised 10 004 men, and the two control groups were of similar size. The intervention consisted of antihypertensive treatment in subjects with screening blood pressure above 175 mmHg systolic or 115 mmHg diastolic, dietary advice to men with serum cholesterol levels above 260 mg per 100 ml (= 6.8 mMol l-1), advice to stop smoking to subjects who smoked more than 15 cigarettes per day. The intervention was applied for 10 years during which time CHD and stroke incidence and mortality were followed by means of special registers. Participation rate at first screening examination was 75%. The risk factor levels, i.e. blood pressure, serum cholesterol and smoking decreased markedly during 10 years in the intervention group, but also among the control groups. Total mortality, stroke and CHD incidence did not differ significantly between the intervention group and any of the two control groups. We conclude that a decrease has taken place in all three major risk factors for CHD in the general male population in Göteborg, Sweden. Strategies other than intervention on high-risk individuals must be chosen if a major impact on disease incidence is to be achieved in the general population.

Aged↗

PubMed1986

A study of injuries during life in three male populations.

In a population study of samples of 60-, 50-, and 30-year-old men, information about injuries suffered during life was obtained by personal interview. Included were head injuries with unconsciousness, and injuries which had caused restricted activity for more than one day or had caused medical attendance. The interview technique was the only way to cover all these injuries. Possible biases are discussed. The results indicated that the young men tended to report a higher incidence of injuries, to suffer their first injury at an earlier age and to attend medical services to a larger extent than the older men. An incidence peak in adolescence was reported in all three cohorts. Accidents with multiple injuries were more common in higher ages in all cohorts. Falls, blows, and impacts, cutting and piercing agents, and traffic accidents were the most common causes of injuries in all cohorts.

Accidents↗

PubMed1986

A study of the association between the prolongation of the QT interval in the resting ECG and myocardial infarction.

The relationship between the incidence of myocardial infarction in the 10 year follow-up period and the length of the QT interval and its two components (the time elapsing between the Q wave and the beginning of the T wave, and the duration of the T wave) was investigated in a study of the records of a group of men drawn from a random sample of all 55-year-old men living in Göteborg, Sweden. A significant association was found between the incidence of myocardial infarction and the first component but not with the second component or the QT interval itself. The two components were found to be independent and thus to have the potential to act as confounding factors if the QT interval is examined alone. Further, our results suggest that correcting the QT interval for heart rate needs careful reassessment.

Arrhythmias, Cardiac↗

PubMed1986

Non-pharmacological treatment of hypertension in two steps--1 year report from eight health centres.

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Adult↗

PubMed1986

Fasting blood glucose and risk of coronary heart disease, stroke, and all-cause mortality: a 17-year follow-up study of men born in 1913.

This report concerns the relationship between baseline levels of fasting blood glucose (FBG) in non-diabetics and the subsequent 17-year incidence of coronary heart disease (CHD), stroke and all-cause mortality. In 1963, 973 men aged 50 years were recruited from a general Swedish urban population for a prospective study of risk factors for CHD. Eight hundred and fifty-five (88%) men agreed to participate and have been observed for 17 years. The 832 men who had no history of myocardial infarction, stroke, diabetes mellitus or who had a fasting blood glucose below 7.0 mmol/l at baseline were selected for this analysis. CHD occurred in 106 men, 35 developed a stroke and 137 died during follow-up. When quintiles and deciles of the FBG distribution were considered, no trend of 17-year incidence of CHD, stroke or death was apparent. However, for men with an FBG above the 95th percentile (greater than 5.7 mmol/l) a non-significant trend towards increasing risk was indicated.

Aged↗

PubMed1985

[Regional mortality variations in middle Sweden].

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Cardiovascular Diseases↗