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Biomedical subjects

Peter Vestergaard

Publications and source records attributed to Peter Vestergaard.

At least 37 records · Page 2Linked to original sources
PubMed2005

Overweight and obesity as risk factors for atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study.

PURPOSE: We examined the association between the body mass index analyzed as a continuous variable and by categorization according to World Health Organization criteria (normal weight, overweight and obesity) and the risk of a hospital (inpatient as well as outpatient) diagnosis of atrial fibrillation or flutter. METHODS: Population-based prospective cohort study conducted from December 1993 to December 2001 among 47589 participants (22482 men and 25107 women) without preexisting cardiovascular or endocrine disease and with a mean age at baseline of 56 years (range 50-64 years) in the Danish Diet, Cancer, and Health Study. Subjects were followed up in the Danish National Registry of Patients and in the Danish Civil Registration System. RESULTS: During follow-up (mean, 5.7 years) atrial fibrillation or flutter developed in 553 subjects (372 men and 181 women). The adjusted hazard ratio for atrial fibrillation or flutter per unit of increase in the body mass index was 1.08 (95% confidence interval [CI]: 1.05 to 1.11) in men and 1.06 (95% CI: 1.03 to 1.09) in women. When using normal weight as a reference, the adjusted hazard ratio for atrial fibrillation or flutter by overweight was 1.75 (95% CI: 1.35 to 2.27) in men and 1.39 (95% CI: 0.99 to 1.94) in women. The adjusted hazard ratio by obesity was 2.35 (95% CI: 1.70 to 3.25) in men and 1.99 (95% CI: 1.31 to 3.02) in women. CONCLUSION: Overweight and obesity are associated with an increased risk of a diagnosis of atrial fibrillation or flutter.

Atrial Fibrillation↗
PubMed2005

n-3 Fatty acids consumed from fish and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study.

BACKGROUND: Experimental studies have shown that n-3 polyunsaturated fatty acids in fish may have antiarrhythmic properties. OBJECTIVE: We examined the association between consumption of n-3 fatty acids from fish and risk of atrial fibrillation or flutter. DESIGN: In a prospective cohort study of 47 949 participants (mean age: 56 y) in the Danish Diet, Cancer, and Health Study, we investigated the relation between the consumption of n-3 fatty acids from fish estimated from a detailed semiquantitative food questionnaire and risk of atrial fibrillation or flutter. The subjects were followed up in the Danish National Registry of Patients for the occurrence of atrial fibrillation or flutter and in the Danish Civil Registration System (vital status and emigration). The consumption of n-3 fatty acids from fish was analyzed as sex-specific quintiles with the use of Cox proportional hazards models. RESULTS: During follow-up (x: 5.7 y), atrial fibrillation or flutter had developed in 556 subjects (374 men and 182 women). When the lowest quintile of n-3 fatty acids consumed from fish was used as a reference, the unadjusted hazard rate ratios in quintiles 2, 3, 4, and 5 were 0.93, 1.11, 1.10, and 1.44, respectively (P for trend = 0.001). The corresponding adjusted hazard rate ratios were 0.86, 1.08, 1.01, and 1.34 (P for trend = 0.006). Inclusion of information on the frequency of fatty fish consumption did not alter these associations. CONCLUSIONS: Consumption of n-3 fatty acids from fish was not associated with a reduction in risk of atrial fibrillation or flutter. We cannot exclude the possibility of residual confounding caused by a lack of information on intake of fish-oil tablets.

Animals↗
PubMed2005

Caffeine and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study.

BACKGROUND: It is not known whether the consumption of caffeine is associated with excess risk of atrial fibrillation. OBJECTIVE: We evaluated the risk of atrial fibrillation or flutter in association with daily consumption of caffeine from coffee, tea, cola, cocoa, and chocolate. DESIGN: We prospectively examined the association between the amount of caffeine consumed per day and the risk of atrial fibrillation or flutter among 47 949 participants (x age: 56 y) in the Danish Diet, Cancer, and Health Study. Subjects were followed in the Danish National Registry of Patients and in the Danish Civil Registration System. The consumption of caffeine was analyzed by quintiles with Cox proportional-hazard models. RESULTS: During follow-up (x: 5.7 y), atrial fibrillation or flutter developed in 555 subjects (373 men and 182 women). When the lowest quintile of caffeine consumption was used as a reference, the adjusted hazard ratios (95% CIs) in quintiles 2, 3, 4, and 5 were 1.12 (0.87, 1.44), 0.85 (0.65, 1.12), 0.92 (0.71, 1.20), and 0.91 (0.70, 1.19), respectively. CONCLUSION: Consumption of caffeine was not associated with risk of atrial fibrillation or flutter.

Atrial Fibrillation↗
PubMed2005

Anti-resorptive therapy for the prevention of postmenopausal osteoporosis : when should treatment begin?

Osteoporosis is a condition associated with decreased bone strength and an increased fracture risk. It may be defined based on bone mineral density (BMD) with a T-score at the hip or spine of less than -2.5 standard deviations in young healthy individuals or from an osteoporotic fracture (i.e. a fracture occurring after low-energy trauma or no apparent trauma). Risk factors predisposing to fractures include: increasing age; female gender; low BMD; a prior fragility fracture; a family history of fragility fractures; low bodyweight; lack of estrogen in women (i.e. post menopause); corticosteroid use; smoking; a number of diseases; deficiency in calcium and vitamin D; an increased risk of falls (i.e. impaired vision); immobilization; and Caucasian race. The more risk factors that are present the higher the risk of fractures over the following 10 years. The need to initiate preventive therapy with anti-osteoporotic treatment increases steeply with the absolute fracture risk. Indications for referral for dual energy x-ray absorptiometry measurement of BMD include: age >65 years; age <65 years in postmenopausal women with any of the risk factors already mentioned; premature menopause (<45 years); prolonged amenorrhea (>1 year) in younger women; fragility fractures; and diseases or conditions known to lead to osteoporosis.Anti-resorptive therapies include calcium plus vitamin D, bisphosphonates (alendronate, etidronate, risedronate, ibandronate), selective estrogen receptor modulators (raloxifene), hormone replacement therapy, and calcitonin. Guidelines from several countries on when to initiate anti-resorptive therapy state that therapy may be started in patients with a prior fragility fracture (some guidelines state that in this situation no BMD measurements are necessary) or in patients with a T-score of less than -2.5 (some guidelines state that additional risk factors need to be present in this situation). Some guidelines state that anti-resorptive therapy may be initiated in patients with a T-score in the osteopenic range (from -1 to -2.5, i.e. not frank osteoporosis) in the presence of other risk factors. The cost effectiveness of anti-resorptive therapy increases with the absolute fracture risk. In some scenarios, treatment with bisphosphonates may be cost effective in a 50-year-old woman with an absolute hip fracture risk of >or=1.1% over the next 10 years.

Bone Density↗
PubMed2004

Alcohol and risk of atrial fibrillation or flutter: a cohort study.

BACKGROUND: The evidence for an association between alcohol consumption and risk of atrial fibrillation is conflicting. METHODS: We prospectively examined the association between alcohol consumption and risk of atrial fibrillation or flutter among 47 949 participants (mean age, 56 years) in the Danish Diet, Cancer, and Health Study. The consumption of alcohol was analyzed as sex-specific quintiles by Cox proportional hazards regression models. RESULTS: The mean +/- SD consumption of alcohol per day was 28.2 +/- 25 g in men and 13.9 +/- 15 g in women. During follow-up (mean, 5.7 years), atrial fibrillation or flutter developed in 556 subjects (374 men and 182 women). After adjusting for established risk factors, there was a modest increase in risk of atrial fibrillation or flutter by increasing alcohol consumption in men. When using the lowest quintile of alcohol consumption in men as a reference, the adjusted hazard rate ratios in men in quintiles 2, 3, 4, and 5 were 1.04, 1.44, 1.25, and 1.46, respectively (P for trend, .04). When using the lowest quintile of alcohol consumption in women as a reference, the adjusted hazard rate ratios in women in quintiles 2, 3, 4, and 5 were 1.09, 1.27, 1.23, and 1.14, respectively (P for trend, .69). Inclusion of information on the frequency of alcohol consumption and the preferred source of alcohol did not change these associations. CONCLUSIONS: Consumption of alcohol was associated with an increased risk of atrial fibrillation or flutter in men. In women, moderate consumption of alcohol did not seem to be associated with risk of atrial fibrillation or flutter.

Alcohol Drinking↗
PubMed2004

Fracture risk in perimenopausal women treated with beta-blockers.

beta2-Adrenergic receptors have been identified on human osteoblastic and osteoclastic cells, raising the question of a sympathetic regulation of bone metabolism. We investigated effects of treatment with beta-adrenergic receptor antagonists (beta-blockers) on bone turnover, bone mineral density (BMD), and fracture risk. Within the Danish Osteoporosis Prevention Study (DOPS) a population based, comprehensive cohort study of 2016 perimenopausal women, associations between treatment with beta-blockers and bone turnover and BMD were assessed in a cross-sectional design at the start of study. Moreover, in a nested case-control design, fracture risk during the subsequent 5 years was assessed in relation to treatment with beta-blockers at baseline. Multiple regression- and logistic regression-analyses were performed. Treatment with beta-blockers was associated with a threefold increased fracture risk (OR(adj) 3.3; 95% CI: 1.1-9.4). Analyses on duration of treatment showed that women who had been treated for more than 8 years had a higher fracture risk (OR(adj) 5.3; 95% CI: 1.1-26.3) than those treated for less than 8 years (OR(adj) 2.4; 95% CI: 0.6-9.5). In addition, cross-sectional data showed 20% lower serum osteocalcin levels (an osteoblastic marker of bone formation) in women treated with beta-blockers compared to untreated women (P < 0.001), whereas BMD at the lumbar spine and femoral neck did not differ between groups. beta-Blockers may decrease the activity of bone-forming cells and thereby increase fracture risk. However, confirmative studies and studies exploring mechanisms of action are needed.

Adrenergic beta-Antagonists↗
PubMed2004

Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark.

AIM: To compare the number of patients diagnosed with osteoporosis and osteoporotic fractures in Denmark, with the number of subjects expected to have osteoporosis. SUBJECTS AND METHODS: From the National Hospital Discharge Register, records for all patients diagnosed with osteoporosis and/or with osteoporotic fractures between 1995 and 1999 were retrieved. Based on normal Danish values for BMD, the expected number of subjects aged 50 years or more with osteoporosis according to the WHO definition was calculated. RESULTS: The estimated prevalence of osteoporosis was 40.8% of women aged >or=50 years and 17.7% among men. The expected annual incidence was 58,658/million inhabitants in women >or=50 years of age and 23,648/million in men >or=50 years. However, the observed incidence was only 4,823 and 862/million per year, respectively (8.2% and 3.6% of the expected). In 1999, a total of 34,691 hip, spine, and forearm fractures were reported in subjects >or=50 years, and of these, 18,566 were potentially attributable to osteoporosis (14,240 fractures in women and 4,326 in men equaling 14,976 and 5,297/million per year). Only 0.3% of men >or=50 years were receiving a bisphosphonate, while 2.2% of women received a bisphosphonate or raloxifene. Among women >or=50 years, 27.7% received hormone replacement therapy. CONCLUSIONS: Osteoporotic fractures of the hip, spine, and forearm are rather frequent in Denmark, but the diagnosis of osteoporosis is rarely used. It seems that osteoporosis is markedly underdiagnosed and undertreated in Denmark as probably also elsewhere. This may have significant implications for the prevention of osteoporotic fractures.

Adult↗
PubMed2004

Hip fracture risk in statin users--a population-based Danish case-control study.

Based on animal studies, statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) have been suggested as potential agents in the treatment of osteoporosis. In some epidemiological studies, statins have been associated with a reduced fracture risk. Our objective was to examine associations between statin treatment and risk of hip fracture in a population-based case-control study. A total of 6660 subjects with hip fracture and 33,274 gender- and age-matched population controls were identified from 1 January 1994 to 31 December 2001 using the Hospital Patient Register in North Jutland County, Denmark, and the Danish Central Personal Registry, respectively. Data on redeemed prescriptions for statins within the last 5 years before the index date were retrieved from a population-based prescription database. We used conditional logistic regression to estimate odds ratios (OR) for hip fracture according to use of statin prescriptions adjusted for potential confounding factors, i.e. gender, other diseases, and use of other drugs known to affect bone metabolism and fracture risk. After adjustment for potential confounders, statin treatment was associated with a reduced risk of hip fracture (OR=0.68; 95% confidence interval: 0.50-0.93) for those who had redeemed more than three prescriptions for a statin drug. We found that risk of hip fracture decreased with the number of statin prescriptions. Stratified analyses on gender and age did not reveal any major differences between men and women or among different age groups on the estimates between use of statins and hip fracture risk. Our findings support an association between statin treatment and a reduced hip fracture risk. However, it is unclear whether this association is causal.

Adolescent↗
PubMed2004

Effects of simvastatin on bone turnover and BMD: a 1-year randomized controlled trial in postmenopausal osteopenic women.

UNLABELLED: To study effects of statins on human bone, 82 postmenopausal women were randomized to 1-year treatment with simvastatin 40 mg/day or placebo. The study showed no effect of simvastatin on biochemical bone markers or on BMD at the hip or spine. Thus, our results do not support a general beneficial effect of simvastatin on bone. INTRODUCTION: Statins have been reported to cause bone anabolic as well as antiresorptive effects, and therefore statins have been suggested as potential agents in treatment of osteoporosis. MATERIALS AND METHODS: In a double-blinded design, 82 healthy postmenopausal women with osteopenia were randomized to 1-year simvastatin treatment 40 mg/day or placebo. BMD and plasma levels of cholesterol, parathyroid hormone (PTH), and biochemical bone markers were measured at baseline, after 1 year of treatment (week 52), and 26 weeks after withdrawal of treatment (week 78). Calcium supplements (400 mg/day) were administrated during the entire 1.5-year study period. RESULTS: Seventy-eight women completed the 1-year treatment. After 1 year, simvastatin but not placebo caused reduced plasma cholesterol (-27% versus +1%, p < 0.001) and low-density lipoprotein (LDL) levels (-43% versus +1%, p < 0.001). After withdrawal of treatment, cholesterol and LDL levels returned to baseline levels and no longer differed from the placebo group. However, plasma levels of PTH and biochemical bone markers did not differ between groups at week 52 or 78. Compared with placebo, simvastatin caused no changes in BMD at the lumbar spine, total hip, femoral neck, or whole body at week 52 or 78. However, a significant increase in BMD was found in response to simvastatin at the forearm. Within the simvastatin group, changes in cholesterol levels did not correlate to BMD changes at any site. CONCLUSIONS: Our results do not support a general beneficial effect of simvastatin on bone.

Aged↗