To study the possible risk factors for cardiovascular disease, we collected data on plasma levels of coagulation factors, blood pressure, serum cholesterol, and smoking in a random sample of 792 men 54 years of age. During 13.5 years of follow-up, myocardial infarction occurred in 92 men, stroke in 37, and death from causes other than myocardial infarction or stroke in 60. The blood pressure, degree of smoking, serum cholesterol, and fibrinogen level measured at the base-line examination proved to be significant risk factors for infarction by univariate analyses during follow-up, and blood pressure and fibrinogen were risk factors for stroke. Fibrinogen and smoking were strongly related to each other. The relation between fibrinogen and infarction, and between fibrinogen and stroke, became weaker when blood pressure, serum cholesterol, and smoking habits were taken into account, but was still significant for stroke. Although causality cannot be inferred from these data, it is possible that the fibrinogen level plays an important part in the development of stroke and myocardial infarction.

A population study of women in Gothenburg, Sweden, is presented. The women were representative of the total female population in Gothenburg in the age strata 38, 46, 50, 54 and 60 years. Altogether 1 462 women participated in the examination, the participation rate being 90.1%. Social data of participants and non‐participants are given. The performance of the examination is described and research projects are outlined. It is concluded that the selection of a strictly representative sample, together with careful uniformity of performance and high participation rate, will make it possible to draw valid conclusions about the total population of middle‐aged women in Gothenburg.

The effects of peroperative electrical calf muscle stimulation with groups of impulses giving a short lasting tetanus of the calf muscles on postoperative deep venous thrombosis (DVT) and pulmonary embolism (PE) were compared with that of dextran 40 given per and postoperatively. The incidence of DVT and PE during the first 4-6 postoperative days was recorded. The diagnosis of DVT was based on the 125I-fibrinogen uptake test and phlebography and of PE on pre- and postoperative perfusion pulmonary scintigram and chest X-ray examination. Both methods reduced the incidence of PE. Calf muscle stimulation reduced the DVT incidence in patients with malignant disease while the reduction in DVT incidence for the whole group only was significant in the stimulation as well as the dextran 40 group. Mean values for preoperatively determined levels of antithrombin III, beta-thromboglobulin, fibrinopeptide A, plasminogen and ability to release fibrinolytic activity during venous stasis did not differ between those patients who developed or those who did not develop postoperative DVT or PE. However, antithrombin III levels below 80 per cent appeared to predispose to postoperative thromboembolism. The two prophylactic methods have similar effects on the incidence of postoperative thromboembolism. The stimulation method has certain advantages due to its safety and simplicity.

No abstract

SummaryA patient with extensive amyloidosis and a selective factor X deficiency is described. The following observations indicate that the factor X deficiency in this case is not inherited.1. The first symptoms of a bleeding tendency appeared at an age of 50 years.2. The patient’s four children had no clotting defect.3. After infusion of 1 liter of fresh plasma no increased factor X activity was observed. No anticoagulants could be demonstrated in vitro.