Obesity and myocardial infarction – vulnerability related to occupational level and marital status. A 23‐year follow‐up of an urban male Swedish population

Hedblad, Bo; Jonsson, Susanna; Nilsson, Peter M.; Engström, Gunnar; Berglund, Göran; Janzon, Lars

doi:10.1046/j.1365-2796.2002.01069.x

Cited by 36 publications

(26 citation statements)

References 40 publications

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“…24 High and medium level nonmanual workers and self-employed men (socioeconomic classification, SEI, groups 46 to 79) were categorized as "high" occupational groups. Low level nonmanual workers, manual workers, and unspecified occupational groups (early retired men, students, and unemployed) were categorized as "low" occupational groups (SEI groups 11 to 36 and 91 to 99).…”

Section: Occupation and Marital Statusmentioning

confidence: 99%

Leukocyte Count and Incidence of Hospitalizations Due to Heart Failure

Engström

Melander

Hedblad

2009

Circ: Heart Failure

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Background-Leukocyte concentration in blood is a classical marker of systemic inflammation. Whether high leukocyte counts are associated with incidence of heart failure (HF) is unknown. This population-based study explored whether the leukocyte concentrations were associated with incidence of hospitalizations due to HF. Methods and results-Leukocyte counts were measured in 16 940 men from the general population (mean age 44 years) without history of myocardial infarction or stroke. Incidence of hospitalizations due to HF (primary diagnosis) was monitored over 23 years of follow-up, in relation to quartiles of leukocytes. Subjects with myocardial infarction during follow-up were censored in the main analysis. During the follow-up, 436 men were hospitalized due to HF. Incidence of HF hospitalizations was increased in men with high leukocyte counts. After adjustments for confounding factors, the adjusted hazards ratio (HR, 95% CI) for HF hospitalization was 1.00 (reference), 1.26 (0.93 to 1.7), 1.24 (0.91 to 1.7), and 1.73 (1.3 to 2.3), respectively, for men with leukocytes in the 1st, 2nd, 3rd, and 4th (highest) quartiles (trend, PϽ0.001). This relationship was consistent in smokers and nonsmokers and in men with and without hypertension, respectively. Conclusion-High leukocyte counts in middle-aged men were associated with increased long-term incidence of HF hospitalizations. (Circ Heart Fail. 2009;2:217-222.)

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Section: Occupation and Marital Statusmentioning

confidence: 99%

Leukocyte Count and Incidence of Hospitalizations Due to Heart Failure

Engström

Melander

Hedblad

2009

Circ: Heart Failure

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“…Enterprisers and farmers (ie, professionals with and without employees) were categorized as self-employed and subjects who were early retied, unemployed, and so on, as others. 15 Information on occupation was available in 53 549 subjects (76.9%).…”

Section: Socioeconomic Statusmentioning

confidence: 99%

Stroke Incidence, Recurrence, and Case-Fatality in Relation to Socioeconomic Position

Hedblad

Rosvall

et al. 2008

Stroke

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Background and Purpose-Low socioeconomic status is associated with increased incidence of stroke. This study investigated stroke incidence, recurrence, and case-fatality after stroke among middle-aged Swedish men and women and whether this association differs by gender or stroke subtype. Methods-A total of 69 625 (49% men) citizens, aged 40 to 65 years, living in the city of Malmö in 1990 were studied in relation to total annual income and occupation class, ie, 2 indicators of socioeconomic status. Incidence of first-ever stroke, stroke recurrence, and case-fatality (death within 28 days or 1 year after stroke) were studied over 10 years of follow-up. Results-During the follow-up, a total of 1648 subjects developed a first-ever stroke of whom 275 also experienced a recurrent stroke. By using Cox regression model with covariate adjustments, the incidence of stroke was significantly increased (relative risk: 1.75, 95% CI:1.36 to 2.25) in women who were in the lowest quartile of income compared with the women being in the highest quartile. Corresponding relative risk in men was 1.29 (1.06 to 1.58). Both in men and women, income was significantly associated with ischemic, but not hemorrhagic, subtypes of stroke. Similar relationships were observed between occupation level and incidence of stroke. In addition, low income was associated with higher 28-day and 1-year fatality rates in men (relative risk: 3.13, 1.35 to 7.24 and 2.17, 1.18 to 4.00, respectively), but not in women. In contrast, recurrence of stroke was inversely associated with income only in women. Conclusions-Incidence of stroke, stroke recurrence, and case-fatality increased with decreasing socioeconomic status; however, this relationship differed by gender and subtype of events.

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“…A follow-up of a subgroup of these men was conducted in 1994 -1996 in another screening investigation called the Malmö Diet and Cancer (MDC) study (17). The mean time between initial testing and this follow-up was 15 years (range [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. The primary aim of the original project, the methodology and general results of which have been described earlier (15,16), had been to find high-risk individuals for preventive interventions directed at cardiovascular disease, diabetes,…”

mentioning

confidence: 99%

“…Manual and low-level nonmanual workers as well as early retirees were categorized as "low social class." Medium-and high-level nonmanual workers, selfemployed individuals, and farmers (n ϭ 19) were categorized as "high social class" (20).…”

mentioning

confidence: 99%

Incidence of Diabetes in Middle-Aged Men Is Related to Sleep Disturbances

et al. 2004

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OBJECTIVE -Sleep deprivation in healthy men has been experimentally found to result in disturbances in glucose metabolism and in sympathovagal imbalance. The aim of the present study was to investigate whether sleep disturbances and elevated resting heart rate are associated with increased risk of developing diabetes. RESEARCH DESIGN AND METHODS-A group of 6,599 initially healthy, nondiabetic men aged 44.5 Ϯ 4.0 years took part in a prospective, population-based study in Malmö , Sweden. The incidence of diabetes during a mean follow-up of 14.8 Ϯ 2.4 years was examined in relation to self-reported difficulties in falling asleep and resting heart rate at baseline. Diabetes was assessed at follow-up in all subjects by questionnaire and in a subgroup of 1,551 men by blood glucose measurement.RESULTS -A total of 615 (9.3%) subjects reported either difficulties in falling asleep or regular use of hypnotics (seen as markers of sleep disturbances), and 158 (2.4%) subjects reported both of these. Altogether, 281 (4.3%) of the men developed diabetes during the follow-up period. Logistic regression models showed difficulties in falling asleep or regular use of hypnotics (odds ratio [OR] 1.52 [95% CI 1.05-2.20]) and resting heart rate (OR per 10 bpm 1.13 [0.99 -1.30]) to be associated with development of diabetes when full adjustments were made for baseline age, biological risk factors, lifestyle, family history of diabetes, and social class.CONCLUSIONS -The results suggest that sleep disturbances and, possibly, elevated resting heart rate, in middle-aged men, are associated with an increased risk of diabetes. Diabetes Care 27:2464 -2469, 2004S leep problems are common in the adult population according to several epidemiological studies (1), as the amounts of hypnotics prescribed reflect as well (2). Although long-term sleep loss is often secondary to somatic or psychiatric illness (3), it appears that insomnia may also play a more central role in the pathogenesis of somatic illness and metabolic dysregulation (4).Divergent sleep duration, either excessively long or excessively short, has been shown (5), together with selfreported poor sleep quality (6), to be a predictor of overall mortality. Sleep disturbances are associated with increased levels of cardiovascular risk factors and coronary artery disease mortality (7,8). The sleep cycle is closely related to endocrine and metabolic functioning and to sympathovagal balance, with sleep deprivation having negative consequences for these systems. Sleep disturbances are associated with an increased concentration of cortisol and such indicators of increased sympathetic activity as elevations in pulse rate, body temperature, and epinephrine secretion (9,10). Experimentally, sleep deprivation has been shown to negatively affect glucose metabolism and to enhance variables associated with type 2 diabetes (11). An elevated heart rate is a risk marker for cardiovascular disease and may, like sleep problems, reflect increased psychosocial stress.A clinical study has shown sleep disord...

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Obesity and myocardial infarction – vulnerability related to occupational level and marital status. A 23‐year follow‐up of an urban male Swedish population

Cited by 36 publications

References 40 publications

Leukocyte Count and Incidence of Hospitalizations Due to Heart Failure

Leukocyte Count and Incidence of Hospitalizations Due to Heart Failure

Stroke Incidence, Recurrence, and Case-Fatality in Relation to Socioeconomic Position

Incidence of Diabetes in Middle-Aged Men Is Related to Sleep Disturbances

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