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  • 1.
    Journath, Gunilla
    et al.
    Karolinska Inst, Dept Neurobiol, Ctr Family & Community Med, Care Sci & Soc, S-14183 Huddinge, Sweden .
    Hellenius, Mai-Lis
    Karolinska Inst, Dept Neurobiol, Ctr Family & Community Med, Care Sci & Soc, S-14183 Huddinge, Sweden .
    Petersson, Ulla
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin.
    Theobald, Holger
    Karolinska Inst, Dept Neurobiol, Ctr Family & Community Med, Care Sci & Soc, S-14183 Huddinge, Sweden .
    Nilsson, Peter M.
    Univ Hosp, Dept Clin Sci Med, Malmo, Sweden.
    Sex differences in risk factor control off treated hypertensives: a national primary healthcare-based study in Sweden2008Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 15, nr 3, s. 258-262Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background To evaluate potential sex differences, this study aimed to investigate blood pressure and lipid control and other risk factors for cardiovascular disease in treated hypertensive (tHT) patients from primary healthcare. Design and methods This cross-sectional survey of tHT patients was carried out between 2002 and 2005 by 264 primary care physicians from Sweden who consecutively recruited 6537 tHT patients (48% men and 52% women) from medical records. Results tHT men more often reached the treatment goal for systolic/diastolic blood pressure, less than 140/90 mmHg, than tHT women (30 vs. 26%, P < 0.01). Men had lower systolic blood pressure than women, however, women had lower diastolic blood pressure and higher pulse pressure. More tHT women had total cholesterol >= 5.0 mmol/l than corresponding men (75 vs. 64% P < 0.001). Men more often had diabetes (25 vs. 20% P < 0.001), left ventricular hypertrophy (20 vs. 16% P < 0.001), and microalbuminuria (24 vs. 16% P < 0.001). Women were more often treated with diuretics (64 vs. 48%) and P-receptor blockers, (54 vs. 51%), and men more often treated with angiotensin-converting enzyme inhibitors (27 vs. 18%), calcium channel blockers (34 vs. 26%), and lipid-lowering drugs (34 vs. 29%). Conclusion A need still exists for more intensified treatment of elevated blood pressure and hypercholesterolemia, especially in women. In hypertensives of both sexes, smoking and other risk factors also need to be addressed to reduce the risk of cardiovascular disease.

  • 2.
    Petersson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Screening for Cardiovascular Risk and Diabetes in Primary Health Care: The Söderåkra Risk Factor Screening Study2009Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background: Cardiovascular disease (CVD) has been the predominant cause of morbidity and mortality for many decades in Sweden. Preventive work in primary health care through individual approach and community-based programmes has shown some success. Still, we need better risk assessment tools and health strategies to lessen the burden of CVD in our population.

    Methods: This thesis is based on four studies that explore the cardiovascular risk factor pattern and its development to CVD morbidity and mortality in the middle-aged (40-59 years) population in Söderåkra, southern Sweden, 1989-2006. At a single physician consultation in 1989-1990 the participants provided information about lifestyle in a self-administered questionnaire, underwent a physical examination and received medical advice after a laboratory investigation. The laboratory tests consisted mainly of blood glucose, serum lipids and thyroid function tests. Blood samples were also frozen for later analyses. A telephone interview on self-reported lifestyle changes was conducted ten years later. In 2006, primary health care medical records were studied for incident diabetes and also for impaired glucose tolerance (IGT). Finally, national registers were studied for incident fatal or nonfatal cardiovascular disease until 2006. Cardiovascular risk assessments using three separate risk algorithms were applied on the population.

    Results: The participation rate was high with 90% attendance. The conclusion of this cross-sectional baseline analysis was that it is meaningful to check for a secondary cause of hyperlipidemia, hypothyroidism, in women with a cholesterol value above 7.0 mmol/L. After 10 years follow-up women reported significantly more lifestyle changes than men, odds ratio (OR) 1.56 (95% CI: 1.11- 2.18; p= 0.010). Men with a history of smoking or CVD at baseline and women with treated hypertension at baseline made successful lifestyle changes, OR 4.77 (95% CI: 2.18-10.5; p<0.001 and OR 1.84 (95% CI: 1.12-3.02; p= 0.016), respectively, than those without these characteristics. Until 2006, 38 participants had developed diabetes and four subjects IGT out of 664 participants, excluding 10 with diabetes at baseline. A low level of IGFBP-1 at baseline was associated with the development of type 2 diabetes/IGT, hazard ratio (HR) 3.54 (95% CI: 1.18-10.6, p=0.024). This was independent of abdominal obesity or inflammation (CRP). After excluding 16 participants with prevalent CVD at baseline, 71 first fatal or nonfatal CVD events in 689 men and women were registered. Several known risk factors and risk markers were applied on this population.

    Those that turned out to be significantly associated with development of incident CVD in univariate Cox´s regression proportional hazard analyses where used in three different risk assessment models: the consultation model, SCORE and the extensive model. A non-laboratory-based risk assessment model, including variables easily obtained during one consultation visit to a general practitioner (GP), predicted cardiovascular events as accurately, HR 2.72; (CI 95% 2.18-3.39, p<0.001), as the established SCORE algorithm, HR 2.73; (CI 95% 2.10-3.55, p<0.001), which requires laboratory testing. Furthermore, adding laboratory measurements covering lipids, inflammation and endothelial dysfunction, did not confer any additional value to the prediction of CVD risk, HR 2.72; (CI 95% 2.19-3.37, p<0.001). The c-statistics for the consultation model (0.794; CI 95% 0.762-0.823) was not significantly different from SCORE (0.767; CI 95% 0.733-0.798, p=0.12) or the extended model (0.806; CI 95% 0.774-0.835, p=0.55).

    Conclusions: Our study showed that it is worth searching for hypothyroidism, in women with a cholesterol value above 7 mmol/L. The study identified female gender, previous CVD, hypertension and smoking as predictors of positive lifestyle change during follow-up. A low level of IGFBP-1 predicted future diabetes/IGT in this population as did increased waist and CRP. Finally, data on nonlaboratory risk factors obtained during one GP visit predicted future cardiovascular risk as accurately as SCORE or a laboratory-based risk algorithm.

    Delarbeten
    1. Thyroid function tests, serum lipids and gender interrelations in a middle-aged population
    Öppna denna publikation i ny flik eller fönster >>Thyroid function tests, serum lipids and gender interrelations in a middle-aged population
    2001 (Engelska)Ingår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 19, nr 3, s. 183-185Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    OBJECTIVE: To study the value of screening for thyroid function in a screening program for hyperlipidaemia.

    DESIGN: A screening study in primary health care.

    SETTING: All individuals in a defined rural area, Söderåkra, Sweden, aged 40-59 years were invited to a screening programme at the local primary health care centre.

    PARTICIPANTS: 782 individuals were invited for screening. Blood samples were obtained from 88% of the invited males and from 92% of the females.

    MAIN OUTCOME MEASURES: Thyroid function tests (thyroid stimulating hormone (TSH) and free T4), serum lipids (total-cholesterol, HDL-cholesterol, LDL-cholesterol and s-triglycerides), b-glucose and body anthropometry (body mass index and waist to hip circumference) were measured.

    RESULTS: 0.57% of males and 1.13% of females showed evidence of hypothyroidism as defined by a TSH value greater than 3.75 mU/l of those with s-cholesterol concentration above 7 mmol/l. In addition, higher TSH values in females were associated with higher s-cholesterol, s-LDL-cholesterol and s-triglycerides.

    CONCLUSION: It seems appropriate to screen for hypothyroidism in females with s-cholesterol above 7.0 mmol/l.

    Nyckelord
    Free, T4, Serum, Lipids, Gender, Primary-CARE, Thyroid; Function, Tsh
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-17688 (URN)10.1080/028134301316982432 (DOI)11697562 (PubMedID)
    Tillgänglig från: 2009-04-14 Skapad: 2009-04-14 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    2. Predictors of successful, self-reported lifestyle changes in a defined middle-aged population: the Soderakra Cardiovascular Risk Factor Study, Sweden
    Öppna denna publikation i ny flik eller fönster >>Predictors of successful, self-reported lifestyle changes in a defined middle-aged population: the Soderakra Cardiovascular Risk Factor Study, Sweden
    Visa övriga...
    2008 (Engelska)Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, nr 4, s. 389-396Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Aims: It is well established that the main cause of the development of cardiovascular disease can be found in unhealthy lifestyle habits. In our study, we wanted to explore the long-term predictors of self-reported lifestyle changes in a middle-aged population after screening for cardiovascular risk factors 10 years earlier.

    Methods: We conducted a 10-year follow-up telephone interview on self-reported lifestyle changes in a rural population in south-eastern Sweden, after a cardiovascular screening programme. The population comprised 90% of all inhabitants (n=705) aged 40-59 years at baseline, and 90% of these (n=629) were reached for the telephone interview.

    Results: When multivariate logistic regression was used, a higher success rate for lifestyle changes was independently associated with female gender (odds ratio (OR)=1.56, 95% confidence interval (CI) 1.11-2.18). When stratified for gender, significant predictors for success in men were prevalent cardiovascular risk conditions (OR=4.77, 95% CI 2.18-10.5; p<0.001) and previous myocardial infarction (OR=22.8, 95% CI 4.73-110; p<0.001) at baseline. For women, elevated blood pressure (> or = 160 and/or > or = 90 mmHg) measured at baseline (OR=1.84, 95% CI 1.12-3.02; p=0.016) was significantly associated with successful lifestyle changes. Smoking at baseline was also associated with significant success: OR=3.36 (95% CI:2.05-5.51; p<0.001) and OR=1.81 (95% CI 1.11-2.95; p=0.017) for men and women, respectively.

    Conclusions: Female gender was associated with significant improvements in self-reported lifestyle changes. Furthermore, smoking, a medical history of diabetes, hypertension, angina pectoris or myocardial infarction at baseline predicted success in lifestyle change in this 10-year follow-up study.

    Nyckelord
    Cardiovascular, lifestyle change, population-based, risk factors
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-17689 (URN)10.1177/1403494808089561 (DOI)18539693 (PubMedID)
    Tillgänglig från: 2009-04-14 Skapad: 2009-04-14 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    3. Low levels of insulin-like growth-factor-binding protein-1 (IGFBP-1) are prospectively associated with the incidence of type 2 diabetes and impaired glucose tolerance (IGT): The Söderåkra Cardiovascular Risk Factor Study
    Öppna denna publikation i ny flik eller fönster >>Low levels of insulin-like growth-factor-binding protein-1 (IGFBP-1) are prospectively associated with the incidence of type 2 diabetes and impaired glucose tolerance (IGT): The Söderåkra Cardiovascular Risk Factor Study
    Visa övriga...
    2009 (Engelska)Ingår i: Diabetes & Metabolism, ISSN 1262-3636, E-ISSN 1878-1780, Vol. 35, nr 3, s. 198-205Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    AIM: To explore the association between baseline levels of insulin-like growth-factor-binding protein-1 (IGFBP-1), a marker of insulin sensitivity, and the development of type 2 diabetes or impaired glucose tolerance (IGT) in a specifically defined middle-aged population.

    METHODS: This cross-sectional population-based screening study was conducted in 1989-1990 and included baseline data for 664 non-diabetic subjects aged 40-59 years. Clinical data were collected and blood samples analyzed for blood glucose, serum lipids and insulin. Blood specimens were frozen at baseline and later analyzed for IGF-I, IGFBP-1 and C-reactive protein (CRP). At the follow-up in 2006, the incidence of type 2 diabetes and IGT was reported based on primary-care medical records.

    RESULTS: During the 17-year observation period, 42 subjects (6.3%) developed type 2 diabetes/IGT. Those in the lowest quintile of IGFBP-1 (/=59mug/L), the incidence was 1.5%. Cox's proportional-hazards model regression analyses were used to determine the incidence of type 2 diabetes/IGT, corrected for age and gender, in relation to IGFBP-1, CRP and waist circumference. Subjects in the lowest IGFBP-1 quintile showed an independently increased risk of type 2 diabetes/IGT [hazards ratio (HR): 3.54; 95% CI 1.18-10.6; P=0.024]. For CRP and waist circumference, the corresponding figures were HR: 6.81; 95% CI 2.50-18.6; P<0.001 and HR: 3.33; 95% CI 1.47-7.6; P=0.004, respectively.

    CONCLUSION: Low levels of IGFBP-1 predicted the long-term development of type 2 diabetes or IGT in a middle-aged population. The association was independent of CRP and abdominal obesity.

    Ort, förlag, år, upplaga, sidor
    Cedex, France: Elsevier, 2009
    Nyckelord
    CRP, IGFBP-1, Prediction; Screening, Type 2 diabetes, Longitudinal study
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-17690 (URN)10.1016/j.diabet.2008.11.003 (DOI)000267655700006 ()19297224 (PubMedID)
    Tillgänglig från: 2009-04-14 Skapad: 2009-04-14 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    4. A consultation-based method is equal to SCORE and an extensive laboratory-based method in predicting risk of future cardiovascular disease
    Öppna denna publikation i ny flik eller fönster >>A consultation-based method is equal to SCORE and an extensive laboratory-based method in predicting risk of future cardiovascular disease
    2009 (Engelska)Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 16, nr 5, s. 536-540Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    BACKGROUND: As cardiovascular disease (CVD) is one of the most common causes of mortality worldwide, much interest has been focused on reliable methods to predict cardiovascular risk.

    DESIGN: A cross-sectional, population-based screening study with 17-year follow-up in Southern Sweden.

    METHODS: We compared a non-laboratory, consultation-based risk assessment method comprising age, sex, present smoking, prevalent diabetes or hypertension at baseline, blood pressure (systolic >/=140 or diastolic >/=90), waist/height ratio and family history of CVD to Systemic COronary Risk Evaluation (SCORE) and a third model including several laboratory analyses, respectively, in predicting CVD risk. The study included clinical baseline data on 689 participants aged 40-59 years without CVD. Blood samples were analyzed for blood glucose, serum lipids, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein-1, C-reactive protein, asymmetric dimethyl arginine and symmetric dimethyl arginine. During 17 years, the incidence of total CVD (first event) and death was registered.

    RESULTS: A non-laboratory-based risk assessment model, including variables easily obtained during one consultation visit to a general practitioner, predicted cardiovascular events as accurately [hazard ratio (HR): 2.72; 95% confidence interval (CI): 2.18-3.39, P<0.001] as the established SCORE algorithm (HR: 2.73; 95% CI: 2.10-3.55, P<0.001), which requires laboratory testing. Furthermore, adding a combination of sophisticated laboratory measurements covering lipids, inflammation and endothelial dysfunction, did not confer any additional value to the prediction of CVD risk (HR: 2.72; 95% CI: 2.19-3.37, P<0.001). The c-statistics for the consultation model (0.794; 95% CI: 0.762-0.823) was not significantly different from SCORE (0.767; 95% CI: 0.733-0.798, P=0.12) or the extended model (0.806; 95% CI: 0.774-0.835, P=0.55).

    CONCLUSION: A risk algorithm based on non-laboratory data from a single primary care consultation predicted long-term cardiovascular risk as accurately as either SCORE or an elaborate laboratory-based method in a defined middle-aged population.

    Ort, förlag, år, upplaga, sidor
    London, UK: Sage Publications, 2009
    Nyckelord
    Algorithm, cardiovascular, mortality, risk, screening
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-17691 (URN)10.1097/HJR.0b013e32832b1833 (DOI)000271456200003 ()19357517 (PubMedID)
    Tillgänglig från: 2009-04-14 Skapad: 2009-04-14 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
  • 3.
    Petersson, Ulla
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Kjellström, Thomas
    2Department of Internal Medicine, Helsingborg Hospital, Sweden.
    Thyroid function tests, serum lipids and gender interrelations in a middle-aged population2001Ingår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 19, nr 3, s. 183-185Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study the value of screening for thyroid function in a screening program for hyperlipidaemia.

    DESIGN: A screening study in primary health care.

    SETTING: All individuals in a defined rural area, Söderåkra, Sweden, aged 40-59 years were invited to a screening programme at the local primary health care centre.

    PARTICIPANTS: 782 individuals were invited for screening. Blood samples were obtained from 88% of the invited males and from 92% of the females.

    MAIN OUTCOME MEASURES: Thyroid function tests (thyroid stimulating hormone (TSH) and free T4), serum lipids (total-cholesterol, HDL-cholesterol, LDL-cholesterol and s-triglycerides), b-glucose and body anthropometry (body mass index and waist to hip circumference) were measured.

    RESULTS: 0.57% of males and 1.13% of females showed evidence of hypothyroidism as defined by a TSH value greater than 3.75 mU/l of those with s-cholesterol concentration above 7 mmol/l. In addition, higher TSH values in females were associated with higher s-cholesterol, s-LDL-cholesterol and s-triglycerides.

    CONCLUSION: It seems appropriate to screen for hypothyroidism in females with s-cholesterol above 7.0 mmol/l.

  • 4.
    Petersson, Ulla
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Primärvården i västra länsdelen.
    Brudin, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Brismar, K.
    Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden.
    Nilsson, P. M.
    Department of Clinical Sciences, Lund University, University Hospital, Malmö, Sweden.
    Low levels of insulin-like growth-factor-binding protein-1 (IGFBP-1) are prospectively associated with the incidence of type 2 diabetes and impaired glucose tolerance (IGT): The Söderåkra Cardiovascular Risk Factor Study2009Ingår i: Diabetes & Metabolism, ISSN 1262-3636, E-ISSN 1878-1780, Vol. 35, nr 3, s. 198-205Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To explore the association between baseline levels of insulin-like growth-factor-binding protein-1 (IGFBP-1), a marker of insulin sensitivity, and the development of type 2 diabetes or impaired glucose tolerance (IGT) in a specifically defined middle-aged population.

    METHODS: This cross-sectional population-based screening study was conducted in 1989-1990 and included baseline data for 664 non-diabetic subjects aged 40-59 years. Clinical data were collected and blood samples analyzed for blood glucose, serum lipids and insulin. Blood specimens were frozen at baseline and later analyzed for IGF-I, IGFBP-1 and C-reactive protein (CRP). At the follow-up in 2006, the incidence of type 2 diabetes and IGT was reported based on primary-care medical records.

    RESULTS: During the 17-year observation period, 42 subjects (6.3%) developed type 2 diabetes/IGT. Those in the lowest quintile of IGFBP-1 (/=59mug/L), the incidence was 1.5%. Cox's proportional-hazards model regression analyses were used to determine the incidence of type 2 diabetes/IGT, corrected for age and gender, in relation to IGFBP-1, CRP and waist circumference. Subjects in the lowest IGFBP-1 quintile showed an independently increased risk of type 2 diabetes/IGT [hazards ratio (HR): 3.54; 95% CI 1.18-10.6; P=0.024]. For CRP and waist circumference, the corresponding figures were HR: 6.81; 95% CI 2.50-18.6; P<0.001 and HR: 3.33; 95% CI 1.47-7.6; P=0.004, respectively.

    CONCLUSION: Low levels of IGFBP-1 predicted the long-term development of type 2 diabetes or IGT in a middle-aged population. The association was independent of CRP and abdominal obesity.

  • 5.
    Petersson, Ulla
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Primärvården i västra länsdelen.
    Brudin, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Nilsson, Peter
    Department of Clinical Sciences, Lund University, University Hospital, Malmö , Sweden.
    A consultation-based method is equal to SCORE and an extensive laboratory-based method in predicting risk of future cardiovascular disease2009Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 16, nr 5, s. 536-540Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: As cardiovascular disease (CVD) is one of the most common causes of mortality worldwide, much interest has been focused on reliable methods to predict cardiovascular risk.

    DESIGN: A cross-sectional, population-based screening study with 17-year follow-up in Southern Sweden.

    METHODS: We compared a non-laboratory, consultation-based risk assessment method comprising age, sex, present smoking, prevalent diabetes or hypertension at baseline, blood pressure (systolic >/=140 or diastolic >/=90), waist/height ratio and family history of CVD to Systemic COronary Risk Evaluation (SCORE) and a third model including several laboratory analyses, respectively, in predicting CVD risk. The study included clinical baseline data on 689 participants aged 40-59 years without CVD. Blood samples were analyzed for blood glucose, serum lipids, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein-1, C-reactive protein, asymmetric dimethyl arginine and symmetric dimethyl arginine. During 17 years, the incidence of total CVD (first event) and death was registered.

    RESULTS: A non-laboratory-based risk assessment model, including variables easily obtained during one consultation visit to a general practitioner, predicted cardiovascular events as accurately [hazard ratio (HR): 2.72; 95% confidence interval (CI): 2.18-3.39, P<0.001] as the established SCORE algorithm (HR: 2.73; 95% CI: 2.10-3.55, P<0.001), which requires laboratory testing. Furthermore, adding a combination of sophisticated laboratory measurements covering lipids, inflammation and endothelial dysfunction, did not confer any additional value to the prediction of CVD risk (HR: 2.72; 95% CI: 2.19-3.37, P<0.001). The c-statistics for the consultation model (0.794; 95% CI: 0.762-0.823) was not significantly different from SCORE (0.767; 95% CI: 0.733-0.798, P=0.12) or the extended model (0.806; 95% CI: 0.774-0.835, P=0.55).

    CONCLUSION: A risk algorithm based on non-laboratory data from a single primary care consultation predicted long-term cardiovascular risk as accurately as either SCORE or an elaborate laboratory-based method in a defined middle-aged population.

  • 6.
    Petersson, Ulla
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Vårdcentraler.
    Brudin, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Ovhed, Ingvar
    Blekinge Institute for R&D, Karlshamn, Sweden.
    Nilsson, Peter M
    Department of Clinical Sciences Medicine, University Hospital, Malmö, Sweden.
    Predictors of successful, self-reported lifestyle changes in a defined middle-aged population: the Soderakra Cardiovascular Risk Factor Study, Sweden2008Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, nr 4, s. 389-396Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: It is well established that the main cause of the development of cardiovascular disease can be found in unhealthy lifestyle habits. In our study, we wanted to explore the long-term predictors of self-reported lifestyle changes in a middle-aged population after screening for cardiovascular risk factors 10 years earlier.

    Methods: We conducted a 10-year follow-up telephone interview on self-reported lifestyle changes in a rural population in south-eastern Sweden, after a cardiovascular screening programme. The population comprised 90% of all inhabitants (n=705) aged 40-59 years at baseline, and 90% of these (n=629) were reached for the telephone interview.

    Results: When multivariate logistic regression was used, a higher success rate for lifestyle changes was independently associated with female gender (odds ratio (OR)=1.56, 95% confidence interval (CI) 1.11-2.18). When stratified for gender, significant predictors for success in men were prevalent cardiovascular risk conditions (OR=4.77, 95% CI 2.18-10.5; p<0.001) and previous myocardial infarction (OR=22.8, 95% CI 4.73-110; p<0.001) at baseline. For women, elevated blood pressure (> or = 160 and/or > or = 90 mmHg) measured at baseline (OR=1.84, 95% CI 1.12-3.02; p=0.016) was significantly associated with successful lifestyle changes. Smoking at baseline was also associated with significant success: OR=3.36 (95% CI:2.05-5.51; p<0.001) and OR=1.81 (95% CI 1.11-2.95; p=0.017) for men and women, respectively.

    Conclusions: Female gender was associated with significant improvements in self-reported lifestyle changes. Furthermore, smoking, a medical history of diabetes, hypertension, angina pectoris or myocardial infarction at baseline predicted success in lifestyle change in this 10-year follow-up study.

  • 7.
    Petersson, Ulla
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Östgren, Carl-Johan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland.
    Brudin, Lars
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi.
    brismar, kerstin
    KI.
    Nilsson, Peter M
    Malmö.
    Association between elevated blood pressure and surrogate markers for insulin resistance in a defined population. The Söderåkra Cardiovascular Risk Factor Study2006Ingår i: ESH,2006, 2006Konferensbidrag (Övrigt vetenskapligt)
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