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Objective: To investigate differences in different aspects of social participation and social capital among baseline daily smokers that had remained daily smokers, become intermittent smokers, or stopped smoking at one [...]

Objective: To investigate differences in snuff consumption, sociodemographic and psychosocial characteristics between baseline intermittent smokers that had become daily smokers, stopped smoking or remained intermittent smokers at the one year [...]

In order to better understand the role of work environment in the earlier stages of the cardiovascular disease process, we wanted to investigate the influence of work-related psychosocial factors on preclinical atherosclerosis.

OBJECTIVE--To study the natural course of carotid artery stenosis detected by ultrasonography. DESIGN--Prospective cohort study. Baseline examination in 1982-3 included ultrasound examination of carotid arteries, measurement of ankle-brachial blood pressure index, and detection of atrial fibrillation by 24 hour ambulatory electrocardiography. SETTING--Malmö, a city in southern Sweden with 230,000 inhabitants. SUBJECTS--470 men aged 68 years randomly selected from the population. MAIN OUTCOME MEASURES--Incidence of stroke and transient ischaemic attack and all cause mortality during 10 years of follow up in relation to carotid stenosis, leg artery disease (ankle-brachial blood pressure index below 0.9), and atrial fibrillation. RESULTS--Fifty men had a stroke; six of these were haemorrhagic. Another 11 had a transient ischaemic attack. Eighteen of the men with carotid stenosis (21.6 events/1000 person years) and 43 of the men with normal carotid arteries (14.8 events/1000 person years) had a stroke or transient ischaemic attack (P = 0.188). Men with atrial fibrillation had an increased rate of cerebrovascular events (36.7/1000 person years (P = 0.048). The highest rate was found in men with asymptomatic disease of the leg arteries (38.6/1000 person years) (P < 0.001). The increased risk of stroke or transient ischaemic attack in this group remained after multivariate analysis (relative risk 2.0; 95% confidence interval 1.1 to 3.7). CONCLUSIONS--In this cohort carotid stenosis was not associated with an increased risk of stroke. Part of this lack of association was explained by the high mortality from ischaemic heart disease in men with severe stenosis. Twenty seven of the 61 cerebrovascular events, however, occurred in men who had normal carotid arteries, normal ankle pressure, and no atrial fibrillation.

OBJECTIVE: To analyse the association between use of antihypertensive treatment, diastolic blood pressure, and long term incidence of ischaemic cardiac events in elderly men. DESIGN: Population based cohort study. Baseline examination in 1982-3 and follow up for up to 10 years. SETTING: Malm, Sweden. SUBJECTS: 484 randomly selected men born in 1914 and living in Malm during 1982. MAIN OUTCOME MEASURES: Observational comparisons of incidence rates and rate and hazard ratios of ischaemic cardiac events (myocardial infarction or death due to chronic ischaemic cardiac disease). RESULTS: The crude incidence rate of ischaemic cardiac events was higher in those subjects who were taking antihypertensive drugs than in those who were not (rate ratio 2.6 (95% confidence interval 1.7 to 3.9)). After adjustment for potential confounders (differences in baseline smoking habits, blood pressure, time since diagnosis of hypertension, ischaemic or other cardiovascular disease, hypercholesterolaemia, hypertriglyceridaemia, diabetes mellitus, obesity, and raised serum creatinine concentration) this rate was reduced but still raised (hazard ratio 1.9 (1.0 to 3.7)). In men with diastolic blood pressure > 90 mm Hg, antihypertensive treatment was associated with a twofold increase in the incidence of ischaemic cardiac events (rate ratio 2.0 (1.1 to 3.6)), which vanished after adjustment for potential confounders (hazard ratio 1.1 (0.5 to 2.6)). In those subjects with diastolic blood pressure < or = 90 mm Hg, antihypertensive treatment was associated with fourfold increase in incidence (rate ratio 3.9 (2.1 to 7.1)), which remained after adjustment for potential confounders (hazard ratio 3.8 (1.3 to 11.0)). CONCLUSION: Antihypertensive treatment may increase the risk of myocardial infarction in elderly men with treated diastolic blood pressures < or = 90 mm Hg.

To test the stress hypothesis by characterising women during their first pregnancy who continue to smoke in early pregnancy in comparison with women who quit smoking, with special reference to psychosocial factors like social network, social support, demands, and control in work and daily life.

Objectives:An increased risk of all-cause and cardiovascular mortality in users of anxiolytic-hypnotic drugs (AHD) has been reported, and use of analgesics may be an additional factor. Therefore, we examined the association of AHD and analgesic use, alone and in combination, with all-cause and ischaemic heart disease (IHD) mortality. Methods:Multivariate 10-year survival analysis in a population based cohort of 500 men born in 1914. Relative risks (RR) were adjusted by relevant confounders (blood pressure, serum cholesterol, diabetes mellitus, smoking habit, high alcohol consumption, history of previous IHD, cancer, and other diseases). Results:The RR of both all-cause and IHD mortality were significantly increased among those using both AHD and analgesics compared to those who took neither of these drugs: RR=1.8 for all-cause mortality, and RR=2.7 for IHD mortality. Conclusion:Although the number of cases was small, warranting interpretative caution, the current study suggests that the combined use of AHD (mainly benzodiazepines) and analgesics seems to be associated with an increase in all-cause and IHD mortality in elderly men.

Twenty-five in-depth interviews were made with middle-aged persons of both sexes, who had suffered a first myocardial infarction (MI) two months previously. The purpose was to assess the layman's understanding of concepts such as social network, social supportand controlwhich are exposures commonly used or suggested for use in quantitative research in the area of social epidemiology. The validity of the instruments and the underlying concepts in assessing such exposures has important implications for the interpretation of the association between psychosocial factors and health or health behavior.The layman's understanding of social network and social support concepts seemed unproblematic, but the concept of control was understood in rather disparate ways among those interviewed. The experience of control/decision latitude in the work environment, seemed to form a model for the overall understanding of control among several of those interviewed and there also seemed to be important differences based on gender. Another impression, was that the individual's level of aspiration might be an important confounder in the assessment of control in population studies. It is therefore suggested that epidemiologcal data should be stratifyed by basic demographic variables like age, sex and social class in analyses including the control variable, to improve the valid use of this type of measure.

Ischaemic heart disease is responsible for a considerable part of chronic pain in society, and is mainly due to angina pectoris. Improvements in pain relief and treatment continue to be developed, and are likely to improve and become cheaper in the future. Prevention is also of great importance for both individuals and society, and is proving cost-effective. However, we have still to learn much about its complex nature.

Base line data together with data in public registers and a structured phone interview of 94 of the 121 non-attenders was used for an assessment of factors influencing participation in the prospective population study 'Men born in 1914' in Malmö, Sweden. The overall attendance rate was 80.5% but varied among areas in the city from 27% to 100%. The lower participation rate among single men remained, when correcting for social class, significant only for single men in social class III. Men who did not feel well and/or had been admitted to hospital during the last 12 months had a lower participation rate. A negative attitude towards health surveys in general was the most common reason for non-participation. The phone interview turned out to be a feasible method to reach non-attenders to assess whether the sample was representative of the population and to learn more about reasons for non-participation.

Since the excess mortality rate associated with an ankle-brachial blood-pressure index (ABPI) less than 0 9 was only partly explained by an excess cardiovascular mortality, we believe that leg artery disease should not only be regarded as a marker of generalised arteriosclerosis but also as a sign associated with an increased risk of premature death. 439 men who were part of a prospective population study in Malmö, Sweden, were, at 68 years of age, invited to a health examination including, ABPI, carotid-artery ultrasonography, and 24 h ambulatory electrocardiographic monitoring. Cause- specific mortality and incidence of myocardial infarction (MI) during 8 years of follow-up was compared in men with and without signs of arteriosclerotic disease. Of 60 men with an ABPI <0·9, 20 (33%) had angina pectoris or previous Ml. Another 11 (18%) had silent ST-segment depression (≽1 mm); 3 (5%) had a history of stroke; and 17 (28%) had symptom-free carotid stenosis (>30% reduction of the cross-sectional diameter). Total mortality rate in men with no signs of arteriosclerotic disease was 19·6 per 1000 person-years and cardiac event rate (fatal and non-fatal Ml and death from chronic ischaemic heart disease was 8·6 per 1000 person-years). Leg artery disease, carotid stenosis, and ischaemic heart disease were in a univariate analysis all associated with an increased cardiac event rate and an increased total mortality rate. In a multivariate analysis an ABPI less than 0·9 was associated with a 2·4 times higher total mortality (95% Cl 1·5-3·9) and a 2·0 times higher cardiac event rate (1·1-3·9). Carotid stenosis and ischaemic heart disease contributed to the risk for Ml (RR 2 1; 95% Cl 1·2-3·8; and 2·1; 1 2-3·9, respectively), whereas no independent association with total mortality was found.

The objective of this study was to determine whether there is an association of all-cause mortality with different aspects of social network, social support, and social influence. The study sample (n = 621) was a random half of all male residents of Malmö, Sweden, born in 1914, of whom 500 (80.5%) were interviewed and examined in 1982-1983. On the basis of a model with carefully defined and well-differentiated concepts integrated in a theoretic framework of social resources, an instrument was developed to measure different aspects of social network, social support, and social influence. During the follow-up period from September 1982 to November 1987, 67 (13.4%) of the 500 participants died. In univariate analysis, a higher mortality risk was found among men with low availability of emotional support and low adequacy of social participation and among men living alone (crude relative risk = 2.3, 2.3, and 1.7, respectively). These relative mortality risks changed little after adjustments for social class, health status at baseline, cardiovascular risk factors, alcohol intake, physical activity, and body mass index in the multivariate analysis (adjusted relative mortality risk = 2.5, 2.2, and 2.0 for men with low availability of social support and low adequacy of social participation and for men living alone, respectively). These findings are consistent with the existence of a general effect of social network and social support on mortality among elderly men.

A method is described by which the acid secretion of the stomach is maintained at a high level for 11 hours by repeated large doses of histalog subcutaneously injected. In this investigation, two groups of cases, with one untreated, the other treated, with a perorally administered anti-cholinergic, it was possible to study the duration of the drug. The anticholinergic investigated was oxyphencyclimine HCl (Daricol®). The mean duration of 10 mg (1 tablet) was in 8 duodenal ulcer patients at least 6 hours, and of 20 mg (2 tablets) given to 5 duodenal ulcer patients at least 11 hours. The long duration of both 10 mg and 20 mg of oxyphencyclimine should facilitate the adjustment of the optimal effective dose (OED), which might be important in the treatment of hypersecretion in cases of duodenal ulcer.

We examined the associations among different aspects of social network and social support and regular leisure-time physical activity. The study sample (N = 621) comprised a random half of all male residents in Malmo, Sweden, born in 1914. The response rate was 80.5%. Eight conceptually differentiated aspects of social networks and social support were measured. All social network indices and two of the four social support indices were associated with regular physical activity (OR 1.9–3.5 and 1.7–2.1, respectively). After adjustment for medical disorders, risk factors and risk behavior in multivariate analysis only minor reductions of the associations were noted. Men who reported being socially anchored, having many social contacts, feeling satisfied with their social participation, and having good material and informational support, more often took part in regular physical activity. Results from this study indicate that the health effect of social network and social support, at least in some part, could be mediated through physical activity. These new psychosocial determinants make it easier to characterize groups of people in need of regular physical activity, a finding of potential importance in the field of health promotion.