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Mülverstedt S, Prescott EIB, Jørgensen H, Heitmann M. Prevalence and management of familial hypercholesterolaemia in patients with chest pain admitted to hospital: a retrospective observational study. BMJ Open 2024; 14:e082075. [PMID: 38388498 PMCID: PMC10884211 DOI: 10.1136/bmjopen-2023-082075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/24/2023] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVES Patients with familial hypercholesterolaemia (FH) are genetically burdened by a lifelong elevation of the low-density lipoprotein cholesterol (LDL-C) level, putting them at a very high risk of premature ischaemic heart disease (IHD). This study aims to assess the prevalence of FH among patients admitted for IHD and the preventive treatment status before admission. DESIGN Observational, retrospective, register-based study. SETTING Individuals discharged with a diagnosis of IHD were enrolled consecutively throughout 2012-2016 from the cardiac care units of two hospitals in Copenhagen. PARTICIPANTS 4223 individuals were discharged during the period. Inclusion criteria for further investigation were the availability of one measurement of LDL-C at the time of admission. In total, 2797 individuals were included for further investigation. There were no exclusion criteria. PRIMARY AND SECONDARY OUTCOME MEASURES The primary objective has been to determine the prevalence of FH in the population. The secondary objective has been to determine the use of lipid-lowering therapy and to which extend the individuals reach their treatment goal. RESULTS Among the 2797 consecutive patients evaluated, the prevalence of potential FH was 7.7% (1: 13) and 6.8% (1:15) had probably or definite FH. The prevalence of FH was age-dependent: Among the 680 patients (24.3%) with premature IHD (men <55 years/women <60 years), 136 patients (20.0%) had potential FH and 21 (3.1%) had probable/definite FH. None were diagnosed and almost none attained their treatment goal. CONCLUSIONS There is still a massive lack of recognition of FH in patients admitted to a cardiac care unit with a diagnosis of IHD. Despite a measured high LDL-C, the diagnosis was not made for any patients not even in patients who were admitted at an early age or had a previous cardiovascular event.
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Affiliation(s)
| | | | | | - Merete Heitmann
- Department of Cardiology, Bispebjerg Frederiksberg University Hospital, Copenhagen, Denmark
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2
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Szymański P, Bossano Prescott EI, Weidinger F. The first European Union approval of a new medicine to treat cardiovascular diseases in 2023: why is it important to collaborate with the European Medicines Agency? Eur Heart J 2024; 45:7-9. [PMID: 37850604 DOI: 10.1093/eurheartj/ehad426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Affiliation(s)
- Piotr Szymański
- Clinical Cardiology Center, National Institute of Medicine MSWiA, Wołoska Street 137, 02-507 Warsaw, Poland
| | - Eva Irene Bossano Prescott
- Department of Cardiology, Bispebjerg Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Franz Weidinger
- Department of Medicine with Cardiology and Intensive Care Medicine, Vienna Healthcare Group, Clinic Landstraße, Juchgasse 25, 1030 Vienna, Austria
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3
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Jensen SM, Prescott EIB, Abdulla J. The prognostic value of coronary flow reserve in patients with non-obstructive coronary artery disease and microvascular dysfunction: a systematic review and meta-analysis with focus on imaging modality and sex difference. Int J Cardiovasc Imaging 2023; 39:2545-2556. [PMID: 37716916 DOI: 10.1007/s10554-023-02948-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/30/2023] [Indexed: 09/18/2023]
Abstract
To clarify prognosis of patients with non-obstructive coronary artery disease (NOCAD) and coronary microvascular disease (CMD) assessed as low coronary flow reserve (CFR) according to imaging modalities and sex difference. Comprehensive systematic literature review and meta-analyses were conducted. Risk of death and major adverse cardiac events (MACE) were pooled and compared in patients with abnormally low versus normal CFR using cut-off limits 2.0-2.5. Random effects model used for estimation of odds ratios (OR) and hazard ratios (HR) with 95% confidence interval (CI). Nineteen eligible observational studies provided data for death and MACE, publication bias was insignificant, p = 0.62. Risk of death and MACE were significantly higher in patients with low (n = 4.612, 29%) than normal CFR (n = 11.367, 71%): using transthoracal echocardiography (TTE) (OR 4.25 (95% CI 2.94, 6.15) p < 0.001) and (OR 6.98 (95% CI 2.56, 19.01) p < 0.001), positron emission tomography (PET) (OR 2.51 (CI 95%: 1.40, 4..49) p = 0.002) and (OR 2.87 (95% CI 2.16, 3.81) p < 0.001), and invasive intracoronary assessment (OR 2.23 (95% CI 1.15, 4.34) p < 0.018), and (OR 4.61 (95% CI 2.51, 8.48) p < 0.001), respectively. Pooled adjusted HR for death and MACE were (HR 2.45(95% CI 1.37, 3.53) p < 0.001) and (HR 2.08 (95% CI 1.54, 2.63) p < 0.001) respectively. Studies comparing men and women with abnormally low CFR demonstrated similar worse prognosis in both sexes. Low CFR is associated with poorer prognosis in patients with NOCAD regardless of sex. TTE may overestimate risk of death and MACE, while PET seems to be more appropriate. Future studies are needed to consolidate the current evidence.
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Affiliation(s)
- Signe Miang Jensen
- Department of Medicine, Section of Cardiology, Glostrup University Hospital of Copenhagen, Valdemar Hansens vej 1, 2600, Glostrup, Denmark
| | - Eva Irene Bossano Prescott
- Department of Cardiology, Bispebjerg Frederiksberg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark
| | - Jawdat Abdulla
- Department of Medicine, Section of Cardiology, Glostrup University Hospital of Copenhagen, Valdemar Hansens vej 1, 2600, Glostrup, Denmark.
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Nissen L, Winding TN, Schmidt SE, Hasan Shafi B, Bossano Prescott EI, Nyegaard M, Winther S, Bøttcher M. Association between socioeconomic position and coronary artery calcium score in patients with symptoms suggestive of obstructive coronary artery disease. J Cardiovasc Comput Tomogr 2023; 17:138-143. [PMID: 36797085 DOI: 10.1016/j.jcct.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 02/16/2023]
Abstract
AIM Low socioeconomic-position (SEP) is associated with increased prevalence of cardiovascular disease. Whether this is caused by earlier development of atherosclerotic calcifications is not well understood. This study aimed to investigate the association between SEP and coronary artery calcium score (CACS) in a population presenting with symptoms suggestive of obstructive coronary artery disease. METHODS We included 50,561 patients (mean age 57 ± 11, 53% women) from a national registry undergoing coronary computed tomography angiography (CTA) from 2008 to 2019. CACS was used as outcome in categories; 1-399 and ≥ 400 in regression analyses. SEP was obtained from central registries and defined as mean personal income and length of education. RESULTS The number of risk factors were negatively associated with income and education among both men and women. The adjusted OR of having a CACS≥400 was 1.67(1.50-1.86) among women with <10 years of education compared to >13 years. For men the corresponding OR was 1.03(0.91-1.16). For women with low income the adjusted OR of CACS ≥400 was 2.29(1.96-2.69) using high income as a reference. For men the corresponding OR was 1.13(0.99-1.29). CONCLUSION In patients referred for coronary CTA we found an increased level of risk factors among men and women with short education and low income. Among women with longer education and a higher income we demonstrated a lower CACS compared to other women and men. Socioeconomic differences seem to affect the development of CACS beyond what can be explained by traditional risk factors. Part of the observed result may be due to referral bias. CLINICALTRIALS GOV IDENTIFIER None.
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Affiliation(s)
- Louise Nissen
- Department of Cardiology, Gødstrup Hospital, Denmark.
| | | | | | | | | | - Mette Nyegaard
- Department of Health Science and Technology, Aalborg University, Denmark
| | - Simon Winther
- Department of Cardiology, Gødstrup Hospital, Denmark
| | - Morten Bøttcher
- Department of Cardiology, Gødstrup Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
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5
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Bjerking LH, Hansen KW, Biering-Sørensen T, Brønnum-Schou J, Engblom H, Erlinge D, Haahr-Pedersen SA, Heitmann M, Hove JD, Jensen MT, Kruse M, Räder S, Strange S, Galatius S, Prescott EIB. Cost-effectiveness of adding a non-invasive acoustic rule-out test in the evaluation of patients with symptoms suggestive of coronary artery disease: rationale and design of the prospective, randomised, controlled, parallel-group multicenter FILTER-SCAD trial. BMJ Open 2021; 11:e049380. [PMID: 34426466 PMCID: PMC8383880 DOI: 10.1136/bmjopen-2021-049380] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Most patients with symptoms suggestive of chronic coronary syndrome (CCS) have no obstructive coronary artery disease (CAD) and better selection of patients to be referred for diagnostic tests is needed. The CAD-score is a non-invasive acoustic measure that, when added to pretest probability of CAD, has shown good rule-out capabilities. We aimed to test whether implementation of CAD-score in clinical practice reduces the use of diagnostic tests without increasing major adverse cardiac events (MACE) rates in patients with suspected CCS. METHODS AND ANALYSIS FILTER-SCAD is a randomised, controlled, multicenter trial aiming to include 2000 subjects aged ≥30 years without known CAD referred for outpatient assessment for symptoms suggestive of CCS. Subjects are randomised 1:1 to either the control group: standard diagnostic examination (SDE) according to the current guidelines, or the intervention group: SDE plus a CAD-score. The subjects are followed for 12 months for the primary endpoint of cumulative number of diagnostic tests and a safety endpoint (MACE). Angina symptoms, quality of life and risk factor modification will be assessed with questionnaires at baseline, 3 months and 12 months after randomisation. The study is powered to detect superiority in terms of a reduction of ≥15% in the primary endpoint between the two groups with a power of 80%, and non-inferiority on the secondary endpoint with a power of 90%. The significance level is 0.05. The non-inferiority margin is set to 1.5%. Randomisation began on October 2019. Follow-up is planned to be completed by December 2022. ETHICS AND DISSEMINATION This study has been approved by the Danish Medical Agency (2019024326), Danish National Committee on Health Research Ethics (H-19012579) and Swedish Ethical Review Authority (Dnr 2019-04252). All patients participating in the study will sign an informed consent. All study results will be attempted to be published as soon as possible. TRIAL REGISTRATION NUMBER NCT04121949; Pre-results.
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Affiliation(s)
- Louise Hougesen Bjerking
- Department of Cardiology, Bispebjerg Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kim Wadt Hansen
- Department of Cardiology, Bispebjerg Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Tor Biering-Sørensen
- Department of Cardiology, Bispebjerg Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Brønnum-Schou
- Department of Cardiology, Amager Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Engblom
- Department of Clinical Physiology, Skåne University Hospital Lund, Lund, Sweden
| | - David Erlinge
- Department of Clinical Science, Skåne University Hospital Lund, Lund, Sweden
| | | | - Merete Heitmann
- Department of Cardiology, Bispebjerg Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jens Dahlgaard Hove
- Department of Cardiology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
- Center of Functional Imaging and Research, Amager Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Magnus Thorsten Jensen
- Department of Cardiology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Marie Kruse
- Danish Centre for Health Economics (DaCHE), Syddansk Universitet, Odense, Denmark
| | - Sune Räder
- Department of Cardiology, Nordsjællands Hospital, University of Copenhagen, Hillerød, Denmark
| | - Søren Strange
- The Danish Association of Practicing Medical Specialists, Copenhagen, Denmark
| | - Søren Galatius
- Department of Cardiology, Bispebjerg Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Eva Irene Bossano Prescott
- Department of Cardiology, Bispebjerg Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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Islamoska S, Ishtiak-Ahmed K, Hansen ÅM, Grynderup MB, Mortensen EL, Garde AH, Gyntelberg F, Prescott EIB, Török E, Waldemar G, Nabe-Nielsen K. Vital Exhaustion and Incidence of Dementia: Results from the Copenhagen City Heart Study. J Alzheimers Dis 2020; 67:369-379. [PMID: 30584138 PMCID: PMC6398840 DOI: 10.3233/jad-180478] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Psychological distress is potentially linked to the risk of dementia through neurologic and cardiovascular mechanisms. Vital exhaustion (VE) is a mental state of psychological distress, which could be a risk factor for dementia. OBJECTIVE To investigate whether VE is a risk factor for dementia in later life. METHODS We used data from 6,807 participants attending the third survey of the Copenhagen City Heart Study in 1991-1994. VE was assessed by 17 symptoms (score: 0-17) from the Maastricht Questionnaire. Information on dementia was obtained from national registers. Risk time for dementia was counted from five years after VE assessment for participants > 55 years at the time of VE assessment. For younger participants, risk time for dementia was counted from the year they turned 60 years and onwards. Participants were followed until 2016. We used Poisson regression to calculate incidence rate ratios (IRR) and their 95% confidence intervals (CI). RESULTS During an average follow-up of 10 years, 872 participants were registered with dementia. We found a dose-response relation between the number of VE symptoms and the incidence of dementia. For every additional VE symptom, the dementia incidence increased by 2% (IRR = 1.024; 95% CI: 1.004-1.043). Adjustment for socio-demographic and health-related factors did not change the results substantially. Neither did stratification by age, sex, educational level, and marital status. CONCLUSION We found evidence that VE is a risk factor for dementia. Our sensitivity analyses supported that this association was not only due to VE being a potential prodromal sign of dementia.
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Affiliation(s)
- Sabrina Islamoska
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kazi Ishtiak-Ahmed
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Åse Marie Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Anne Helene Garde
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Finn Gyntelberg
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Eszter Török
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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7
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Johansson MS, Korshøj M, Schnohr P, Marott JL, Prescott EIB, Søgaard K, Holtermann A. Time spent cycling, walking, running, standing and sedentary: a cross-sectional analysis of accelerometer-data from 1670 adults in the Copenhagen City Heart Study : Physical behaviours among 1670 Copenhageners. BMC Public Health 2019; 19:1370. [PMID: 31651272 PMCID: PMC6814105 DOI: 10.1186/s12889-019-7679-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 09/23/2019] [Indexed: 01/31/2023] Open
Abstract
Background Information about how much time adults spend cycling, walking and running can be used for planning and evaluating initiatives for active, healthy societies. The objectives of this study were to describe how much time adult Copenhageners cycle, walk, run, stand and spend sedentary using accelerometers, and to describe differences between population groups. Methods In the fifth examination of the Copenhagen City Heart Study, 2335 individuals gave consent to wear accelerometers (skin-attached; right thigh and iliac crest; 24 h/day, 7 consecutive days) of which 1670 fulfilled our inclusion criteria (≥16 h/day for ≥5 days; median wear time: 23.8 h/day). Daily time spent cycling, walking, running, standing and sedentary was derived from accelerometer-based data using the Acti4 software, and differences between sex, age groups, level of education and BMI were investigated using Kruskal-Wallis rank sum tests. Results Among those cycling (61%), the median cycling time was 8.3 min/day. The median time walking, running, standing and sedentary was 82.6, 0.1, 182.5 and 579.1 min/day, respectively. About 88% walked fast (i.e., ≥100 steps/min) ≥30 min/day. The shortest duration and lowest prevalence of cycling, walking and running were found among older individuals, those with a low level of education, and individuals being overweight or obese. Conclusions We found a long duration and high prevalence of cycling and walking, but also that many adult Copenhageners spent much time sedentary. Population groups with low participation in physical activities such as cycling and walking should be targeted in future initiatives towards an active, healthy society.
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Affiliation(s)
- Melker Staffan Johansson
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark. .,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Mette Korshøj
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, Hovedvejen indg. 5, st, 2000, Frederiksberg, Denmark
| | - Jacob Louis Marott
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, Hovedvejen indg. 5, st, 2000, Frederiksberg, Denmark
| | - Eva Irene Bossano Prescott
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, Hovedvejen indg. 5, st, 2000, Frederiksberg, Denmark.,Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Andreas Holtermann
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Bondo Petersen S, Flachs EM, Prescott EIB, Tjønneland A, Osler M, Andersen I, Juel K, Budz-Jørgensen E, Kolstad HA, Schlünssen V, Bonde JP. Job-exposure matrices addressing lifestyle to be applied in register-based occupational health studies. Occup Environ Med 2018; 75:890-897. [PMID: 30173143 PMCID: PMC6252369 DOI: 10.1136/oemed-2018-104991] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 06/19/2018] [Accepted: 07/25/2018] [Indexed: 12/03/2022]
Abstract
Objectives Information about lifestyle factors in register-based occupational health studies is often not available. The objective of this study was therefore to develop gender, age and calendar-time specific job-exposure matrices (JEMs) addressing five selected lifestyle characteristics across job groups as a tool for lifestyle adjustment in register-based studies. Methods We combined and harmonised questionnaire and interview data on lifestyle from several Danish surveys in the time period 1981–2013 for 264 054 employees registered with a DISCO-88 code (the Danish version of International Standard Classification of Occupations (ISCO)-88) in a nationwide register-based Danish Occupational Cohort. We modelled the probability of specified lifestyles in mixed models for each level of the four-digit DISCO code with age and sex as fixed effects and assessed variation in terms of intraclass correlation coefficients (ICCs) and exposure-level percentile ratios across jobs for six different time periods from 1981 through 2013. Results The ICCs were overall low (0.26%–7.05%) as the within-job group variation was large relative to the between job group variation, but across jobs the calendar period-specific ratios between highest and lowest predicted levels were ranging from 1.2 to 6.9, and for the 95%/1% and the 75%/5% percentile ratios ranges were 1.1–2.8 and 1.1–1.6, respectively, thus indicating substantial contrast for some lifestyle exposures and some occupations. Conclusions The lifestyle JEMs may prove a useful tool for control of lifestyle-related confounding in register-based occupational health studies where lacking information on individual lifestyle factors may compromise internal validity.
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Affiliation(s)
- Sesilje Bondo Petersen
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | | | | | - Merete Osler
- Research Centre for Prevention and Health, Glostrup, Denmark
| | - Ingelise Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Knud Juel
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Vivi Schlünssen
- National Research Centre for Working Environment, Copenhagen, Denmark.,Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
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9
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Korshøj M, Hannerz H, Marott JL, Schnohr P, Prescott EIB, Clays E, Holtermann A. The Effect of Occupational Lifting on Hypertension Risk: Protocol for a Project Using Data From the Copenhagen City Heart Study. JMIR Res Protoc 2018; 7:e93. [PMID: 29703713 PMCID: PMC5948412 DOI: 10.2196/resprot.9692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/11/2018] [Accepted: 02/11/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hypertension is a major risk factor for cardiovascular disease and is responsible for 14% of all annual deaths globally. The prevalence of hypertension varies across occupational groups, possibly affected by differences in the working environment. One work-related factor that might impose a risk for hypertension is lifting due to the acute large increases in blood pressure (BP) during lifting. OBJECTIVE The aim of this study is to explore associations between heavy occupational lifting and hypertension in the Copenhagen City Heart Study. METHODS This study will use data from the third, fourth, and fifth examination of the Copenhagen City Heart Study. The dataset contains person-based information on health as well as a large variety of biological, environmental, and lifestyle-related factors. Using a cross-sectional design, we will investigate the association between heavy occupational lifting and hypertension, defined as using antihypertensive drugs or having a measured systolic BP (SBP) ≥140 mm Hg or diastolic BP (DBP) ≥90 mm Hg. Furthermore, in a prospective design, we will investigate the association between heavy occupational lifting and risk of becoming an SBP case, defined as the shift from not using antihypertensive drugs in examination n to use of antihypertensive drugs in examination n+1 or an above median delta value of SBP (SBP in examination n+1−SBP in examination n). RESULTS In the third examination in 1991-1994, 10,135 out of 16,560 participants attended (61.20%), in the fourth examination in 2001-2003, 6237 out of 12,599 participants attended (49.50%), and in the fifth examination in 2011-2015, 4550 out of 9765 participants attended (46.59%). On the basis of the inclusion criteria of answering to the level of occupational physical activity, 5031 observations were excluded from examination 3, 2600 from examination 4, and 1621 from examination 5. Hence, the final populations for the cross-sectional and prospective analysis are assumed to include less than 7166 participants in the cross-sectional analysis and less than 1850 participants in the prospective analysis due to the additional inclusion criteria of measured BP and use of antihypertensive drugs. CONCLUSIONS One-third of the workforce in Europe reports to carry or move heavy loads regularly during working hours (6th survey in Eurofound). Thus, if this study shows occupational lifting to increase the risk for hypertension, the prevention for hypertension can be improved.
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Affiliation(s)
- Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Harald Hannerz
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jacob Louis Marott
- Copenhagen City Heart Study, Frederiksberg and Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Peter Schnohr
- Copenhagen City Heart Study, Frederiksberg and Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Eva Irene Bossano Prescott
- Copenhagen City Heart Study, Frederiksberg and Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Els Clays
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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10
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Ruano-Ravina A, Pena-Gil C, Abu-Assi E, Raposeiras S, van 't Hof A, Meindersma E, Bossano Prescott EI, González-Juanatey JR. Participation and adherence to cardiac rehabilitation programs. A systematic review. Int J Cardiol 2016; 223:436-443. [DOI: 10.1016/j.ijcard.2016.08.120] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 12/14/2022]
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