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Bruna Galobardes

Publications and source records attributed to Bruna Galobardes.

14 recordsLinked to original sources
PubMed2006

Associations between tooth loss and mortality patterns in the Glasgow Alumni Cohort.

OBJECTIVE: To use data from the Glasgow Alumni Cohort to investigate whether oral health in young adulthood is independently associated with later life cardiovascular disease (CVD) and cancer mortality. METHODS AND RESULTS: Of the original cohort (n = 15 322), 12 631 subjects were traced through the National Health Service Central Register. Of these, 9569 men and 2654 women were 30 years or younger at baseline. During up to 57 years of follow-up, 1432 deaths occurred among subjects with complete data, including 509 deaths from CVD and 549 from cancer. After adjusting for potential confounders, no substantial association was found between the number of missing teeth (as a continuous variable) and all-cause mortality (hazard ratio (HR) for each extra missing tooth = 1.01; 95% confidence interval (CI) 1.00 to 1.02), CVD mortality (HR = 1.01; 95% CI 0.99 to 1.03) or cancer mortality (HR = 1.00; 95% CI 0.98 to 1.02). When the number of missing teeth was treated as a categorical variable, there was evidence that students with nine or more missing teeth at baseline had an increased risk of CVD (HR = 1.35; 95% CI 1.03 to 1.77) compared with those with fewer than five missing teeth. When the number of missing teeth was transformed using fractional polynomials, there seemed to be a non-linear relation between missing teeth and CVD mortality. CONCLUSIONS: Although some evidence was found to support the relation between tooth loss and CVD mortality, causal mechanisms underlying this association remain uncertain.

Adolescent↗
PubMed2006

Association of body mass index measured in childhood, adolescence, and young adulthood with risk of ischemic heart disease and stroke: findings from 3 historical cohort studies.

BACKGROUND: It is unclear whether early life body mass index (BMI; in kg/m(2)) is associated with adult cardiovascular disease. OBJECTIVE: The objective was to assess the association of early life BMI with the risk of ischemic heart disease (IHD) and stroke. DESIGN: The association between early life BMI and risk of adult mortality from IHD and stroke was assessed in 3 historical cohort studies in which height and weight had been assessed by using standard procedures. Participants were traced and linked to national mortality data. Participants in the 3 cohorts were born between 1922 and 1937, 1927 and 1956, and 1928 and 1950 and were aged 2-15, 9-18, and 16-22 y, respectively, at the time of assessment of their height and weight. RESULTS: Participants in all 3 cohorts had mean BMIs similar to those reported for contemporary children and young adults, but fewer of the cohort participants were overweight or obese. BMI was not associated with future risk of IHD or stroke in any cohort. The pooled (all 3 cohorts) adjusted hazard ratio per SD of early life BMI was 1.09 (95% CI: 1.01, 1.19) for IHD and 0.94 (95% CI: 0.82, 1.08) for stroke. The pooled hazard ratio of IHD when participants who were overweight or obese for their age were compared with all other participants was 1.34 (95% CI: 0.95, 1.91), and no association was found between overweight or obesity and stroke risk. The effects of BMI did not vary by cohort or by age. CONCLUSION: These results do not provide strong evidence that being overweight or obese in childhood is associated with future cardiovascular disease risk.

Adolescent↗
PubMed2006

Indicators of socioeconomic position (part 1).

This glossary presents a comprehensive list of indicators of socioeconomic position used in health research. A description of what they intend to measure is given together with how data are elicited and the advantages and limitation of the indicators. The glossary is divided into two parts for journal publication but the intention is that it should be used as one piece. The second part highlights a life course approach and will be published in the next issue of the journal.

Evidence-Based Medicine↗
PubMed2005

Systematic review of the influence of childhood socioeconomic circumstances on risk for cardiovascular disease in adulthood.

PURPOSE: Adverse socioeconomic circumstances in childhood may confer a greater risk for adult cardiovascular disease (CVD). The purpose of this review is to systematically evaluate evidence for an association between socioeconomic circumstances during childhood and specific CVD subtypes, independent of adult socioeconomic conditions. METHODS: We systematically retrieved individual-level studies of morbidity and mortality from CVD and specific CVD subtypes linked to early life influences, including coronary heart disease (CHD), ischemic and hemorrhagic stroke, peripheral vascular disease, markers of atherosclerosis (carotid intima-media thickness and stenosis), and rheumatic heart disease. Indicators of socioeconomic position in childhood varied, although most studies relied on father's occupation. RESULTS: We located 40 studies (24 prospective, 11 case-control, and 5 cross-sectional) reported in 50 publications. Thirty-one studies (19 prospective, 7 case-control, and all 5 cross-sectional) found a robust inverse association between childhood circumstances and CVD risk, although findings sometimes varied among specific outcomes, socioeconomic measures, and sex. Case-control studies reported mixed results. The association was stronger for stroke and, in particular, hemorrhagic stroke, than for CHD. Childhood socioeconomic conditions remained important predictors of CVD, even in younger cohorts. CONCLUSION: Childhood and adulthood socioeconomic circumstances are important determinants of CVD risk. The specific contribution of childhood and adulthood characteristics varies across different CVD subtypes. Disease-specific mechanisms are likely to explain the childhood origins of these adult health inequalities.

Adult↗
PubMed2005

Use of hormone replacement therapy by menopausal women: a comparison between primary care patients and the general population.

OBJECTIVES: To compare frequency and patterns of hormone replacement therapy (HRT) between primary care patients and the local community. METHODS: Comparison of data from a questionnaire survey of 107 peri- and postmenopausal patients in an academic primary care clinic during 1998 to similar data from a sample (n = 241) of an ongoing annual epidemiological survey representative of the general population. RESULTS: Mean age, menopause status, age of initiation of HRT, and prior use of contraceptive pill were similar in both groups. Current HRT use tended to be lower among patients in the clinic than in the community. HRT users in the clinic were more likely to have had a surgical menopause (34.4% vs. 16.1%, p = 0.04) and to have used hormones for shorter periods than in the general population. Differences remained significant after adjustment in multivariate analysis. CONCLUSIONS: Compared to the general population, patterns of HRT use in the outpatient clinic were more restrictive than recommendations on HRT that were published at the time. This is an example of how comparison of health issues between patients in medical care and a local epidemiological survey can help to understand clinical practice.

Aged↗
PubMed2005

Mortality after a first episode of status epilepticus in the United States and Europe.

OBJECTIVE: In the last decade several studies have been published on incidence, etiology, and prognosis of status epilepticus (SE) with population-based data from the United States and Europe. The aim of this review is to summarize the available information on the epidemiology of SE and to outline the sources of the variability in reported mortality after SE. METHODS: Comparison of mortality studies in SE from the United States and Europe. RESULTS: The incidence of SE is lower in Europe (9.9-15.8/10,000) than in the United States (18.3-41/100,000). The overall mortality after SE is similar in the two U.S. studies: the case fatality is 21% in Rochester, and 22% in Richmond. All European studies excluded SE after anoxic encephalopathy following cardiac arrest. This exclusion may partly explain the lower case fatality (around 10%) found in two of the European studies. The study from Bologna showed the highest case fatality (33%) even after exclusion of anoxic encephalopathy. The mortality in acute symptomatic SE was higher than for other forms of SE across all studies. CONCLUSIONS: Short-term mortality after SE occurs mainly in the acute symptomatic group. Based on published data, it is not clear if differences in early management and medical treatment have any impact on prognosis or whether the differences can be attributed only to differences in distribution of the underlying causes in acute symptomatic SE. Future studies should address this issue.

Acute Disease↗
PubMed2003

Trends in risk factors for the major "lifestyle-related diseases" in Geneva, Switzerland, 1993-2000.

PURPOSE: Continuous monitoring of health determinants in populations is necessary to predict future disease burdens. The objective of this study was to assess the prevalences of major risk factors for lifestyle diseases for 8 years (1993 to 2000) in representative samples of the general population. METHODS: Independent cross-sectional surveys representative of adults aged 35 to 74 years (4228 men and 4190 women) in Geneva, Switzerland, conducted continuously between 1993 and 2000. RESULTS: Prevalence of hypertension decreased 15% in men and 10% in women (trend p's<.0001), while overweight/obesity prevalences increased 10% in men and 8% in women (trend p's<.05). The prevalences of smoking (men: 29%; women: 24%) and physical inactivity (men: 44%; women: 50%) remained high and unchanged, and the dietary unsaturated/saturated fat ratio did not change (men: 0.40; women: 0.48). CONCLUSIONS: Because of the persistent high prevalence of risk factors, the global burden of chronic diseases is likely to grow in the next decade and beyond. Continuous monitoring provides reliable trends, beyond seasonal and sampling variations.

Adult↗
PubMed2003

Trends in risk factors for lifestyle-related diseases by socioeconomic position in Geneva, Switzerland, 1993-2000: health inequalities persist.

OBJECTIVES: We report on trends in risk factors for lifestyle-related diseases among socioeconomic position (SEP) groups. METHODS: We continuously surveyed the adult population of Geneva, Switzerland, for 8 years (1993-2000) with independent, cross-sectional surveys of representative samples (4207 men and 3987 women aged 35-74 years). Age-adjusted linear regression slopes estimated annual risk factor trends. Interaction terms were tested for trend differences between SEP groups. RESULTS: Overall, low-SEP persons had the worst risk factor profiles. Eight-year trends indicate that (1) number of pack-years smoked decreased by half a pack-year among high-SEP female current smokers only; (2) obesity prevalence more than doubled from 5% to 11% among high-SEP men only; (3) systolic and diastolic blood pressures decreased similarly in all SEP groups; (4) unsaturated-to-saturated dietary fat ratio declined in the low-SEP group only; and (5) physical inactivity and current/former cigarette smoking prevalences remained unchanged in all SEP groups. CONCLUSIONS: Smoking, obesity, high blood pressure, and physical inactivity are more prevalent among low-SEP persons. Most socioeconomic risk factor differences remained stable in the 1990s. Thus, social inequalities in chronic disease morbidity and mortality will persist in the next decades.

Adult↗