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Biomedical subjects

E Billing

Publications and source records attributed to E Billing.

17 recordsLinked to original sources
PubMed2000

Psychosocial variables in relation to various risk factors in patients with stable angina pectoris.

OBJECTIVES: To evaluate relationships between psychosocial variables and common risk factors such as age, concomitant diseases (hypertension, diabetes mellitus, myocardial infarction, heart failure) and smoking habits in patients with stable angina pectoris. SETTING: University Hospital. SUBJECTS: Participants in the Angina Prognosis Study in Stockholm (APSIS), which comprised 809 patients (248 females) <70 years of age, with chronic stable angina pectoris, of whom 767 (236 females) participated in the present report. Patients with angina pectoris occurring only at rest constituted one group, patients with angina pectoris on effort with or without angina at rest were stratified according to signs of marked ischaemia on exercise and/or clinical signs of heart failure. METHODS: Psychosomatic symptoms, job strain, Type-A behaviour, sleep disturbances and overall life satisfaction were evaluated by a structured interview, which also included questions regarding how the patients usually felt, and health related problems, according to a standardized check-list. RESULTS: Age correlated with several psychosomatic symptoms and tendency to worry. When adjusted for age and sex, patients with previous myocardial infarction and heart failure described more psychosomatic symptoms, but worried less about the future than patients without these diseases. In the group with angina pectoris at rest only there were fewer smokers than amongst other groups, regardless of risk stratification. CONCLUSIONS: Smoking habits and concomitant diseases influence psychosocial variables in patients with stable angina pectoris. The severity of angina pectoris does not seem to relate to life satisfaction and attitudes towards the future.

Aged↗
PubMed1997

Psychosocial variables in female vs male patients with stable angina pectoris and matched healthy controls.

AIM: This study was set up to evaluate psychosocial risk factors in patients with stable angina pectoris, with particular attention to gender differences, as this has previously been studied mainly in relation to myocardial infarction in males. MATERIAL: Seven hundred and sixty-seven patients (236 women) were studied. They were selected from the 809 patients included in the Angina Prognosis Study in Stockholm (APSIS), and 50 matched healthy subjects. METHOD: Data were gathered by structured psychosocial interviews on inclusion into the APSIS study. RESULTS: Patients with stable angina pectoris experienced significantly more stressful events, and suffered more frequently from disturbed and psychosomatic symptoms than healthy controls. At work they experienced less skill discretion and less control. The patients had higher rating scores for hostility and lower levels of self-rated overall well-being. With regard to gender differences, women were more likely to suffer from the strain of work, psychosomatic symptoms, disturbed sleep and stressful events than male patients. Females rated less type A-behaviour and hostility than males. CONCLUSIONS: These findings suggest that previously known psychosocial risk factors for acute myocardial infarction are more common in patients with stable angina pectoris than in controls, and differ between female and male patients.

Adrenergic beta-Antagonists↗
PubMed1996

Effects of metoprolol vs verapamil in patients with stable angina pectoris. The Angina Prognosis Study in Stockholm (APSIS)

OBJECTIVE: To study long-term treatment effects of metoprolol or verapamil on combined cardiovascular end points and psychological variables in patients with stable angina pectoris. DESIGN: Randomized, double-blind, double-dummy trial. PATIENTS: The study included 809 patients under 70 years of age with stable angina pectoris. The mean age of the patients was 59 +/- 7 years and 31% were women. Exclusion criteria were myocardial infarction within the previous 3 years and contraindications to beta-blockers and calcium antagonists. The patients were followed between 6 and 75 months (median 3.4 years and a total of 2887 patient years). INTERVENTION: The patients were treated with either metoprolol (Seloken ZOC 200 mg o.d.) or verapamil (Isoptin Retard 240 b.i.d.). Acetylsalicylic acid, ACE inhibitors, lipid lowering drugs and long acting nitrates were allowed in the study. END POINTS: Death, non-fatal cardiovascular events including acute myocardial infarction, incapacitating or unstable angina, cerebrovascular or peripheral vascular events. Psychological variables reflecting quality of life i.e. psychosomatic symptoms, sleep disturbances and an evaluation of overall life satisfaction. RESULTS: Combined cardiovascular events did not differ and occurred in 30.8% and 29.3% of metoprolol and verapamil treated patients respectively. Total mortality in metoprolol and verapamil treated patients was 5.4 and 6.2%, respectively. Cardiovascular mortality was 4.7% in both groups. Non-fatal cardiovascular events occurred in 26.1 and 24.3% of metoprolol and verapamil-treated patients, respectively. Psychosomatic symptoms and sleep disturbances were significantly improved in both treatment groups. The magnitudes of change were small and did not differ between treatments. Life satisfaction did not change on either drug. Withdrawals due to side effects occurred in 11.1 and 14.6% respectively. CONCLUSION: This long term study indicates that both drugs are well tolerated and that no difference was shown on the effect on mortality, cardiovascular end points and measures of quality of life.

Adrenergic beta-Antagonists↗
PubMed1995

Primary prevention in patients with coronary heart disease: the APSIS study.

Symptomatic treatment of patients with angina pectoris is well established and consists of nitrates, calcium antagonists, or beta-blockers. All these drugs improve symptomatology and reduce signs of ischemia on exercise test or long-term electrocardiogram recordings. It is not known, however, whether these drugs also improve prognosis. The only drug shown to improve prognosis is aspirin. In order to study the prognostic effect of calcium antagonists and beta-blockers, these two drugs were compared in the APSIS study.

Adrenergic beta-Antagonists↗
PubMed1991

The relationship between causal attribution and rehabilitation in patients after their first myocardial infarction. A cross cultural study.

Full rehabilitation of a patient following myocardial infarction (MI) involves resumption of work and the restoration of quality of life. Two groups of patients (87 Israeli and 98 Swedish) were admitted to the CCU and followed up after their first MI. To evaluate the patients' own perception of events ('causal attribution theory'), sequential interviews were scheduled. Physical risk factors correlated poorly with rehabilitation outcome at 6 months. However, two patient clusters were pinpointed according to the patients' subjective explanation of the factors contributing to their MI. These 'causal attribution scores' had a predictive value, independent of culture, age, education, disease severity and depression. It is therefore concluded that evaluation of patient perception may assist in planning intervention for high risk psychologically debilitated patients, and thus favourably enhance their rehabilitation outcome.

Adaptation, Psychological↗
PubMed1987

Pharmacokinetics of felodipine and effect on digoxin plasma levels in patients with heart failure.

Some calcium antagonist drugs used in hypertension and cardiac diseases have been shown to increase plasma digoxin levels mainly as a result of reduced renal clearance. Felodipine is a new dihydropyridine calcium antagonist drug with cardiovascular effects, whose pharmacokinetics and effects on plasma digoxin levels have been studied in patients with left ventricular failure. 12 patients (11 men) on long term digoxin therapy were given 2.5 or 5 mg felodipine bid for 7 days followed by 1 week on 10mg bid. Plasma levels of digoxin and felodipine were measured before dosage and 30, 60 and 90 minutes and 2, 3, 4, 6, 8, 10 and 24 hours after the first dose and after 1 week of therapy (steady state). The area under plasma concentration versus time curve was calculated after the first dose and in steady state both for digoxin and felodipine. The absorption characteristics Cmax and Tmax were calculated both for felodipine and digoxin on the different felodipine doses. There was a linear relationship between dose and plasma level of felodipine. Plasma half-life in the 4- to 10-hour period of felodipine was 5.5 hours after a 10mg single dose, and 12 hours after 10mg bid. Felodipine 2.5mg, 5mg and 10mg all transiently increased peak plasma digoxin concentrations (by about 40%) at 1 hour after intake. Urinary excretion of digoxin during the day was unchanged, but impaired renal clearance may account for the transient increase in digoxin plasma level after felodipine.

Aged↗
PubMedDate not supplied

Determinants of lifestyle changes after a first myocardial infarction.

Ninety-eight men aged <60 years with a first myocardial infarction were followed for 6 months. The aim was to characterize patients who succeeded in changing their lifestyles by modifying risk factors and to correlate them to subjective and objective outcome. We focused on the interplay between the patient's causal attribution of the infarction and compared this with the influence of background factors. The patient attribution most often predicted positive objective outcome and subjective functioning. This study shows that background factors are of prognostic value, but the patient's attribution and his own ideas about coping add information on the outcome of the rehabilitation as evaluated by more specific outcome measures.

Follow-Up Studies↗
PubMedDate not supplied

Causal attribution by patients, their spouses and the physicians in relation to patient outcome after a first myocardial infarction: subjective and objective outcome.

Ninety-eight men <60 years of age with a first myocardial infarction (MI), their spouses and treating physicians were interviewed at the patients' hospitalization. The aim was to determine the three groups' perception of the causes of the patients' MI, and the importance of those for patient outcome 6 months after the MI. Patients and spouses agreed in general and attributed the MI to similar causes, while the patients and physicians had a lower level of agreement. The patients tended towards the more 'social' and 'psychological' items, while the physicians relied on medical information. The causal attributions of each of the groups were more important than background variables when subjective and objective outcome measures were estimated.

Adaptation, Psychological↗