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Biomedical subjects

G Bolinder

Publications and source records attributed to G Bolinder.

At least 19 recordsLinked to original sources
PubMed1998

Ambulatory 24-h blood pressure monitoring in healthy, middle-aged smokeless tobacco users, smokers, and nontobacco users.

Ambulatory 24-h blood pressure monitoring was conducted in 135 healthy, normotensive, middle-aged (35 to 60 years) men, with no antihypertensive medication, to study the influence of habitual smokeless tobacco use (n = 47) and smoking (n = 29) on diurnal blood pressure and heart rate. Comparisons were made with nonusers of tobacco (n = 59). Adjustments were made for differences in age, body mass index, waist-hip ratio, physical fitness, and alcohol intake. Daytime ambulatory heart rates were significantly (P < .05) elevated in both smokeless tobacco users and smokers compared with nonusers (69 +/- 14 and 74 +/- 13 beats/min, respectively, versus 63 +/- 12 beats/min). In subjects > or = 45 years old, ambulatory daytime diastolic blood pressures were significantly elevated, on average by 5 mm Hg, in both smokeless tobacco users and smokers (P < .001) compared with nonusers. Clinical measurements of heart rate and systolic blood pressure in smokers were significantly lower compared with the ambulatory mean values. Nighttime measurements showed only minor differences between the tobacco habit groups. The higher heart rates and blood pressures noted during the daytime in smokers and smokeless tobacco users were most likely due to the effects of nicotine. A strong positive relationship was found between cotinine (major nicotine metabolite) and blood pressure in smokeless tobacco users (systolic blood pressure, r = 0.48, P < .001; diastolic blood pressure, r = 0.41, P = .005), whereas an inverse relationship was found in smokers (systolic blood pressure, r = -0.12, P = .47; diastolic blood pressure, r = -0.03, P = .84), indicating additional and more complex influences on vascular tone in smokers than the influence of nicotine in smokeless tobacco users.

Adult↗
PubMed1997

[Overview of knowledge of health effects of smokeless tobacco. Increased risk of cardiovascular diseases and mortality because of snuff].

Oral snuff, used by 20% of all Swedish males in 1996, causes blood nicotine levels similar to those in smokers. In a report by the National Board of Health and Welfare in 1997, it is concluded that scientific evidence of oral snuff as a cause of oral cancer is weak. Epidemiological studies of more than 100,000 construction workers showed hypertension (blood pressure > 160/90) to be more common among oral snuff users than among non-users. Twelve-year follow-up showed the relative risk of death due to cardiovascular disease to be 2-fold greater among snuff users, but 3-fold greater among smokers, as compared to never-users of tobacco (p < 0.001). The risk of death due to cancer was similar among snuff users and among never-users. In a clinical study of 151 healthy middle-aged men, 24-hour monitoring showed daytime heart rates and blood pressure to be significantly higher in snuff users > or = 45 years of age than in age-matched non-users (p < 0.05). The estimated 10-year future risk of cardiovascular events was 13.2% for smokers (p < 0.001) and 4.6% for oral snuff users (p = 0.3) as compared with 3.4% for never-users. As compared with non-users, oral snuff users manifested neither significant signs of accelerated atherosclerosis nor significantly reduced maximum physical capacity. Oral snuff usage causes physiological nicotine dependence, and results in the release of sympatho-adrenergic stimuli associated with an increased risk of cardiovascular stress, which might in turn exacerbate the risk of fatal cardiovascular events. However, oral snuff usage does not seem to be associated with the same risk of accelerated atherosclerosis as is smoking.

Adult↗
PubMed1997

Smokeless tobacco use and atherosclerosis: an ultrasonographic investigation of carotid intima media thickness in healthy middle-aged men.

There is well-documented evidence of accelerated atherosclerosis in smokers but the mechanisms still remain unclear. The relationship to the use of smokeless tobacco, involving high exposure to nicotine, have not been evaluated before. The possible role of nicotine was investigated in a clinical study of the intima media thickness in the carotid artery of 143 healthy, middle-aged men (35-60 years old) with different tobacco consumption habits. B-mode ultrasonography was performed and biochemical risk factors for cardiovascular disease (serum lipids, serum lipoproteins and plasma fibrinogen) were determined. Long term smokeless tobacco users (n = 28) did not differ significantly from never-users (n = 40) regarding bulb intima media thickness (0.80 +/- 0.13 versus 0.78 +/- 0.12 mm) or common carotid intima media thickness (0.67 +/- 0.11 versus 0.68 +/- 0.11 mm), whereas smokers (n = 29) had significantly increased wall measurements (bulb 0.87 +/- 0.19, P = 0.002 common carotid 0.74 +/- 0.13, P = 0.03) compared to never-users. Only in smokers were biochemical risk factors significantly altered towards an elevated risk. Significant effects of interaction of smoking and increased s-cholesterol levels on carotid intima media thickness were also found. Smokeless tobacco users showed similar tendencies, but without definite statistical significance. On the basis of these data, it appears most likely that the increased occurrence of atherosclerosis in smokers is caused by other components of tobacco smoke than nicotine.

Adult↗
PubMed1997

Long-term use of smokeless tobacco and physical performance in middle-aged men.

To determine the influence of prolonged nicotine exposure on maximal physical working capacity, a study of clinical measures of physical fitness and cardiovascular response to exercise was performed in 144 healthy men, 35-60 years old, subdivided into smokeless tobacco users, smokers and non-users of tobacco. Regular users of smokeless tobacco, with exposures of more than 20 years, showed similar maximal oxygen uptake (mean 3.48 L min-1, SD 0.49, n = 48) to non-users (mean 3.51 L min-1, SD 0.51, n = 65). In smokeless tobacco users, higher blood pressure and heart rate values were observed at rest and at submaximal work, after exposure to tobacco shortly before the exercise test, but not at maximal work. However, significantly lower maximal oxygen uptake was found for smokers (mean 2.88 L min-1, SD 0.49, n = 31) compared with non-users (P < 0.001). Plasma concentration of continine, the main metabolite of nicotine, was significantly higher in smokeless tobacco users (mean 347 ng mL-1, SD 175, n = 48) than in smokers (mean 253 ng mL-1, SD 153, n = 31, P < 0.001). The findings indicate that long-term use of smokeless tobacco does not significantly influence exercise capacity in healthy, physically well-trained subjects.

Adult↗
PubMed1997

Tobacco research funded by the tobacco industry--an ethical conflict.

What moral misgivings may arise in connection with the financing of research? Does the source of the funds for a research project matter? Tobacco exemplifies this problem well. Tobacco smoking is the largest single cause of illness and premature death in the industrialized world, but the tobacco industry is also one of its most profitable commercial undertakings. Decades of increasing scientific evidence for the harmfulness of smoking have increased the moral pressure on manufacturers. Good relations with the scientific community is a desirable way to demonstrate the legitimacy of their operations. Medical researchers should act in accordance with the classical ethical principles of medicine; autonomy, doing good, justice and doing no harm. The activities of the tobacco manufacturing companies are not in accordance with these principles. Every medical researcher or physician who uses funding from the tobacco companies cannot escape the fact of lending his or her name to the manufacture of a lethal product.

Attitude to Health↗
PubMed1994

Smokeless tobacco use and increased cardiovascular mortality among Swedish construction workers.

OBJECTIVES: Little is known about the risks of cardiovascular disease associated with the use of smokeless tobacco, which produces blood nicotine levels similar to those caused by cigarette smoking. METHODS: Male Swedish construction industry employees (n = 135,036) who attended a health examination were followed by studying cause-specific mortality during a 12-year period. The study population comprised 6297 smokeless tobacco users, 14,983 smokers of fewer than 15 cigarettes per day, 13,518 smokers of 15 or more cigarettes per day, 17,437 ex-smokers, 50,255 "other" tobacco users, and 32,546 nonusers. RESULTS: The age-adjusted relative risk of dying from cardiovascular disease was 1.4 for smokeless tobacco users and 1.9 for smokers of 15 or more cigarettes per day, compared with nonusers. Among men aged 35 through 54 years at the start of follow-up, the relative risk was 2.1 for smokeless tobacco users and 3.2 for smokers. When data were adjusted for body mass index, blood pressure, and history of heart symptoms, the results were essentially unchanged. Cancer mortality was not raised in smokeless tobacco users. CONCLUSIONS: Both smokeless tobacco users and smokers face a higher risk of dying from cardiovascular disease than nonusers. Although the risk is lower for smokeless tobacco users than for smokers, the excess risk gives cause for preventive actions.

Adult↗
PubMed1992

Effectiveness of low-dose cotrimoxazole prophylaxis against Pneumocystis carinii pneumonia after renal and/or pancreas transplantation.

We retrospectively examined the effectiveness of prophylaxis with cotrimoxazole in preventing Pneumocystis carinii pneumonia in recipients of kidney and combined kidney-pancreas transplants between 1985 and 1989. Cotrimoxazole prophylaxis (480 mg daily or 300 mg/m2), when used, was started within 2 months after transplantation and usually continued until 6 months after surgery. Eight (3.7%) of the 214 patients who were not given prophylaxis were infected with Pneumocystis carinii, and there were 4 fatalities (50% mortality). There were no cases among the 161 patients given prophylaxis (P less than or equal to 0.03). No serious adverse effects were noted in the prophylaxis group. It is concluded that prophylaxis against Pneumocystis carinii infection is well tolerated and should be given as soon as possible to all organ transplant recipients for at least 6 months.

Adolescent↗
PubMed1972

[Aerodontalgia].

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Aerospace Medicine↗