Biomedical subjects

Gunnar Erikssen

Publications and source records attributed to Gunnar Erikssen.

5 recordsLinked to original sources

PubMed2004

[Exercise ECG].

Exercise ECG testing is the most widely used method for detecting myocardial ischaemia, but the test is also applied in numerous other settings. The method requires close attention to technical details and application of appropriate test protocols. Attention to absolute and relative contraindications and criteria for test abortion is mandatory. In addition to the ECG, work capacity, heart rate and blood pressure responses are also important diagnostic and prognostic markers. Interpretation of the test results depends on the setting; knowledge of potential confounders is important. The diagnostic and prognostic value of the test is population-dependent. Exercise ECG testing is most valuable as a diagnostic tool for myocardial ischaemia when pretest disease probability is high.

Contraindications↗

PubMed2004

Exercise testing of healthy men in a new perspective: from diagnosis to prognosis.

AIM: It has recently been suggested that exercise testing may be more valuable prognostically than it is diagnostically in apparently healthy subjects. We wanted to compare the accuracy of CHD risk assessment based on classical risk factors with an assessment also based on multiple exercise test parameters. METHODS AND RESULTS: In 1972-75, 2014 apparently healthy men aged 40-60 had a symptom limited exercise test during a cardiovascular survey. Three hundred died from CHD during 26 years of follow-up. Compared to Cox regression models solely including classical risk factors (CRF), models also including multiple exercise test parameters (CRF+X) were clearly superior (P < 0.0001). Risk scores were computed based on the models. CRF and CRF+X risk scores often differed markedly; CRF+X scores were generally most reliable in both the high and low risk range. In smokers with cholesterol >6.5 mmol/l (n = 470), the CRF and CRF+X models identified 67 vs. 110 men at the highest CHD risk level according to European guidelines (34.2% vs. 38.2% CHD mortality). Three in five CRF+X-identified smokers with cholesterol >6.5 mmol/l had CHD mortality similar to the mean of all 2014 men. CONCLUSION: Integration of multiple exercise test parameters and conventional risk factors improved CHD risk assessment substantially--especially in smokers with high cholesterol.

Adult↗

PubMed2004

Symptom-limited exercise testing, ST depressions and long-term coronary heart disease mortality in apparently healthy middle-aged men.

BACKGROUND: Previous studies have shown that ST depressions > or =1.0 mm during or post-exercise increase long-term risk of dying from coronary heart disease (CHD), the need for coronary artery bypass grafting (CABG) or the development of acute myocardial infarction (AMI) in healthy men. In the present prospective cohort study we investigate whether less marked ST depressions may influence CHD mortality, incidence of AMI, the need for a CABG or having a non-fatal stroke. METHODS: During 1972-75, 2014 men aged 40-59 years, free from somatic diseases and not using any drugs, underwent an examination programme including case history, clinical examination, various blood tests and a symptom-limited exercise ECG-test. ECG was registered during exercise and at 30 s, 1, 2, 3 and 5 min post-exercise. The possible prognostic impact of ST-changes of 0.50-0.99 mm and > or =1.00 mm compared with normal ST-segments were studied separately and combined. Horizontal, down-sloping and slowly up-sloping ST-segment patterns were combined. RESULTS: After adjustment for age, smoking, blood pressure, cholesterol, maximal heart rate, left ventricular hypertrophy and physical fitness ST depressions > or =0.50 mm--during and/or post-exercise--were associated with a 1.47-fold [95% confidence interval (CI) 1.10-1.95], and 1.54-fold (95% CI of 1.17-2.04) increased 26 years risk of CHD-mortality, respectively. The same ST-changes also increased 22 years risk of developing non-fatal AMI or needing CABG but not developing non-fatal stroke. CONCLUSIONS: Even an ST depression > or =0.50 mm during and/or after exercise increases the long-term risk of CHD-death, developing an AMI or needing CABG. No association was found between ST-changes and incidence of non-fatal strokes.

Adult↗

PubMed2003

Fasting blood glucose is independently associated with resting and exercise blood pressures and development of elevated blood pressure.

OBJECTIVE: To assess whether fasting blood glucose is independently related to blood pressure at rest and during exercise, and to development of elevated blood pressure. DESIGN: Cross-sectional and prospective cohort study of 2014 apparently healthy middle-aged men. METHODS: The baseline survey included carefully standardized blood pressure measurements at rest and during exercise testing, an intravenous glucose tolerance test and a panel of fasting blood tests, including fasting blood glucose. Results from 7-years follow-up provided data on development of elevated blood pressure. RESULTS: Strong associations were found between quartiles of fasting blood glucose and baseline resting and/or exercise levels of blood pressure, and also development of elevated blood pressure over 7 years. Physical fitness, calculated from an exercise test, had a strong modulating effect on blood pressure at all levels of fasting blood glucose. In multivariate models - after adjusting for intravenous glucose tolerance, physical fitness, age, body mass index, triglycerides and cholesterol - fasting blood glucose was strongly associated with blood pressure at rest (coefficient = 2.83, P = 0.0004) and during exercise (coefficient = 6.57, P < 0.0001), and further to development of treated hypertension and/or elevated blood pressure [odds ratio (OR), 1.17; 95% confidence interval (CI), 1.05-1.31]. CONCLUSION: In healthy non-diabetic and non-hypertensive men, strong associations were found between fasting blood glucose and blood pressure at rest and during exercise and to development of elevated blood pressure after 7-years follow-up. Fasting glucose metabolism deserves scrutiny when studying the pathogenesis of hypertension.

Adult↗

PubMed2002

Early versus late morning measurement of blood pressure in healthy men. A potential source of measurement bias?

Standardization of blood pressure (BP) measurement is important for both clinical and epidemiological purposes. The aim of the present study was to investigate early vs late morning measurements of BP and heart rate in healthy subjects. During the years 1972-75, healthy men aged 40-59 years (n = 2014) participated in a cardiovascular survey in Oslo. Two to four men underwent the examination program per day; it included height/weight, a spirographic study, chest X-ray, a number of blood tests, case history, clinical examination, resting ECG and physical exercise testing. BP and heart rate measurements were meticulously standardized. When adjusting for age, smoking habits and season of year we found that men who were examined as number one in the row of two to four subjects each morning had higher systolic BP (3.6 mmHg, p < 0.001) and heart rate (3.6 beats/min, p < 0.001) at rest compared to others. They were virtually identical in all other aspects. These differences in systolic BP and heart rate at rest disappeared during bicycle exercise. Thus, we suggest that the increased BP and heart rate at rest represent a stress reaction to being number one in a row of subjects to be examined, i.e. a bias in BP and heart rate measurements, possibly of both clinical and epidemiological importance.

Adult↗