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Biomedical subjects

H Hedstrand

Publications and source records attributed to H Hedstrand.

At least 19 recordsLinked to original sources
PubMed1987

Alcohol intemperance and sudden death.

Ten years after a health screening examination was offered to 50 year old men 32 of the 2322 participants and 12 of the 454 nonparticipants had died of ischaemic heart disease. Of these, 26 and 11 respectively had suffered sudden death, for which necropsy was performed. Half of the men who had died suddenly had been registered for alcohol intemperance up to 1973, which was four times the prevalence of such registrations in the general population. Registration at both the Swedish Temperance Board and the Bureau of Social Services was associated with an odds ratio of 3.74 for sudden death as compared with not being registered at either. Logistic analysis including the classical risk factors for ischaemic heart disease together with registration for alcohol intemperance and at the Bureau of Social Services showed only the two types of registration and systolic blood pressure to be independent risk factors. On the other hand, there was no overrepresentation of subjects entered in the registers among those surviving a myocardial infarction. For non-fatal myocardial infarction blood pressure and serum triglyceride concentration were significant risk factors and serum cholesterol concentration, smoking, and body mass index probable risk factors; the two types of registration were not independent risk factors. Alcohol intemperance is strongly associated with an increased risk of sudden death after myocardial infarction.

Alcoholism↗
PubMed1986

Alcohol intemperance and social disability as risk factors for different causes of death.

At a follow-up 7-10 years after a health screening of 50-year-old men in Uppsala, 101 of the 2322 participants and 51 of the 446 non-participants had died. The incidence was thus almost three times as high among non-participants as among participants. Registration at the Temperance Board and/or the Bureau of Social Services was 2-3 times more common among the deceased subjects than among the living irrespective of participation in the health screening. A multiple logistic analysis revealed that non-participation and both types of registration were associated with an increased risk of death. For death from neoplasm only registration at the Bureau of Social Services, and not that at the Temperance Board, was a risk factor. For ischaemic heart disease (IHD), on the other hand, registration at the Temperance Board was the strongest risk factor, the other type of registration being secondary, and non-participation in the screening was a non-significant risk factor. The importance of alcohol intemperance as a risk factor for IHD was reflected in the fact that every second subject dying a sudden death (classified as IHD death) was registered at the Temperance Board. These results indicate that alcohol intemperance entails an increased risk of developing fatal complications to IHD, and social disability may carry with it a risk of both neoplasm and, to a lesser extent, death from IHD.

Alcohol Drinking↗
PubMed1985

Serum triglycerides are a risk factor for myocardial infarction but not for angina pectoris. Results from a 10-year follow-up of Uppsala primary preventive study.

At a follow-up 7-10 years after a health survey of men born in 1920-1924 in the municipality of Uppsala, 31 of the participants (n = 2322) had died from ischaemic heart disease (IHD). In response to a letter to all men alive in 1980, 106 men declared that they had had a myocardial infarction (MI) (verified or suspected). In 58 cases MI was verified from the hospital records. 28 other men had had typical central chest pain (angina pectoris) only. In another 20 men other diagnoses explained the chest pain for which they were treated in hospital. The health screening values for S-cholesterol and S-triglycerides, blood pressure and smoking habits were analysed in relation to the occurrence of IHD. In this prospective study, smoking, hypertension, S-cholesterol and S-triglycerides were identified as risk factors for fatal and non-fatal MI. The risk factor values were similar in subjects suffering from angina pectoris only to those in subjects who also developed ECG and/or transferase changes, with the exception of S-triglyceride concentration, which was normal in the group with angina pectoris. The subjects who had a fatal MI had a significantly higher blood pressure than those with non-fatal MIs, but otherwise these two groups did not differ. The results emphasize the importance of scrutinizing questionnaire data with regard to chest pain and of selection of end-points when risk factor patterns are described for cardiovascular diseases.

Aged↗
PubMed1984

The primary preventive study in Uppsala. Fatal and non-fatal myocardial infarction during a 10-year follow-up of a middle-aged male population with treatment of high-risk individuals.

A health survey of middle-aged men was carried out in 1970-73 in the municipality of Uppsala. Subjects with hypertension, hyperlipidaemia, reduced glucose tolerance, and smokers were invited to join various therapy groups. By 1980 this multifactorial intervention programme had thus been running for 10 years. This report describes the results of a follow-up undertaken to evaluate the efficacy of the programme. The annual rate of fatal myocardial infarction (MI) was lower among the participants (n = 2322) in the health examination as well as among participants and non-participants (n = 446) combined than among the male Swedish population of the same age (162 and 187 compared with 296 per 100 000 men, respectively). The annual rate of non-fatal MI among participants and non-participants combined was 295 per 100 000 men, which is lower than in other Swedish cities. In the hypertensive group (n = 126), six men had fatal and seven non-fatal MI. These 13 men had higher blood pressures (BPs) from the start than the other hypertensives. In addition, their BP reduction was smaller than in a control group randomly selected among the hypertensive subjects. In the hyperlipidaemic treatment group (n = 363) there were eight fatal and 10 non-fatal MIs. Nine of these events occurred in individuals who had dropped out from therapy. It is suggested that the low total mortality and the low rates of fatal and non-fatal MI in this middle-aged male population may be related to the multifactorial intervention programme, as the incidences were also low among the treated high-risk groups.

Age Factors↗
PubMed1982

Labetalol in resistant hypertension.

In 12 patients with resistant hypertension labetalol was added to existing therapy. The average dose was 1333 mg (range 400--3600). The subjects were followed up for three and a half years. Mean supine blood pressure (BP) was reduced from 202/123 to 163/103 mm Hg and mean standing BP from 193/127 to 144/100 mm Hg. Mean BP after exercise was 134/93 mm Hg. The main side-effect was postural hypotension during exercise, causing withdrawal of labetalol in two subjects. In patients with severe hypertension, resistant to several combinations of antihypertensive drugs, the addition of labetalol may lead to satisfactory BP reduction, especially when combined with a potent diuretic.

Adult↗
PubMed1978

Glucose metabolism in renal stone formers.

Epidemiological studies indicate that renal stone disease is a rapidly increasing problem, already affecting around 10% of the entire adult male population. It has been suggested that environmental factors are responsible for this development, among them particularly disorders of carbohydrate metabolism. In the present study, therefore, 156 patients with active renal stone formation were investigated with respect to glucose tolerance and glucose-stimulated insulin response. Similar to other reports it was found that hypercalciuric subjects had evidence of an impaired glucose metabolism. However, this was mainly attributed to a tendency towards overweight in this group of patients and there were no firm indications of a true disorder of carbohydrate metabolism connected with hypercalciuria or the process of stone formation.

Blood Glucose↗
PubMed1977

Inheritance of type-III hyperlipoproteinemia. Lipoprotein patterns in first-degree relatives.

The lipoprotein (LP) patterns were studied in the families of 19 index cases with type-III hyperlipoproteinemia (HLP). Seventy adult first-degree relatives (93% ascertainment) to the 19 probands were analyzed. The diagnosis of HLP type III among the first-degree relatives was based on three criteria, all of which had to be fulfilled to make the diagnosis: (1) presence of a slow-moving band in very-low-density LP (VLDL) on agarose gel electrophoresis migrating in beta or close to beta position; (2) A cholesterol/triglyceride ratio (mg/100 ml: mmoles/liter) in VLDL greater than 29.0; and (3) A "III-index" [cholesterol/triglycerides in VLDL x 10 divided by cholesterol/triglycerides in low-density LP (LDL)] greater than 1.30. When defined according to these criteria there was a marked over-representation of HLP type III among the relatives (27%). There was also an increased frequency of hypertriglyceridemia (28% against expected 15%), mainly because of a high prevalence of HLP type IV (24%). On agarose gel electrophoresis a "late pre-beta" band, probably indicative of an increased amount of intermediary LP particles, was frequently present (47%) among relatives not classified as HLP type III. Type-III patients with hypertriglyceridemia were characterized by a significantly higher body weight than those with normotriglyceridemic type III. However, there was no qualitative difference in the composition of the lipoproteins in normotriglyceridemic and hypertriglyceridemic type-III patients. A genetic analysis of the LP patterns within the families showed several examples of vertical transmission of HLP type III. There was no sex linkage. Six of thirteen analyzed parents showed LP patterns classified as HLP type III. Another two parents were most probably carriers of the gene. Of the siblings to the probands, 23% showed a type-III pattern and another four (7%) showed LP patterns very similar to type III, fulfilling two of three criteria for HLP type III. The data support the concept that HLP type III is inherited as an autosomal dominant gene. It was indicated that HLP type IV with a late pre-beta band in VLDL may represent another expression of the gene for HLP type III. It is suggested that HLP type III may be a pathogenetically heterogenous group of lipid disorders. A separation of type III into two subgroups with low or normal and high LDL cholesterol concentration, respectively, may facilitate the understanding of the inheritance of type III as well as of the pathogenesis behind this LP abnormality.

Adult↗
PubMed1977

Anaemia in middle-aged men. Prevalence and aetiology in a population study.

A health examination survey showed that 5.7% of 2322 middle-aged men had a haematocrit value below 40%. Only 1.2% had two consecutive low values. 14 men had no bone marrow haemosiderin and increased their haematocrits following iron therapy. In 13 men with no cause of the anaemia detected there was also a significant increase in haematocrit following therapy. The true prevalence of iron deficiency anaemia in this population may be estimated to about 1%.

Age Factors↗
PubMed1977

Calcium, phosphate and albumin in serum. A population study with special reference to renal stone formers and the prevalence of hyperparathyroidism in middle-aged men.

Serum valuse for calcium, phosphate and albumin have been determined in a population study of 2322 49-50-year-old men participating in a health examination survey. Calcium and albumin were significantly correlated (r = 0.34) but adjustment for albumin only caused minor effects on the distribution of calcium. No inverse relationship was found between calcium and phosphate. Seasonal variations over the three years of the health survey could not be established for either calcium or phosphate, whereas there was a slight tendency for albumin to decline during summer. The prevalence of hyperparathyroidism (HPT) in this population of men up to the age of 50 was 0.3% and among those with recurrent renal stones 5.3%. All subjects with verified HPT had a history of recurrent renal stones. One man on thiazide treatment had a slight elevation of calcium which returned to normal after cessation of the drug. No other case of hypercalcemia besides those caused by HPT was found. Mean values and frequency distributions for calcium, phosphate and albumin were almost identical in renal stone formers and matched controls. Hence it seems likely that other factors than those which markedly affect serum levels of calcium and phosphate are of major importance in common renal stone formation.

Age Factors↗