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Biomedical subjects

J Holmen

Publications and source records attributed to J Holmen.

68 records · Page 4Linked to original sources
PubMed1992

Genetic and environmental effects on blood pressure in a Norwegian sample.

Systolic (SBP) and diastolic (DBP) blood pressures were measured in a health screening of the adult population in Nord-Trøndelag, Norway. Correlations were computed for 23,936 pairs of spouses, 43,586 pairs of parent and offspring, 19,151 pairs of siblings, 1,251 pairs of grandparents-grandchildren, 1,146 pairs of biological uncles/aunts-nephews/nieces (avuncular), 801 non-biological avuncular pairs, 169 pairs of same-sex twins, and smaller groups of other types of relationships. Spouse correlations of 0.08 and 0.09 were approximately constant or slightly decreasing with marital duration. The correlation values for SBP and DBP were approximately 0.16 for parents-offspring, 0.19 to 0.23 for same-sex siblings with similar values for DZ twins, 0.19 and 0.16 for opposite-sex siblings, 0.52 and 0.43 for MZ twins, and close to zero for most of the second-order relationships. Genetic additive variance was estimated at 0.29 and genetic dominance variance at 0.18 with the best model for SBP. The corresponding estimates from the best models for DBP were 0.29 or lower and 0.22 or lower, the sum not exceeding 0.35. There was evidence of a moderate effect of environmental factors shared by same-sex siblings and twins (for DBP), but no cultural transmission, and whether or not adult relatives live together does not affect familial resemblance for BP. The data did not permit a very precise resolution of the relative magnitude of genetic dominance and sibling effects. The correlation structure did not show sex-specific genetic effects.

Adult↗
PubMed1992

Is questionnaire information valid in the study of a chronic disease such as diabetes? The Nord-Trøndelag diabetes study.

STUDY OBJECTIVE: The aim was to validate information about diabetes mellitus collected by questionnaire in a large epidemiological survey. DESIGN: Questions on diabetes diagnosis, medical treatment for diabetes, diabetes duration, and hypertension treatment were selected from the Nord-Trøndelag health survey questionnaires. One of the municipalities was selected for the validation study. SETTING: The health survey 1984-86 addressed all inhabitants > or = 20 years of age in Nord-Trøndelag county, Norway; 76,885 (90.3%) of the eligible population participated in answering the question on diabetes. PARTICIPANTS: All inhabitants in the municipality answering "yes" to the question on diabetes (n = 169) and the persons with the same sex born closest before and after each diabetic patient and answering "no" to the diabetes question (n = 338) were included. MEASUREMENTS AND MAIN RESULTS: A very thorough search was made in the medical files of the general practitioners in the municipality for corresponding information. Compared to the files, diabetes was verified in 163 out of the 169. The commonest cause of discrepancy was renal glycosuria. One out of the 338 registered non-diabetic persons was found to have diabetes. Diabetic patients tended to overestimate diabetes duration significantly. Insulin treatment was verified in 19/20 (95%) and treatment with oral hypoglycaemic agents in all 44 with an affirmative questionnaire answer. A negative answer on insulin and oral hypoglycaemic agents was verified in 100% and 99% respectively. CONCLUSIONS: The concordance was considerably higher than in a comparable Norwegian study performed 10 years earlier. Patient administered questionnaires may be a very reliable source of information for epidemiological purposes in a well defined chronic disease such as diabetes mellitus.

Adult↗
PubMed1992

Lifestyle factors and risk of cerebral infarction.

BACKGROUND AND PURPOSE: We evaluated the impact of lifestyle factors on the risk of ischemic stroke. METHODS: We used a nested case-control design. The cases comprised 163 persons (median age 69 years) admitted to a stroke unit and diagnosed with acute cerebral infarction. All cases had earlier participated in the North Trøndelag Health Survey. The controls comprised 567 participants from the North Trøndelag Health Survey, matched by sex and year of birth. RESULTS: Raised systolic (p less than 0.001) and diastolic (p = 0.02) blood pressure, antihypertensive treatment (p less than 0.001), previous myocardial infarction (p less than 0.001), prior stroke (p = 0.002), diabetes (p less than 0.001), and former daily smoking (p = 0.02) were identified as significant risk factors by univariate conditional logistic regression. No difference in risk was detected at different levels of alcohol consumption, salt intake, physical activity, or body mass index. Current smokers had virtually the same risk as nonsmokers. No association was found between stroke and the number of cigarettes smoked per day or the number of years of smoking. Multivariate conditional logistic regression identified diabetes (p = 0.002), raised systolic blood pressure (p less than 0.001), and former daily smoking (p = 0.01) as significant and independent risk factors. Previous myocardial infarction (p = 0.07), previous stroke (p = 0.1), and current daily smoking (p = 0.1) were of marginal significance. CONCLUSIONS: The established medical risk factors for stroke are confirmed. With the possible exception of smoking, we have not identified any lifestyle factor with a significant impact on the risk of ischemic stroke.

Case-Control Studies↗
PubMed1991

[Physical activity habits among adults in Nord-Trøndelag].

This article describes the physical activity of 61,732 adults in the Norwegian county of Nord-Trøndelag. We collected information about physical activity by questionnaire during the Nord-Trøndelag Health Survey in 1984-86. Non-attendents are systematically analyzed and discussed. The article also deals with problems of defining physical activity. The frequency of physical activity gives a different measure of physical activity than does intensity and duration. 15% of the women and 14% of the men were totally inactive. If we consider physical activity at a level high enough to have a preventive effect as regards development of disease, for example, we found that 65% did not practise physical activity often enough or with sufficient intensity or duration. The groups of men aged 70-79 years and women aged 60-69 years contained the persons who practised physical activity most often, while the 20-29 age group contained those who practised physical activity with greatest intensity and for the longest time. We used age, sex, education, residential municipality and physically strenuous work as variables explaining inactivity and high activity. All the variables made a significant contribution to the logistic regression, but gave a better persons characterization of highly active than of inactive persons.

Adult↗
PubMed1991

[Management programs for hypertension and diabetes mellitus. Attitudes and experiences of general practitioners].

In 1987 and 1988 treatment programmes prepared by general practitioners were sent to the 2,900 doctors working in primary health care in Norway. In March 1990 a random sample (n = 600) were sent a questionnaire. The response rate was 63%. The general practitioners were greatly in favour of such programmes. 80% had read the programmes fully or in part, and one third used them regularly (at least once a month). Young doctors with little experience used them most and reported greatest benefit from the programmes. Reading and use of the programmes were strongly associated with participation in meetings and courses where the programmes had been used, and also with whether the general practitioners had used them for teaching the staff in their practices. 40% of the doctors who had received the programmes reported changes in their practice. Most of the changes referred to the doctors' own treatment routines, and less to areas requiring organizational changes in their practices. The general practitioners also answered questions on a test case with type 2 diabetes. 80% answered in accordance with the diabetes programme. The answers of those who had read and used the programme complied best with its recommendations.

Diabetes Mellitus, Type 2↗
PubMed1991

Detecting hypertension: screening versus case finding in Norway.

OBJECTIVE: Evaluation of detection of hypertension in adults in the county of Nord-Trøndelag, Norway. DESIGN: Cross sectional survey with clinical follow up examinations. SETTING: Health survey by screening teams from the national health screening service, and examinations by all 106 general practitioners in the county. SUBJECTS: During 1984-6, 74,977 persons (88.1% of those aged 20 years and over) participated in the health survey. MAIN OUTCOME MEASURES: Hypertension (when assessed by standardised recording and by questionnaires on drug treatment for hypertension) according to the blood pressure thresholds used in the Norwegian treatment programme. Subjects positive on screening were grouped after clinical examination into treatment groups. RESULTS: In all, 2399 subjects were positive for hypertension. Before screening 6210 (8.3%) patients reported taking antihypertensive drugs and another 3849 (5.1%) had their blood pressure monitored regularly. All who screened positive were referred to their general practitioner and evaluated according to a standard programme. As a result, drug treatment was started in 406 (0.5%) participants screened and blood pressure monitoring in another 1007 (1.3%). Of all patients taking antihypertensive drugs after the screening, 6399 (94.0%) had been diagnosed before screening, and of those whose blood pressure was monitored after the screening, 79.3% had been diagnosed before screening. CONCLUSIONS: At the blood pressure screening thresholds used, and when hypertension is defined by an overall clinical diagnosis, the results indicate that general practitioners can find and diagnose hypertensive patients with the case finding strategy.

Adult↗
PubMed1990

[Opinion of patients with back pain about the treatment received. A questionnaire study].

6 1/2 years after hospitalization for low back pain 364 patients answered a questionnaire on their opinion of the help they had received. 53.5% were satisfied with the help and support provided by their general practitioner and 78.7% were satisfied with the hospital treatment. We discuss possible reasons for this difference. It seems difficult for many patients to accept the conservative treatment prescribed by the general practitioner.

Adult↗
PubMed1990

[A health survey in Nord-Trøndelag 1984-86. Participation and comparison of attendants and non-attendants].

A large Health Survey was carried out in 1984-86 in the county of Nord-Trøndelag. All residents 20 years of age and older were invited to attend, and there was no upper age limit. Totally 74,977 persons have attended (88.1%). In the age group 45-64 more than 95% of the women attended. In cooperation with the district nurses we have studied the non-attendants, based on a 10% sample. The main reasons for not attending were: 1) Many were busy. 2) Some were not interested, 3) Some had moved, 4) Some had health problems. As a group, the non-attendants were less healthy than the attendants, but this was the case for only 12% of non-attendants. These 12%, however, were seriously ill. The data from the Nord-Trøndelag Health Survey are probably the most complete screening data from Norway. The data are especially suitable for epidemiologic studies on blood pressure, diabetes, quality of life, and tuberculosis and other lung diseases. However, the study has also supplied data on cardiovascular diseases, lifestyle, disablement, work and working environment. Several projects in these fields are in progress. The article is based on a report published in 1989.

Adult↗
PubMed1990

Hypertension labelling, life events and psychological well-being.

Almost all previous studies of the psychological sequelae of hypertension labelling have lacked a prospective, longitudinal design which could allow for causal interpretations. The present study relies on questionnaire data from a hypertension screening carried out on the entire adult population of a medium-sized, Norwegian county (total number of participants = 74977). 'Labelled' individuals, i.e. previously unaware hypertensives (N = 173), false positives (N = 233), and patients in need of continued BP control (N = 474) have been followed up after 1-3 years, and comparisons are made with aware hypertensives (N = 206), patients previously treated for hypertension (N = 118), and a random sample of normotensives (N = 2326). 'Pre-labelling', baseline measures of subjective well-being had been carried out on all comparison groups in connection with the screening. Changes in psychological well-being are not significantly related to labelling or BP-status. However, there is a deterioration in psychological well-being among participants who have been subjected to one or more negative life events/stresses (other than labelling) in the preceding 12 months.

Adaptation, Psychological↗
PubMed1984

Relation between drug utilization and morbidity pattern: antihypertensive drugs.

Drug utilization studies are a valuable tool in health services research aiming to improve quality of health care and use of resources. We first present a simple model for drug utilization studies and then give practical examples from our studies in Norway, mainly dealing with the treatment of hypertension. There are marked differences in drug utilization between hospitals, counties, and the five Nordic countries. The medical consequences of these differences are probably small, but they have important economic implications. The marked regional differences in drug utilization argue for better organization of health care, for standardized treatment programs, and for continuing education of doctors.

Adult↗