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S Graff-Iversen

Publications and source records attributed to S Graff-Iversen.

At least 19 recordsLinked to original sources
PubMed2000

Cost and health consequences of reducing the population intake of salt.

STUDY OBJECTIVE: The aim was to estimate health and economic consequences of interventions aimed at reducing the daily intake of salt (sodium chloride) by 6 g per person in the Norwegian population. Health promotion (information campaigns), development of new industry food recipes, declaration of salt content in food and taxes on salty food/subsidies of products with less salt, were possible interventions. DESIGN: The study was a simulation model based on present age and sex specific mortality in Norway and estimated impact of blood pressure reductions on the risks of myocardial infarction and stroke as observed in Norwegian follow up studies. A reduction of 2 mm Hg systolic blood pressure (range 1-4) was assumed through the actual interventions. The cost of the interventions in themselves, welfare losses from taxation of salty food/subsidising of food products with little salt, cost of avoided myocardial infarction and stroke treatment, cost of avoided antihypertensive treatment, hospital costs in additional life years and productivity gains from reduced morbidity and mortality were included. RESULTS: The estimated increase in life expectancy was 1.8 months in men and 1.4 in women. The net discounted (5%) cost of the interventions was minus $118 millions (that is, cost saving) in the base case. Sensitivity analyses indicate that the interventions would be cost saving unless the systolic blood pressure reduction were less than 2 mm Hg, productivity gains were disregarded or the welfare losses from price interventions were high. CONCLUSION: Population interventions to reduce the intake of salt are likely to improve the population's health and save costs to society.

Blood Pressure↗
PubMed1999

Treatment of hypertensive and hypercholesterolaemic patients in general practice. The effect of captopril, atenolol and pravastatin combined with life style intervention.

OBJECTIVE: To elucidate the effect on blood pressure and blood lipids of an angiotensin converting enzyme inhibitor (captopril), and a beta-receptor blocking agent (atenolol), given alone or in combination with a cholesterol reducing drug, the beta-hydroxy-methylglutaryl-coenzyme A reductase inhibitor pravastatin, in patients who were also encouraged to improve their lifestyle. DESIGN: A longitudinal study consisting of three phases. I: Lifestyle intervention alone. II: Continued lifestyle intervention combined with captopril or atenolol. III: Continued lifestyle intervention combined with the same drugs as in phase II and in addition pravastatin or placebo. SETTING: Fifty-four general practice surgeries in Norway. PARTICIPANTS: Hypertensive patients, 210 females and 160 males, treated or untreated with antihypertensive drugs with a sitting diastolic blood pressure between 95 and 115 mmHg and a serum total cholesterol between 6.5 mmol/l (7.0 for those age 60-67 years) and 9.0 mmol/l. RESULTS: The antihypertensive effect of captopril and atenolol was not influenced by concurrent administration of pravastatin. The effect of pravastatin was not limited by concurrent medication with captopril or atenolol. Improvement in lifestyle seemed to reduce the need for supplementary treatment with diuretics. CONCLUSION: Pravastatin can be used in combination with captopril or atenolol in the treatment of hypertensive and hypercholesterolaemic patients.

Adrenergic beta-Antagonists↗
PubMed1998

Serum lipids in postmenopausal or perimenopausal women using estrogen alone, estrogen with levonorgestrel, or estrogen with norethisterone, compared with nonusers: results from a cross-sectional study in two Norwegian counties 1985-1988.

The aim of this study was to compare, in a population setting of postmenopausal or perimenopausal women aged 40 to 54, the levels of serum lipids in women using different hormone replacement therapy (HRT) regimens with women using no sex hormones. There was no unequivocal tendency of a more healthy lifestyle among those using HRT than among nonusers. Any type of regimen was associated with a lower mean level of total and calculated low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol was 0.08 mmol/L (5.2%) higher in those using estrogen alone, 0.07 mmol/L (4.5%) higher in users of HRT with norethisterone, and 0.07 mmol/L (4.5%) lower in users of HRT with levonorgestrel, compared with nonusers. The ratio of total-to-HDL cholesterol was lower by 0.37 (6.1%) in those using estrogen alone, by 0.65 (12.3%) in those using HRT with norethisterone, and by 0.24 (5.3%) in those using estrogen with levonorgestrel. There was no association between body mass index and HDL-cholesterol among women who used HRT with norethisterone, whereas an inverse relationship was present in those using estrogen alone and in nonusers (P [interaction] < 0.05).

Adult↗
PubMed1997

[Cardiovascular risk factors in persons aged 40-42 years in the county of Hedmark 1988-94].

We present the results from three surveys conducted in 1988, 1991 and 1994 in Hedmark comparing risk factors for cardiovascular disease among men and women age 40-42 years. The data are compared with the results for persons in the same age group from the counties Vestfold, Rogaland and Nordland, and examined in the same periods. In 1991 the average levels of total cholesterol and infarction risk score were the same in Hedmark and the three other counties, but in 1994 Hedmark compared less favourably. While the mean levels of total cholesterol showed minimal difference between rural and urban municipalities in Hedmark, triglycerides and systolic blood pressure were higher in the rural areas. Adjustment of the results in Hedmark for lower attendance rate among unmarried, divorced and widowed persons in 1991 and 1994 than in 1988 does not affect other risk factors than smoking. We discuss possible explanations of the less favourable results and the implications for primary prevention of cardiovascular diseases.

Adult↗
PubMed1996

[Do people exercise less than they think?].

Physical activity is important for health. Physical inactivity is an independent risk factor for disease and speeds up aging. People say in health surveys that they exercise more than they did before. This does not conform with two important facts: Over the last 20 years people have reduced their calorie intake, but their weight is increasing. The only possible explanation is that they exercise less than before, probably because their daily life requires less and less physical activity. We believe this to be a serious health problem, and support the most recent recommendation: A daily walk for 30 minutes.

Aging↗
PubMed1996

[Risk as a concept and a challenge in health care].

In epidemiology and preventive medicine, absolute risk, relative risk and population attributable risk are well defined concepts. In research, the relative risks are of great interest, but to make medical decisions it is necessary to assess the risks and benefits in absolute rather than relative terms. Therefore, editors and referees should promote the presentation of absolute risks in medical journals. Critical comments on risk interventions are often of a general nature, and include all risk factors and all actual interventions. To assess the benefits, each disease, each risk, and each intervention has to be handled separately. In the prevention of cardiovascular diseases the effects of several interventions have been documented. The quality of the performance is of great importance, however, when interventions from clinical trials are applied in practical medicine.

Humans↗
PubMed1996

Cardiovascular risk factors in Norwegian women using oral contraceptives: results from a cardiovascular health screening 1985-88.

We analyzed data from 4,905 women aged 20-39 and 14,803 aged 40-49 who attended a health survey in Norway 1985-88, to study cardiovascular risk factors in users of oral contraceptives, all types and specifically by formulation. In age group 20-39, users of low-dose estrogen/ progestin regimens were younger, had lower body mass index (BMI), less often reported coronary heart disease in relatives, and less often used saturated fat on bread than did non-users. In age group 40-49, smoking was more prevalent in users of low-dose estrogen/progestin than in non-users. In both age groups the mean ratio of total/HDL cholesterol, the mean level of non-fasting triglycerides, and the mean systolic and diastolic blood pressures were higher in oral contraceptive users than in non-users. Among the users, a more favorable pattern was found in women using progestin-only oral contraceptives, as blood pressure levels were equal to those of non-users and total cholesterol and triglycerides were both 0.1-0.2 mmol/l below the non-users, in both age groups. However, users of low-dose estrogen formulations containing desogestrel 0.15 mg, norethisterone (norethindrone) 0.5 mg or lynestrenol 2.5 mg had the highest levels of HDL, even higher than the non-users. A pattern of higher triglycerides and higher ratio of total/ HDL cholesterol was found in smokers, compared with non-smokers, among users of any type of contraceptives, and in non-users.

Adult↗
PubMed1996

Left ventricular diastolic function in young men with high normal blood pressure.

OBJECTIVE: Abnormalities in left ventricular (LV) diastolic filling have been reported in hypertensive patients. This study was designed to compare LV diastolic filling between individuals with high normal blood pressure (HNBP) and optimal blood pressure (OBP). SUBJECTS AND DESIGN: From a survey of 219 young male individuals (age 21 +/- 0.1 years), two groups were selected according to their BP (group A: systolic BP [SBP] 120 mmHg and diastolic BP [DBP] 80 mmHg, n = 23 and group B: SBP 130 to 139 mmHg and/or DBP 85 to 89 mmHg, n = 21). Subjects habits, anthropometric characteristics, LV structure and systolic and diastolic function were compared. RESULTS: No differences were detected between the two groups in habits, systolic function or early diastole. LV mass index (LVMI) was higher in group B (103.6 +/- 4.58 g/m2 versus 90.49 +/- 3.27 g/m2 in group A, P < 0.05), though the values were not high enough to indicate LV hypertrophy. The pattern of LV late filling was different between the two groups. The peak late diastolic flow velocity (A) was 0.45 +/- 0.02 m/s in group B and 0.52 +/- 0.03 m/s in group A (P < 0.05). The early peak velocity (E):A ratio was 1.82 +/- 0.08 in group A and 1.59 +/- 0.08 in group B (P < 0.05). The early filling fraction also demonstrated a significant shift to more prominent late diastolic filling in group B (0.68 +/- 0.01% versus 0.73 +/- 0.01% in group A, P < 0.05). This pattern in LV filling did not correlate to inheritance, age, sex, heart rate, habits or body mass index. CONCLUSIONS: This shift in filling pattern to a late flow in young men with HNBP seemed to be an early indicator of an increased dependence of LV filling on atrial contraction and may reflect an impairment in LV relaxation.

Adult↗
PubMed1995

[Development of risk factors for cardiovascular diseases among persons aged 40-42 years in the county of Finnmark 1973-93].

During the period 1973-1993, the National Health Screening Service carried out five screenings of risk factors for cardiovascular disease among 40-42 years of age in the county of Finnmark. Risk for myocardial infarction has decreased, mainly due to reductions in total cholesterol, which fell by more than 10% in both sexes from 1973-74 to 1993. Cholesterol levels now seem to be stabilizing. Considerably fewer persons smoked daily in 1977-78 than in 1973-74. From 1977-78 to 1993, little change occurred among men, but the percentage of women who smoked daily increased by 10%. Systolic and diastolic blood pressure were slightly higher in 1993 than in 1990. Since 1987-88 consumption of butter and of traditionally made coffee (boiled, not filtered) has decreased. Compared with other counties, Finnmark shows high values for cholesterol, smoking habits and "boiled" coffee. Preventive measures still have a potential to influence the future trend.

Adult↗
PubMed1994

[Criteria of general practitioners on the high risk factors for cardiovascular diseases. Information from health survey cards of 40-year old persons in Telemark 1992].

After a health survey of men and women aged 40-42 in Telemark county in 1992, a total of 539 persons were recommended to consult their general practitioner. The physicians returned survey cards for 322 persons, 60% of those recommended, to the National Health Screening Service. A total of 282 persons had consulted the doctor. Non-pharmacological treatment was offered to 93% of the men and 78% of the women. About 10% had either a new diagnosis, a new medication, or were referred to a hospital or an out-patient clinic. The lack of returned survey cards for 40% of the persons who were recommended a consultation is a challenge for the National Health Screening Service to improve communication with general practitioners.

Adult↗
PubMed1993

Non-fasting serum triglyceride concentration and mortality from coronary heart disease and any cause in middle aged Norwegian women.

OBJECTIVE: To study the association between non-fasting serum triglyceride concentrations and mortality in women from coronary and cardiovascular disease and all causes. DESIGN: Follow up by ambulatory teams of men and women who underwent cardiovascular screening for a mean of 14.6 years. SETTING: National health screening service in Norway. SUBJECTS: 25,058 men and 24,535 women aged 35-49 years. MAIN OUTCOME MEASURE: Predictive value of non-fasting serum triglyceride concentrations. RESULTS: At initial screening total serum cholesterol concentration, serum triglyceride concentration, blood pressure, height, and weight were measured, and self reported information about smoking habits, physical activity, and time since last meal were recorded. During subsequent follow up 108 women died from coronary heart disease, 238 from cardiovascular diseases, and 931 from all causes. In women mortality increased steadily with increasing triglyceride concentration for all three causes of death. With the proportional hazards model and adjustment for age, systolic blood pressure, total cholesterol concentration, time since last meal, and number of cigarettes a day the relative risk between triglyceride concentration > or = 3.5 mmol/l and < 1.5 mmol/l was 4.7 (95% confidence interval 2.5 to 8.9) for deaths from coronary heart disease, 3.0 (1.9 to 4.8) for deaths from cardiovascular disease, 2.3 (1.8 to 2.9) for total deaths in all women. CONCLUSIONS: A raised non-fasting concentration of triglycerides is an independent risk factor for mortality from coronary heart disease, cardiovascular disease, and any cause mortality among middle aged Norwegian women in contrast to what is seen in men.

Adult↗
PubMed1992

[Social network, alcohol drinking habits and injuries caused by violence among women and men in the county of Akershus. Results from anonymous questionnaires among persons aged 40-42 years. 1990-91].

All residents aged 40-42 in Akershus county were invited to screening for cardiovascular risk factors in 1990-91 as part of a prevention programme. Of the 13,607 attendants, 8,960 answered an anonymous questionnaire about social network, drinking habits, and injuries due to violence. Compared with data from the Central Bureau of Statistics, our material included a high percentage of persons with a higher education, a high percentage of married persons, and a low percentage of persons living alone. Results in respect of social network and drinking habits roughly agreed with those of other studies. Of the males, 15.7% had been injured at least once as a result of violence, most often assault and robbery. Of the females, the corresponding percentage was 18.1. Here the dominating forms of violence were maltreatment, threats and sexual assault. Females were more often exposed than males to repeated violence and more often suffered persisting problems as a result of maltreatment. Compared with other studies, we found a high prevalence of injuries from violence among females, suggesting underreporting of experiences of violence by females in studies based on personal interview or the hospitals' injury register.

Adult↗
PubMed1992

[Risk factors and mortality of myocardial infarction in Kristiansund, Alesund and Molde].

We have examined mortality from ischaemic heart disease, prevalence of self-reported coronary heart disease and risk factor levels in three towns (Kristiansund, Alesund and Molde) in the county of Møre og Romsdal. The results for mortality were based on vital statistics for the age group 40-69 years, for the periods 1966-76 and 1977-87. Risk factor data and data on self-reported coronary heart disease for the age groups 40-42 years and 65-67 years were obtained from a health screening survey conducted in the county in 1990. According to the official statistics, the towns share important socio-economic characteristics, but Kristiansund is thought to have stronger roots in the coastal culture, with a historically economic basis in fishery and shipbuilding. We observed substantial differences between the three towns, both as regards risk factor levels and mortality from ischaemic heart disease. By far the highest mortality rates were found in Kristiansund, both for men and for women. A similar gradient existed for the levels of main risk factors, including serum cholesterol, systolic blood pressure and prevalence of smokers. We discuss the implications of these findings for prevention strategies.

Adult↗
PubMed1991

[Why do women still smoke while men quit?].

Norwegian men have reduced their rates of daily smoking, while the overall rate of smoking among women has remained unchanged for the last 15 years. The prevalence of smoking among adolescent girls has declined. Highly educated women are less likely to smoke, compared with women with lower education. Some groups of Norwegian women, however, are maintaining their smoking habits. We discuss possible explanations of the remaining high rates of smoking among women, and suggest strategies to improve the smoking cessation rate among women.

Adolescent↗
PubMed1991

[Treatment of hypercholesterolemia in adults. A treatment program 1991].

A Norwegian programme for treatment of hypercholesterolemia in adults was published in 1988. In 1990 the Norwegian Medical Association appointed a group to modify this programme in the light of current knowledge, and taking into consideration the recommendations of the Consensus Conference on Cholesterol of October 1989. The present article presents this modified programme. When evaluating the risk of developing coronary heart disease a combined risk score should be calculated which also takes into account important risk factors other than cholesterol, such as family history, sex, age, smoking, hypertension, presence of diabetes etc. For those considered to be at high risk of developing coronary heart disease, the programme gives guidelines on how to intervene. With regard to treatment, special emphasis is placed on changing the diet.

Adult↗
PubMed1991

[Cardiovascular screenings in Norwegian counties. Trends in risk pattern during the period 1985-90 among persons aged 40-42 in 4 counties].

In 1985-90, two screenings for cardiovascular disease risk factors were carried out with an interval of three years in four Norwegian counties. All residents aged 40-42 were invited to both screening rounds, and certain subgroups from the first round were re-invited to the second round. Compared with the score attained by the first generation, the total mean risk score for myocardial infarction achieved by the second generation was 19% lower in males, and 15.5% lower in females. The main cause of this reduction was lower serum cholesterol level. Based on results from the subgroups, the estimated mean risk score for the total male cohort from the first round had decreased by 10% at the rescreening three years later. It is concluded that the results indicate a continued, and perhaps accelerated, decrease in coronary heart disease mortality, as new generations populate the age groups where this disease is more prevalent. The screenings were part of a prevention programme, and it is reasonable to assume that the efforts by the primary health care services contributed to the improvement.

Adult↗