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Se Lindell - One of the best experts on this subject based on the ideXlab platform.
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low pulse wave amplitude during reactive Leg hyperaemia an independent early marker for ischaemic heart disease and death results from the 21 year follow up of the prospective cohort study men born in 1914 malmo sweden
Journal of Internal Medicine, 1994Co-Authors: Bo Hedblad, Mats Ogren, So Isacsson, Lars Janzon, Se LindellAbstract:.Objective. To study the incidence of myocardial infarction, all-cause mortality and mortality from ischaemic heart disease in relation to arterial Leg blood flow determined by venous occlusion plethysmography of the calf. Design. A prospective cohort study ‘Men born in 1914’. Setting. Malmo, a city in southern Sweden with 256000 inhabitants, and a single referral hospital. Subjects. Six-hundred and thirty-six 55-year-old men, randomly selected from the general population. None of them had signs or symptoms of Leg Artery disease. Main outcome measures. All-cause mortality, morbidity and mortality from ischaemic heart disease during 21 years of follow-up following the initial examination in 1968. Results. A low pulse-wave amplitude (i.e. < 5 mm) during reactive hyperaemia was, independently of other known arteriosclerotic risk factors, associated with a higher cardiac event rate of 37.1% (relative risk: 2.2; 95% CI: 1.3–3.6) and a higher all-cause mortality rate of 62.9% (relative risk: 1.7; 95% CI: 1.2–2.4) during 21 years of follow-up. No other plethysmographically recorded variable was associated with an increased mortality and cardiac event rate. Conclusions. The plethysmographically recorded pulse-wave amplitude during reactive hyperaemia can be used as an early independent marker to identify individuals at risk of developing ischaemic heart disease and death at an early age.
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non invasively detected carotid stenosis and ischaemic heart disease in men with Leg arteriosclerosis
The Lancet, 1993Co-Authors: Mats Ogren, Bo Hedblad, So Isacsson, Lars Janzon, G Jungqvist, Se LindellAbstract:Abstract Since the excess mortality rate associated with an ankle-brachial blood-pressure index (ABPI) less than 0 9 was only partly explained by an excess cardiovascular mortality, we believe that Leg Artery disease should not only be regarded as a marker of generalised arteriosclerosis but also as a sign associated with an increased risk of premature death. 439 men who were part of a prospective population study in Malmo, Sweden, were, at 68 years of age, invited to a health examination including, ABPI, carotid-Artery ultrasonography, and 24 h ambulatory electrocardiographic monitoring. Cause- specific mortality and incidence of myocardial infarction (MI) during 8 years of follow-up was compared in men with and without signs of arteriosclerotic disease. Of 60 men with an ABPI 30% reduction of the cross-sectional diameter). Total mortality rate in men with no signs of arteriosclerotic disease was 19·6 per 1000 person-years and cardiac event rate (fatal and non-fatal Ml and death from chronic ischaemic heart disease was 8·6 per 1000 person-years). Leg Artery disease, carotid stenosis, and ischaemic heart disease were in a univariate analysis all associated with an increased cardiac event rate and an increased total mortality rate. In a multivariate analysis an ABPI less than 0·9 was associated with a 2·4 times higher total mortality (95% Cl 1·5-3·9) and a 2·0 times higher cardiac event rate (1·1-3·9). Carotid stenosis and ischaemic heart disease contributed to the risk for Ml (RR 2 1; 95% Cl 1·2-3·8; and 2·1; 1 2-3·9, respectively), whereas no independent association with total mortality was found.
Mats Ogren - One of the best experts on this subject based on the ideXlab platform.
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Occurrence and Prognosis of Ventricular Arrhythmia in Men With and Without Asymptomatic Leg Artery Disease: Results from a Prospective Population Study “Men Born in 1914,” Malmö, Sweden
Annals of Noninvasive Electrocardiology, 1999Co-Authors: Bo Hedblad, Lars Janzon, Mats OgrenAbstract:Background:The occurrence of frequent or complex ventricular arrhythmia in apparently healthy men during ambulatory ECG recording has been shown to be associated with an increased incidence and mortality in ischemic heart disease. Similar risk has been documented for individuals with asymptomatic Leg Artery disease. The objective of this follow-up of 450 men from the prospective cohort study “Men born in 1914” in Malmo, Sweden has been to assess whether there is any relationship between the occurrence of ventricular arrhythmia and asymptomatic Leg Artery disease and whether the prognosis with regard to survival and incidence of myocardial infarction is different in men with and without asymptomatic Leg Artery disease. Methods:The ECG was recorded during 24 hours. Mortality and incidence of cardiac events (i.e., acute myocardial infarction and death in chronic ischaemic heart disease) during the 10 years following the baseline examination 1982–1983 has been related to occurrence of frequent or complex ventricular arrhythmia (i.e., Lown class 2–5) and prevalence of asymptomatic Leg Artery disease (i.e., ankle-arm blood pressure index, ABPI < 0.9 at rest). Results:There was no association between the prevalence (14% vs 13%) or severity of Leg Artery disease and the occurrence of ventricular arrhythmia. History of cardiovascular disease was related to both conditions. In men without Leg Artery disease, occurrence of arrhythmia was associated with an increased mortality rate, from 29.1 to 41.5 per 1000 person-years (P = 0.046) and cardiac event rate, from 15.6 to 27.1 per 1000 person-years (P = 0.023). The increased incidence of cardiac events and death associated with arrhythmia was modified by the presence of Leg Artery disease. There was a low ABPI in the group with arrhythmia associated with an increase in mortality rate from 41.5 to 95.8 per 1000 person-years and an increase of the cardiac event rate from 27.1 to 76.1 per 1000 person-years. These associations remained statistically significant after adjustment in the analysis with regard to history of cardiovascular disease and other potential confounders. Conclusions:Occurrence of ventricular arrhythmia is a common condition in apparently healthy elderly men. Although it seems to be equally common in men with and without asymptomatic Leg Artery disease, with regard to the incidence of cardiac events and death it is associated with a more serious prognosis in men with Leg Artery disease. A.N.E. 1999;4(3):309–315
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Ten year cerebrovascular morbidity and mortality in 68 year old men with asymptomatic carotid stenosis.
BMJ (Clinical research ed.), 1995Co-Authors: Mats Ogren, Bo Hedblad, So Isacsson, Lars Janzon, Gudrun Jungquist, Sven-eric LindellAbstract:Abstract Objective: To study the natural course of carotid Artery stenosis detected by ultrasonography. Design: Prospective cohort study. Baseline examination in 1982-3 included ultrasound examination of carotid arteries, measurement of anklebrachial blood pressure index, and detection of atrial fibrillation by 24 hour ambulatory electrocardiography. Setting: Malmo, a city in southern Sweden with 230000 inhabitants. Subjects: 470 men aged 68 years randomly selected from the population. Main outcome measures: Incidence of stroke and transient ischaemic attack and all cause mortality during 10 years of follow up in relation to carotid stenosis, Leg Artery disease (ankle-brachial blood pressure index below 0.9), and atrial fibrillation. Results: Fifty men had a stroke; six of these were haemorrhagic. Another 11 had a transient ischaemic attack. Eighteen of the men with carotid stenosis (21.6 events/1000 person years) and 43 of the men with normal carotid arteries (14.8 events/1000 person years) had a stroke or transient ischaemic attack (P=0.188). Men with atrial fibrillation had an increased rate of cerebrovascular events (36.7/1000 person years (P=0.048). The highest rate was found in men with asymptomatic disease of the Leg arteries (38.6/1000 person years) (P Conclusions: In this cohort carotid stenosis was not associated with an increased risk of stroke. Part of this lack of association was explained by the high mortality from ischaemic heart disease in men with severe stenosis. Twenty seven of the 61 cerebrovascular events, however, occurred in men who had normal carotid arteries, normal ankle pressure, and no atrial fibrillation. Key messages Key messages Asymptomatic atherosclerosis in carotid and Leg arteries is a common occurrence among elderly people Both conditions were found to be associated with an excess cardiovascular mortality Compared with Leg Artery disease, asymptomatic carotid stenosis was not found to be associated with an increased risk of stroke Assessment of peripheral atherosclerotic disease by measurement of arm and ankle blood pressure is a useful method for identifying patients with an increased risk of stroke
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low pulse wave amplitude during reactive Leg hyperaemia an independent early marker for ischaemic heart disease and death results from the 21 year follow up of the prospective cohort study men born in 1914 malmo sweden
Journal of Internal Medicine, 1994Co-Authors: Bo Hedblad, Mats Ogren, So Isacsson, Lars Janzon, Se LindellAbstract:.Objective. To study the incidence of myocardial infarction, all-cause mortality and mortality from ischaemic heart disease in relation to arterial Leg blood flow determined by venous occlusion plethysmography of the calf. Design. A prospective cohort study ‘Men born in 1914’. Setting. Malmo, a city in southern Sweden with 256000 inhabitants, and a single referral hospital. Subjects. Six-hundred and thirty-six 55-year-old men, randomly selected from the general population. None of them had signs or symptoms of Leg Artery disease. Main outcome measures. All-cause mortality, morbidity and mortality from ischaemic heart disease during 21 years of follow-up following the initial examination in 1968. Results. A low pulse-wave amplitude (i.e. < 5 mm) during reactive hyperaemia was, independently of other known arteriosclerotic risk factors, associated with a higher cardiac event rate of 37.1% (relative risk: 2.2; 95% CI: 1.3–3.6) and a higher all-cause mortality rate of 62.9% (relative risk: 1.7; 95% CI: 1.2–2.4) during 21 years of follow-up. No other plethysmographically recorded variable was associated with an increased mortality and cardiac event rate. Conclusions. The plethysmographically recorded pulse-wave amplitude during reactive hyperaemia can be used as an early independent marker to identify individuals at risk of developing ischaemic heart disease and death at an early age.
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non invasively detected carotid stenosis and ischaemic heart disease in men with Leg arteriosclerosis
The Lancet, 1993Co-Authors: Mats Ogren, Bo Hedblad, So Isacsson, Lars Janzon, G Jungqvist, Se LindellAbstract:Abstract Since the excess mortality rate associated with an ankle-brachial blood-pressure index (ABPI) less than 0 9 was only partly explained by an excess cardiovascular mortality, we believe that Leg Artery disease should not only be regarded as a marker of generalised arteriosclerosis but also as a sign associated with an increased risk of premature death. 439 men who were part of a prospective population study in Malmo, Sweden, were, at 68 years of age, invited to a health examination including, ABPI, carotid-Artery ultrasonography, and 24 h ambulatory electrocardiographic monitoring. Cause- specific mortality and incidence of myocardial infarction (MI) during 8 years of follow-up was compared in men with and without signs of arteriosclerotic disease. Of 60 men with an ABPI 30% reduction of the cross-sectional diameter). Total mortality rate in men with no signs of arteriosclerotic disease was 19·6 per 1000 person-years and cardiac event rate (fatal and non-fatal Ml and death from chronic ischaemic heart disease was 8·6 per 1000 person-years). Leg Artery disease, carotid stenosis, and ischaemic heart disease were in a univariate analysis all associated with an increased cardiac event rate and an increased total mortality rate. In a multivariate analysis an ABPI less than 0·9 was associated with a 2·4 times higher total mortality (95% Cl 1·5-3·9) and a 2·0 times higher cardiac event rate (1·1-3·9). Carotid stenosis and ischaemic heart disease contributed to the risk for Ml (RR 2 1; 95% Cl 1·2-3·8; and 2·1; 1 2-3·9, respectively), whereas no independent association with total mortality was found.
Bo Hedblad - One of the best experts on this subject based on the ideXlab platform.
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Occurrence and Prognosis of Ventricular Arrhythmia in Men With and Without Asymptomatic Leg Artery Disease: Results from a Prospective Population Study “Men Born in 1914,” Malmö, Sweden
Annals of Noninvasive Electrocardiology, 1999Co-Authors: Bo Hedblad, Lars Janzon, Mats OgrenAbstract:Background:The occurrence of frequent or complex ventricular arrhythmia in apparently healthy men during ambulatory ECG recording has been shown to be associated with an increased incidence and mortality in ischemic heart disease. Similar risk has been documented for individuals with asymptomatic Leg Artery disease. The objective of this follow-up of 450 men from the prospective cohort study “Men born in 1914” in Malmo, Sweden has been to assess whether there is any relationship between the occurrence of ventricular arrhythmia and asymptomatic Leg Artery disease and whether the prognosis with regard to survival and incidence of myocardial infarction is different in men with and without asymptomatic Leg Artery disease. Methods:The ECG was recorded during 24 hours. Mortality and incidence of cardiac events (i.e., acute myocardial infarction and death in chronic ischaemic heart disease) during the 10 years following the baseline examination 1982–1983 has been related to occurrence of frequent or complex ventricular arrhythmia (i.e., Lown class 2–5) and prevalence of asymptomatic Leg Artery disease (i.e., ankle-arm blood pressure index, ABPI < 0.9 at rest). Results:There was no association between the prevalence (14% vs 13%) or severity of Leg Artery disease and the occurrence of ventricular arrhythmia. History of cardiovascular disease was related to both conditions. In men without Leg Artery disease, occurrence of arrhythmia was associated with an increased mortality rate, from 29.1 to 41.5 per 1000 person-years (P = 0.046) and cardiac event rate, from 15.6 to 27.1 per 1000 person-years (P = 0.023). The increased incidence of cardiac events and death associated with arrhythmia was modified by the presence of Leg Artery disease. There was a low ABPI in the group with arrhythmia associated with an increase in mortality rate from 41.5 to 95.8 per 1000 person-years and an increase of the cardiac event rate from 27.1 to 76.1 per 1000 person-years. These associations remained statistically significant after adjustment in the analysis with regard to history of cardiovascular disease and other potential confounders. Conclusions:Occurrence of ventricular arrhythmia is a common condition in apparently healthy elderly men. Although it seems to be equally common in men with and without asymptomatic Leg Artery disease, with regard to the incidence of cardiac events and death it is associated with a more serious prognosis in men with Leg Artery disease. A.N.E. 1999;4(3):309–315
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Ten year cerebrovascular morbidity and mortality in 68 year old men with asymptomatic carotid stenosis.
BMJ (Clinical research ed.), 1995Co-Authors: Mats Ogren, Bo Hedblad, So Isacsson, Lars Janzon, Gudrun Jungquist, Sven-eric LindellAbstract:Abstract Objective: To study the natural course of carotid Artery stenosis detected by ultrasonography. Design: Prospective cohort study. Baseline examination in 1982-3 included ultrasound examination of carotid arteries, measurement of anklebrachial blood pressure index, and detection of atrial fibrillation by 24 hour ambulatory electrocardiography. Setting: Malmo, a city in southern Sweden with 230000 inhabitants. Subjects: 470 men aged 68 years randomly selected from the population. Main outcome measures: Incidence of stroke and transient ischaemic attack and all cause mortality during 10 years of follow up in relation to carotid stenosis, Leg Artery disease (ankle-brachial blood pressure index below 0.9), and atrial fibrillation. Results: Fifty men had a stroke; six of these were haemorrhagic. Another 11 had a transient ischaemic attack. Eighteen of the men with carotid stenosis (21.6 events/1000 person years) and 43 of the men with normal carotid arteries (14.8 events/1000 person years) had a stroke or transient ischaemic attack (P=0.188). Men with atrial fibrillation had an increased rate of cerebrovascular events (36.7/1000 person years (P=0.048). The highest rate was found in men with asymptomatic disease of the Leg arteries (38.6/1000 person years) (P Conclusions: In this cohort carotid stenosis was not associated with an increased risk of stroke. Part of this lack of association was explained by the high mortality from ischaemic heart disease in men with severe stenosis. Twenty seven of the 61 cerebrovascular events, however, occurred in men who had normal carotid arteries, normal ankle pressure, and no atrial fibrillation. Key messages Key messages Asymptomatic atherosclerosis in carotid and Leg arteries is a common occurrence among elderly people Both conditions were found to be associated with an excess cardiovascular mortality Compared with Leg Artery disease, asymptomatic carotid stenosis was not found to be associated with an increased risk of stroke Assessment of peripheral atherosclerotic disease by measurement of arm and ankle blood pressure is a useful method for identifying patients with an increased risk of stroke
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low pulse wave amplitude during reactive Leg hyperaemia an independent early marker for ischaemic heart disease and death results from the 21 year follow up of the prospective cohort study men born in 1914 malmo sweden
Journal of Internal Medicine, 1994Co-Authors: Bo Hedblad, Mats Ogren, So Isacsson, Lars Janzon, Se LindellAbstract:.Objective. To study the incidence of myocardial infarction, all-cause mortality and mortality from ischaemic heart disease in relation to arterial Leg blood flow determined by venous occlusion plethysmography of the calf. Design. A prospective cohort study ‘Men born in 1914’. Setting. Malmo, a city in southern Sweden with 256000 inhabitants, and a single referral hospital. Subjects. Six-hundred and thirty-six 55-year-old men, randomly selected from the general population. None of them had signs or symptoms of Leg Artery disease. Main outcome measures. All-cause mortality, morbidity and mortality from ischaemic heart disease during 21 years of follow-up following the initial examination in 1968. Results. A low pulse-wave amplitude (i.e. < 5 mm) during reactive hyperaemia was, independently of other known arteriosclerotic risk factors, associated with a higher cardiac event rate of 37.1% (relative risk: 2.2; 95% CI: 1.3–3.6) and a higher all-cause mortality rate of 62.9% (relative risk: 1.7; 95% CI: 1.2–2.4) during 21 years of follow-up. No other plethysmographically recorded variable was associated with an increased mortality and cardiac event rate. Conclusions. The plethysmographically recorded pulse-wave amplitude during reactive hyperaemia can be used as an early independent marker to identify individuals at risk of developing ischaemic heart disease and death at an early age.
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non invasively detected carotid stenosis and ischaemic heart disease in men with Leg arteriosclerosis
The Lancet, 1993Co-Authors: Mats Ogren, Bo Hedblad, So Isacsson, Lars Janzon, G Jungqvist, Se LindellAbstract:Abstract Since the excess mortality rate associated with an ankle-brachial blood-pressure index (ABPI) less than 0 9 was only partly explained by an excess cardiovascular mortality, we believe that Leg Artery disease should not only be regarded as a marker of generalised arteriosclerosis but also as a sign associated with an increased risk of premature death. 439 men who were part of a prospective population study in Malmo, Sweden, were, at 68 years of age, invited to a health examination including, ABPI, carotid-Artery ultrasonography, and 24 h ambulatory electrocardiographic monitoring. Cause- specific mortality and incidence of myocardial infarction (MI) during 8 years of follow-up was compared in men with and without signs of arteriosclerotic disease. Of 60 men with an ABPI 30% reduction of the cross-sectional diameter). Total mortality rate in men with no signs of arteriosclerotic disease was 19·6 per 1000 person-years and cardiac event rate (fatal and non-fatal Ml and death from chronic ischaemic heart disease was 8·6 per 1000 person-years). Leg Artery disease, carotid stenosis, and ischaemic heart disease were in a univariate analysis all associated with an increased cardiac event rate and an increased total mortality rate. In a multivariate analysis an ABPI less than 0·9 was associated with a 2·4 times higher total mortality (95% Cl 1·5-3·9) and a 2·0 times higher cardiac event rate (1·1-3·9). Carotid stenosis and ischaemic heart disease contributed to the risk for Ml (RR 2 1; 95% Cl 1·2-3·8; and 2·1; 1 2-3·9, respectively), whereas no independent association with total mortality was found.
Lars Janzon - One of the best experts on this subject based on the ideXlab platform.
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Occurrence and Prognosis of Ventricular Arrhythmia in Men With and Without Asymptomatic Leg Artery Disease: Results from a Prospective Population Study “Men Born in 1914,” Malmö, Sweden
Annals of Noninvasive Electrocardiology, 1999Co-Authors: Bo Hedblad, Lars Janzon, Mats OgrenAbstract:Background:The occurrence of frequent or complex ventricular arrhythmia in apparently healthy men during ambulatory ECG recording has been shown to be associated with an increased incidence and mortality in ischemic heart disease. Similar risk has been documented for individuals with asymptomatic Leg Artery disease. The objective of this follow-up of 450 men from the prospective cohort study “Men born in 1914” in Malmo, Sweden has been to assess whether there is any relationship between the occurrence of ventricular arrhythmia and asymptomatic Leg Artery disease and whether the prognosis with regard to survival and incidence of myocardial infarction is different in men with and without asymptomatic Leg Artery disease. Methods:The ECG was recorded during 24 hours. Mortality and incidence of cardiac events (i.e., acute myocardial infarction and death in chronic ischaemic heart disease) during the 10 years following the baseline examination 1982–1983 has been related to occurrence of frequent or complex ventricular arrhythmia (i.e., Lown class 2–5) and prevalence of asymptomatic Leg Artery disease (i.e., ankle-arm blood pressure index, ABPI < 0.9 at rest). Results:There was no association between the prevalence (14% vs 13%) or severity of Leg Artery disease and the occurrence of ventricular arrhythmia. History of cardiovascular disease was related to both conditions. In men without Leg Artery disease, occurrence of arrhythmia was associated with an increased mortality rate, from 29.1 to 41.5 per 1000 person-years (P = 0.046) and cardiac event rate, from 15.6 to 27.1 per 1000 person-years (P = 0.023). The increased incidence of cardiac events and death associated with arrhythmia was modified by the presence of Leg Artery disease. There was a low ABPI in the group with arrhythmia associated with an increase in mortality rate from 41.5 to 95.8 per 1000 person-years and an increase of the cardiac event rate from 27.1 to 76.1 per 1000 person-years. These associations remained statistically significant after adjustment in the analysis with regard to history of cardiovascular disease and other potential confounders. Conclusions:Occurrence of ventricular arrhythmia is a common condition in apparently healthy elderly men. Although it seems to be equally common in men with and without asymptomatic Leg Artery disease, with regard to the incidence of cardiac events and death it is associated with a more serious prognosis in men with Leg Artery disease. A.N.E. 1999;4(3):309–315
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Ten year cerebrovascular morbidity and mortality in 68 year old men with asymptomatic carotid stenosis.
BMJ (Clinical research ed.), 1995Co-Authors: Mats Ogren, Bo Hedblad, So Isacsson, Lars Janzon, Gudrun Jungquist, Sven-eric LindellAbstract:Abstract Objective: To study the natural course of carotid Artery stenosis detected by ultrasonography. Design: Prospective cohort study. Baseline examination in 1982-3 included ultrasound examination of carotid arteries, measurement of anklebrachial blood pressure index, and detection of atrial fibrillation by 24 hour ambulatory electrocardiography. Setting: Malmo, a city in southern Sweden with 230000 inhabitants. Subjects: 470 men aged 68 years randomly selected from the population. Main outcome measures: Incidence of stroke and transient ischaemic attack and all cause mortality during 10 years of follow up in relation to carotid stenosis, Leg Artery disease (ankle-brachial blood pressure index below 0.9), and atrial fibrillation. Results: Fifty men had a stroke; six of these were haemorrhagic. Another 11 had a transient ischaemic attack. Eighteen of the men with carotid stenosis (21.6 events/1000 person years) and 43 of the men with normal carotid arteries (14.8 events/1000 person years) had a stroke or transient ischaemic attack (P=0.188). Men with atrial fibrillation had an increased rate of cerebrovascular events (36.7/1000 person years (P=0.048). The highest rate was found in men with asymptomatic disease of the Leg arteries (38.6/1000 person years) (P Conclusions: In this cohort carotid stenosis was not associated with an increased risk of stroke. Part of this lack of association was explained by the high mortality from ischaemic heart disease in men with severe stenosis. Twenty seven of the 61 cerebrovascular events, however, occurred in men who had normal carotid arteries, normal ankle pressure, and no atrial fibrillation. Key messages Key messages Asymptomatic atherosclerosis in carotid and Leg arteries is a common occurrence among elderly people Both conditions were found to be associated with an excess cardiovascular mortality Compared with Leg Artery disease, asymptomatic carotid stenosis was not found to be associated with an increased risk of stroke Assessment of peripheral atherosclerotic disease by measurement of arm and ankle blood pressure is a useful method for identifying patients with an increased risk of stroke
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low pulse wave amplitude during reactive Leg hyperaemia an independent early marker for ischaemic heart disease and death results from the 21 year follow up of the prospective cohort study men born in 1914 malmo sweden
Journal of Internal Medicine, 1994Co-Authors: Bo Hedblad, Mats Ogren, So Isacsson, Lars Janzon, Se LindellAbstract:.Objective. To study the incidence of myocardial infarction, all-cause mortality and mortality from ischaemic heart disease in relation to arterial Leg blood flow determined by venous occlusion plethysmography of the calf. Design. A prospective cohort study ‘Men born in 1914’. Setting. Malmo, a city in southern Sweden with 256000 inhabitants, and a single referral hospital. Subjects. Six-hundred and thirty-six 55-year-old men, randomly selected from the general population. None of them had signs or symptoms of Leg Artery disease. Main outcome measures. All-cause mortality, morbidity and mortality from ischaemic heart disease during 21 years of follow-up following the initial examination in 1968. Results. A low pulse-wave amplitude (i.e. < 5 mm) during reactive hyperaemia was, independently of other known arteriosclerotic risk factors, associated with a higher cardiac event rate of 37.1% (relative risk: 2.2; 95% CI: 1.3–3.6) and a higher all-cause mortality rate of 62.9% (relative risk: 1.7; 95% CI: 1.2–2.4) during 21 years of follow-up. No other plethysmographically recorded variable was associated with an increased mortality and cardiac event rate. Conclusions. The plethysmographically recorded pulse-wave amplitude during reactive hyperaemia can be used as an early independent marker to identify individuals at risk of developing ischaemic heart disease and death at an early age.
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non invasively detected carotid stenosis and ischaemic heart disease in men with Leg arteriosclerosis
The Lancet, 1993Co-Authors: Mats Ogren, Bo Hedblad, So Isacsson, Lars Janzon, G Jungqvist, Se LindellAbstract:Abstract Since the excess mortality rate associated with an ankle-brachial blood-pressure index (ABPI) less than 0 9 was only partly explained by an excess cardiovascular mortality, we believe that Leg Artery disease should not only be regarded as a marker of generalised arteriosclerosis but also as a sign associated with an increased risk of premature death. 439 men who were part of a prospective population study in Malmo, Sweden, were, at 68 years of age, invited to a health examination including, ABPI, carotid-Artery ultrasonography, and 24 h ambulatory electrocardiographic monitoring. Cause- specific mortality and incidence of myocardial infarction (MI) during 8 years of follow-up was compared in men with and without signs of arteriosclerotic disease. Of 60 men with an ABPI 30% reduction of the cross-sectional diameter). Total mortality rate in men with no signs of arteriosclerotic disease was 19·6 per 1000 person-years and cardiac event rate (fatal and non-fatal Ml and death from chronic ischaemic heart disease was 8·6 per 1000 person-years). Leg Artery disease, carotid stenosis, and ischaemic heart disease were in a univariate analysis all associated with an increased cardiac event rate and an increased total mortality rate. In a multivariate analysis an ABPI less than 0·9 was associated with a 2·4 times higher total mortality (95% Cl 1·5-3·9) and a 2·0 times higher cardiac event rate (1·1-3·9). Carotid stenosis and ischaemic heart disease contributed to the risk for Ml (RR 2 1; 95% Cl 1·2-3·8; and 2·1; 1 2-3·9, respectively), whereas no independent association with total mortality was found.
So Isacsson - One of the best experts on this subject based on the ideXlab platform.
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Ten year cerebrovascular morbidity and mortality in 68 year old men with asymptomatic carotid stenosis.
BMJ (Clinical research ed.), 1995Co-Authors: Mats Ogren, Bo Hedblad, So Isacsson, Lars Janzon, Gudrun Jungquist, Sven-eric LindellAbstract:Abstract Objective: To study the natural course of carotid Artery stenosis detected by ultrasonography. Design: Prospective cohort study. Baseline examination in 1982-3 included ultrasound examination of carotid arteries, measurement of anklebrachial blood pressure index, and detection of atrial fibrillation by 24 hour ambulatory electrocardiography. Setting: Malmo, a city in southern Sweden with 230000 inhabitants. Subjects: 470 men aged 68 years randomly selected from the population. Main outcome measures: Incidence of stroke and transient ischaemic attack and all cause mortality during 10 years of follow up in relation to carotid stenosis, Leg Artery disease (ankle-brachial blood pressure index below 0.9), and atrial fibrillation. Results: Fifty men had a stroke; six of these were haemorrhagic. Another 11 had a transient ischaemic attack. Eighteen of the men with carotid stenosis (21.6 events/1000 person years) and 43 of the men with normal carotid arteries (14.8 events/1000 person years) had a stroke or transient ischaemic attack (P=0.188). Men with atrial fibrillation had an increased rate of cerebrovascular events (36.7/1000 person years (P=0.048). The highest rate was found in men with asymptomatic disease of the Leg arteries (38.6/1000 person years) (P Conclusions: In this cohort carotid stenosis was not associated with an increased risk of stroke. Part of this lack of association was explained by the high mortality from ischaemic heart disease in men with severe stenosis. Twenty seven of the 61 cerebrovascular events, however, occurred in men who had normal carotid arteries, normal ankle pressure, and no atrial fibrillation. Key messages Key messages Asymptomatic atherosclerosis in carotid and Leg arteries is a common occurrence among elderly people Both conditions were found to be associated with an excess cardiovascular mortality Compared with Leg Artery disease, asymptomatic carotid stenosis was not found to be associated with an increased risk of stroke Assessment of peripheral atherosclerotic disease by measurement of arm and ankle blood pressure is a useful method for identifying patients with an increased risk of stroke
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low pulse wave amplitude during reactive Leg hyperaemia an independent early marker for ischaemic heart disease and death results from the 21 year follow up of the prospective cohort study men born in 1914 malmo sweden
Journal of Internal Medicine, 1994Co-Authors: Bo Hedblad, Mats Ogren, So Isacsson, Lars Janzon, Se LindellAbstract:.Objective. To study the incidence of myocardial infarction, all-cause mortality and mortality from ischaemic heart disease in relation to arterial Leg blood flow determined by venous occlusion plethysmography of the calf. Design. A prospective cohort study ‘Men born in 1914’. Setting. Malmo, a city in southern Sweden with 256000 inhabitants, and a single referral hospital. Subjects. Six-hundred and thirty-six 55-year-old men, randomly selected from the general population. None of them had signs or symptoms of Leg Artery disease. Main outcome measures. All-cause mortality, morbidity and mortality from ischaemic heart disease during 21 years of follow-up following the initial examination in 1968. Results. A low pulse-wave amplitude (i.e. < 5 mm) during reactive hyperaemia was, independently of other known arteriosclerotic risk factors, associated with a higher cardiac event rate of 37.1% (relative risk: 2.2; 95% CI: 1.3–3.6) and a higher all-cause mortality rate of 62.9% (relative risk: 1.7; 95% CI: 1.2–2.4) during 21 years of follow-up. No other plethysmographically recorded variable was associated with an increased mortality and cardiac event rate. Conclusions. The plethysmographically recorded pulse-wave amplitude during reactive hyperaemia can be used as an early independent marker to identify individuals at risk of developing ischaemic heart disease and death at an early age.
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non invasively detected carotid stenosis and ischaemic heart disease in men with Leg arteriosclerosis
The Lancet, 1993Co-Authors: Mats Ogren, Bo Hedblad, So Isacsson, Lars Janzon, G Jungqvist, Se LindellAbstract:Abstract Since the excess mortality rate associated with an ankle-brachial blood-pressure index (ABPI) less than 0 9 was only partly explained by an excess cardiovascular mortality, we believe that Leg Artery disease should not only be regarded as a marker of generalised arteriosclerosis but also as a sign associated with an increased risk of premature death. 439 men who were part of a prospective population study in Malmo, Sweden, were, at 68 years of age, invited to a health examination including, ABPI, carotid-Artery ultrasonography, and 24 h ambulatory electrocardiographic monitoring. Cause- specific mortality and incidence of myocardial infarction (MI) during 8 years of follow-up was compared in men with and without signs of arteriosclerotic disease. Of 60 men with an ABPI 30% reduction of the cross-sectional diameter). Total mortality rate in men with no signs of arteriosclerotic disease was 19·6 per 1000 person-years and cardiac event rate (fatal and non-fatal Ml and death from chronic ischaemic heart disease was 8·6 per 1000 person-years). Leg Artery disease, carotid stenosis, and ischaemic heart disease were in a univariate analysis all associated with an increased cardiac event rate and an increased total mortality rate. In a multivariate analysis an ABPI less than 0·9 was associated with a 2·4 times higher total mortality (95% Cl 1·5-3·9) and a 2·0 times higher cardiac event rate (1·1-3·9). Carotid stenosis and ischaemic heart disease contributed to the risk for Ml (RR 2 1; 95% Cl 1·2-3·8; and 2·1; 1 2-3·9, respectively), whereas no independent association with total mortality was found.