Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Alternative names
Publications (10 of 157) Show all publications
Mahmoud, M., Johansson, B., Rinnström, D., Sandberg, C., Christersson, C., Sörensson, P., . . . Ljungberg, J. (2025). Reinterventions in patients with congenital aortic stenosis and a commissurotomy. Open heart, 12(1), Article ID e003128.
Open this publication in new window or tab >>Reinterventions in patients with congenital aortic stenosis and a commissurotomy
Show others...
2025 (English)In: Open heart, E-ISSN 2053-3624, Vol. 12, no 1, article id e003128Article in journal (Refereed) Published
Abstract [en]

Background: In congenital aortic stenosis (CAS), commissurotomy is an option in patients not suitable to receive a valve prosthesis. However, there is often a need for future additional interventions on the aortic valve. The fate of the aortic valve is, however, essentially unknown. This study reports the need for reinterventions after surgical commissurotomy, based on a national register.

Materials and methods: The national register on congenital heart diseases (CHDs) was searched for patients with CAS, simple or associated with other CHD and an index commissurotomy with later data from follow-up.

Results: 300 patients with CAS and an index commissurotomy (mean age at the operation 7.4±7.8 years, 72.4% males) were identified. After an observation time of 27.4±10.0 years, 54.7% of the patients had a reintervention that occurred 14.2±10.1 years after the index operation. The cumulative incidence of reintervention was approximately 25% 10 years after and 60% 30 years after the index intervention. The prevalence of left ventricular hypertrophy (LVH) was higher among those that needed reintervention (41.3 vs 26.8%, p=0.023). Furthermore, eight patients died with a cumulative incidence of 7% 30 years after the index intervention, where most were (7/8) without reintervention (p=0.025). There were no additional important differences between patients with and without reintervention. The prevalence of left ventricular dysfunction and New York Heart Association class >1 was low.

Conclusion: Most (54.7%) patients with a commissurotomy, more than half of them within 30 years and eventually all will need a reintervention. This is important information to patients, especially for women in childbearing age. The higher prevalence of LVH in the group with reintervention needs attention during follow-up. Furthermore, those without reintervention, for unknown reasons, had a higher mortality. Our data strengthen the arguments for close outpatient follow-up among patients with a previous commissurotomy.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2025
Keywords
Hjärta
National Category
Cardiology and Cardiovascular Disease
Research subject
Cardiology
Identifiers
urn:nbn:se:umu:diva-237001 (URN)10.1136/openhrt-2024-003128 (DOI)001437257100001 ()40032608 (PubMedID)2-s2.0-86000499455 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 2023-0593Region Västerbotten, RV-996417Visare Norr, 994832
Available from: 2025-03-27 Created: 2025-03-27 Last updated: 2025-03-28Bibliographically approved
Kovacs, A. H., Luyckx, K., Thomet, C., Budts, W., Enomoto, J., Sluman, M. A., . . . Moons, P. (2024). Anxiety and depression in adults with congenital heart disease. Journal of the American College of Cardiology, 83(3), 430-441
Open this publication in new window or tab >>Anxiety and depression in adults with congenital heart disease
Show others...
2024 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 83, no 3, p. 430-441Article in journal (Refereed) Published
Abstract [en]

Background: A comprehensive understanding of adult congenital heart disease outcomes must include psychological functioning. Our multisite study offered the opportunity to explore depression and anxiety symptoms within a global sample.

Objectives: In this substudy of the APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults With Congenital Heart Disease–International Study), the authors we investigated the prevalence of elevated depression and anxiety symptoms, explored associated sociodemographic and medical factors, and examined how quality of life (QOL) and health status (HS) differ according to the degree of psychological symptoms.

Methods: Participants completed the Hospital Anxiety and Depression Scale, which includes subscales for symptoms of anxiety (HADS-A) and depression (HADS-D). Subscale scores of 8 or higher indicate clinically elevated symptoms and can be further categorized as mild, moderate, or severe. Participants also completed analogue scales on a scale of 0 to 100 for QOL and HS. Analysis of variance was performed to investigate whether QOL and HS differed by symptom category.

Results: Of 3,815 participants from 15 countries (age 34.8 ± 12.9 years; 52.7% female), 1,148 (30.1%) had elevated symptoms in one or both subscales: elevated HADS-A only (18.3%), elevated HADS-D only (2.9%), or elevations on both subscales (8.9%). Percentages varied among countries. Both QOL and HS decreased in accordance with increasing HADS-A and HADS-D symptom categories (P < 0.001).

Conclusions: In this global sample of adults with congenital heart disease, almost one-third reported elevated symptoms of depression and/or anxiety, which in turn were associated with lower QOL and HS. We strongly advocate for the implementation of strategies to recognize and manage psychological distress in clinical settings. (Patient-Reported Outcomes in Adults With Congenital Heart Disease [APPROACH-IS]; NCT02150603)

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
adult congenital heart disease, anxiety, depression, quality of life
National Category
Nursing Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-219533 (URN)10.1016/j.jacc.2023.10.043 (DOI)001166976200001 ()2-s2.0-85181800376 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20130607University of Gothenburg
Available from: 2024-01-16 Created: 2024-01-16 Last updated: 2025-04-24Bibliographically approved
Frykholm, E., Simonsson, E., Levik Sandström, S., Hedlund, M., Holmberg, H., Johansson, B., . . . Rosendahl, E. (2024). Applicability of a supramaximal high-intensity interval training program for older adults previously not engaged in regular exercise: analyses of secondary outcomes from the Umeå HIT Study. Psychology of Sport And Exercise, 73, Article ID 102647.
Open this publication in new window or tab >>Applicability of a supramaximal high-intensity interval training program for older adults previously not engaged in regular exercise: analyses of secondary outcomes from the Umeå HIT Study
Show others...
2024 (English)In: Psychology of Sport And Exercise, ISSN 1469-0292, E-ISSN 1878-5476, Vol. 73, article id 102647Article in journal (Refereed) Published
Abstract [en]

This analysis of secondary outcomes investigated the applicability of supramaximal high-intensity interval training (HIT) with individually prescribed external intensity performed on stationary bicycles. Sixty-eight participants with a median (min; max) age of 69 (66; 79), at the time not engaged in regular exercise were randomized to 25 twice-weekly sessions of supramaximal HIT (20-min session with 10 × 6-s intervals) or moderate-intensity training (MIT, 40-min session with 3 × 8-min intervals). The primary aim was outcomes on applicability regarding; adherence to prescribed external interval intensity, participant reported positive and negative events, ratings of perceived exertion (RPE 6–20), and affective state (Feeling Scale, FS -5–5). A secondary aim was to investigate change in exercise-related self-efficacy (Exercise Self-Efficacy Scale) and motivation (Behavioural Regulations in Exercise Questionnaire-2). Total adherence to the prescribed external interval intensity was [median (min; max)] 89 % (56; 100 %) in supramaximal HIT, and 100 % (95; 100 %) in MIT. The supramaximal HIT group reported 60 % of the positive (112 of 186) and 36 % of the negative (52 of 146) events. At the end of the training period, the median (min; max) session RPE was 15 (12; 17) for supramaximal HIT and 14 (9; 15) for MIT. As for FS, the median last within-session rating was 3 (−1; 5) for supramaximal HIT and 3 (1; 5) for MIT. Exercise-related motivation increased (mean difference in Relative Autonomy Index score = 1.54, 95 % CI [0.69; 2.40]), while self-efficacy did not change (mean difference = 0.55, 95 % CI [-0.75; 1.82]), regardless of group. This study provide support for supramaximal HIT in supervised group settings for older adults.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Feasibility, HIIT, Randomized controlled trial, SIT, Sprint interval training
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-223607 (URN)10.1016/j.psychsport.2024.102647 (DOI)001229900800001 ()38604572 (PubMedID)2-s2.0-85190305065 (Scopus ID)
Funder
Swedish Research Council, 2017–00912Forte, Swedish Research Council for Health, Working Life and Welfare, 2020–00159The Kamprad Family FoundationThe Dementia Association - The National Association for the Rights of the DementedFoundation for the Memory of Ragnhild and Einar LundströmThe Kempe Foundations
Available from: 2024-05-02 Created: 2024-05-02 Last updated: 2025-04-24Bibliographically approved
Holstad, Y., Johansson, B., Lindqvist, M., Westergren, A., Sundström Poromaa, I., Christersson, C., . . . Bay, A. (2024). Breastfeeding in primiparous women with congenital heart disease: a register study. International Breastfeeding Journal, 19(1), Article ID 19.
Open this publication in new window or tab >>Breastfeeding in primiparous women with congenital heart disease: a register study
Show others...
2024 (English)In: International Breastfeeding Journal, E-ISSN 1746-4358, Vol. 19, no 1, article id 19Article in journal (Refereed) Published
Abstract [en]

Background: The number of pregnant women with congenital heart disease (CHD) is rising, and the disease poses increased risks of cardiovascular and obstetric complications during pregnancy, potentially impacting breastfeeding success. This study aimed to investigate breastfeeding in primiparous women with CHD compared to primiparous women without CHD, and to examine potential hindering factors for breastfeeding in women with CHD.

Methods: The data were gathered between 2014 and 2019 and obtained by merging the Swedish Congenital Heart Disease Register (SWEDCON) with the Swedish Pregnancy Register. Primiparous women ≥ 18 years of age with CHD (n = 578) were matched by age and municipality to 3049 women without CHD, giving birth after 22 gestational weeks. Multivariable logistic regression analysis was used to identify factors associated with non-breastfeeding in women with CHD.

Results: Fewer women with CHD breastfed than women without CHD two days (94% vs. 97%, p = 0.001) and four weeks after birth (84% vs. 89%, p = 0.006). When all women were analysed, having CHD was associated with non-breastfeeding at both two days and four weeks after birth. For women with CHD, body mass index (BMI) ≥ 30 (OR 3.1; 95% CI 1.4, 7.3), preterm birth (OR 6.4; 95% CI 2.1, 19.0), self-reported history of psychiatric illness (OR 2.4; 95% CI 1.2, 5.1), small for gestational age (OR 4.2; 95% CI 1.4, 12.2), and New York Heart Association Stages of Heart Failure class II − III (OR 6.0; 95% CI 1.4, 26.7) were associated with non-breastfeeding two days after birth. Four weeks after birth, factors associated with non-breastfeeding were BMI ≥ 30 (OR 4.3; 95% CI 2.1, 9.0), self-reported history of psychiatric illness (OR 2.2; 95% CI 1.2, 4.2), and preterm birth (OR 8.9; 95% CI 2.8, 27.9).

Conclusions: The study shows that most women with CHD breastfeed, however, at a slightly lower proportion compared to women without CHD. In addition, factors related to the heart disease were not associated with non-breastfeeding four weeks after birth. Since preterm birth, BMI ≥ 30, and psychiatric illness are associated with non-breastfeeding, healthcare professionals should provide greater support to women with CHD having these conditions.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
National Category
Cardiology and Cardiovascular Disease Nursing
Identifiers
urn:nbn:se:umu:diva-222559 (URN)10.1186/s13006-024-00627-y (DOI)001190554400002 ()38509505 (PubMedID)2-s2.0-85188251664 (Scopus ID)
Funder
Umeå UniversityNorrländska HjärtfondenSwedish Heart Lung FoundationThe Swedish Heart and Lung Association
Available from: 2024-03-21 Created: 2024-03-21 Last updated: 2025-04-24Bibliographically approved
Frykholm, E., Hedlund, M., Becker, C., Holmberg, H., Johansson, B., Klenk, J., . . . Rosendahl, E. (2024). Effects of controlled supramaximal high-intensity interval training on muscle capacities and physical functions for older adults: analysis of secondary outcomes from the Umeå HIT study-a randomised controlled trial. Age and Ageing, 53(10)
Open this publication in new window or tab >>Effects of controlled supramaximal high-intensity interval training on muscle capacities and physical functions for older adults: analysis of secondary outcomes from the Umeå HIT study-a randomised controlled trial
Show others...
2024 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 53, no 10Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: This study investigated the effectiveness of supramaximal high-intensity interval training (supramaximal HIT) on muscle capacities and physical function compared to moderate-intensity training (MIT) for older adults.

METHODS: Sixty-eight older adults (66-79 years, 56% women), not engaged in regular exercise, were randomised to 3 months of twice-weekly supramaximal HIT (20 minutes including 10 × 6-second intervals) or MIT (40 minutes including 3 × 8-minute intervals). Both groups performed the training on stationary bicycles in a group setting. Target intensity was watt-controlled, with standardised cadence and individualised resistance. Outcomes analysed with linear-mixed models included leg power (Nottingham Power Rig), hand grip strength (Jamar dynamometer), static and dynamic balance (One leg stance, 30-second step test), chair stand (30-second chair stand), and anaerobic cycling performance (modified Borg Cycle Strength Test).

RESULTS: Baseline values were (supramaximal HIT/MIT, mean ± SD) leg power 198 ± 60/189 ± 53 W, hand grip strength 4.2 ± 1.0/4.3 ± 1.1 N/kg, static balance 64 ± 41/62 ± 41 s, dynamic balance 39 ± 7/38 ± 5 steps, chair stands 22 ± 6/22 ± 6 and anaerobic cycling performance 224 ± 60/217 ± 55 W. At 3-month follow-up, a between-group difference in favour of supramaximal HIT [95% CI] was observed in anaerobic cycling performance of 19[3;35] W. Within-group mean changes for supramaximal HIT/MIT were for leg power 8.4[0.9;15.8]/6.0[-1.3;13.3] W, hand grip strength 0.14[0.00;0.27]/0.13[-0.01;0.26] N/kg, static balance 11[3;20]/10[1;18] s, dynamic balance 1.6[0.3;2.8]/2.3[1.1;3.6] steps, 2.1[1.1;3.1]/1.4[0.4;2.3] chair stands and anaerobic cycling performance 31.3[19.6;43.0]/12.0[0.4;23.5] W.

CONCLUSION: Supramaximal HIT showed superior effect on anaerobic cycling performance when compared to MIT. Additionally, the results indicate that supramaximal HIT is comparably beneficial as MIT in terms of effects on muscle capacity and physical function for older adults.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
aged, exercise, high-intensity interval training (HIIT), older people, randomised controlled trial, sprint interval training (SIT)
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-231040 (URN)10.1093/ageing/afae226 (DOI)001336473100002 ()2-s2.0-85206279989 (Scopus ID)
Funder
Swedish Research Council, 2017-00912Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-00159The Kamprad Family FoundationThe Dementia Association - The National Association for the Rights of the DementedFoundation for the Memory of Ragnhild and Einar LundströmThe Kempe FoundationsUmeå University
Available from: 2024-10-23 Created: 2024-10-23 Last updated: 2025-04-24Bibliographically approved
Daelman, B., Van Bulck, L., Luyckx, K., Kovacs, A. H., Van De Bruaene, A., Ladouceur, M., . . . Wijayarathne, P. M. (2024). Frailty and cognitive function in middle-aged and older adults with congenital heart disease. Journal of the American College of Cardiology, 83(12), 1149-1159
Open this publication in new window or tab >>Frailty and cognitive function in middle-aged and older adults with congenital heart disease
Show others...
2024 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 83, no 12, p. 1149-1159Article in journal (Refereed) Published
Abstract [en]

Background: Life expectancy of patients with congenital heart disease (CHD) has increased rapidly, resulting in a growing and aging population. Recent studies have shown that older people with CHD have higher morbidity, health care use, and mortality. To maintain longevity and quality of life, understanding their evolving medical and psychosocial challenges is essential.

Objectives: The authors describe the frailty and cognitive profile of middle-aged and older adults with CHD to identify predictor variables and to explore the relationship with hospital admissions and outpatient visits.

Methods: Using a cross-sectional, multicentric design, we included 814 patients aged ≥40 years from 11 countries. Frailty phenotype was determined using the Fried method. Cognitive function was assessed by the Montreal Cognitive Assessment.

Results: In this sample, 52.3% of patients were assessed as robust, 41.9% as prefrail, and 5.8% as frail; 38.8% had cognitive dysfunction. Multinomial regression showed that frailty was associated with older age, female sex, higher physiologic class, and comorbidities. Counterintuitively, patients with mild heart defects were more likely than those with complex lesions to be prefrail. Patients from middle-income countries displayed more prefrailty than those from higher-income countries. Logistic regression demonstrated that cognitive dysfunction was related to older age, comorbidities, and lower country-level income.

Conclusions: Approximately one-half of included patients were (pre-)frail, and more than one-third experienced cognitive impairment. Frailty and cognitive dysfunction were identified in patients with mild CHD, indicating that these concerns extend beyond severe CHD. Assessing frailty and cognition routinely could offer valuable insights into this aging population.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
aging, cognition, congenital heart defects, frailty, frailty phenotype
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-222575 (URN)10.1016/j.jacc.2024.01.021 (DOI)001228252000001 ()38508848 (PubMedID)2-s2.0-85187024075 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20190525
Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2025-04-24Bibliographically approved
Angerbjörn, M., Johansson, B., Eriksson, M., Rinnström, D., Sandberg, C., Christersson, C., . . . Pennlert, J. (2024). Ischemic stroke in adults with congenital heart disease: cumulative incidence and associated factors. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 13(19), Article ID e034206.
Open this publication in new window or tab >>Ischemic stroke in adults with congenital heart disease: cumulative incidence and associated factors
Show others...
2024 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, E-ISSN 2047-9980, Vol. 13, no 19, article id e034206Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: When more patients with congenital heart disease reach adult age, increased incidence of long-term complications, including ischemic stroke, are expected. The aim of this study was to analyze cumulative incidence of ischemic stroke, associated factors, and case fatality in adult congenital heart disease.

METHODS AND RESULTS: The study is based on Swedish national registers on congenital heart disease and stroke. Patients with congenital heart disease were followed between 2001 and 2018 for first-ever ischemic stroke events (ischemic stroke due to patent foramen ovale excluded). Factors possibly associated with ischemic stroke were analyzed using Cox regression models. Out of 8914 adult patients with congenital heart disease, 108 suffered ischemic stroke over a mean period of 7.6±4.7 years. The mean age at ischemic stroke was 53.8 years, and the cumulative incidence was 0.15% at 1 year, 0.5% at 5 years, and 1.5% at 10 years. In multivariable analysis, age (hazard ratio [HR], 1.04 [95% CI, 1.03-1.06]), diabetes (HR, 2.9 [95% CI, 1.3-6.4]), ejection fraction <50% (HR, 1.9 [95% CI, 1.1-3.4]), atrial septal defect (HR, 3.0 [95% CI, 1.03-8.5]), and aortic valve lesions (HR, 4.8 [95% CI, 1.6-14.1]) were associated with increased risk. Among those with ischemic stroke, approximately half were on antithrombotic treatment (anticoagulants or antiplatelets) before admission. Case fatality was 6.5%.

CONCLUSIONS: The cumulative incidence of ischemic stroke was 1.5% after 10 years. In adult congenital heart disease, the type of heart lesion, diabetes, ejection fraction <50%, and age were important factors associated with ischemic stroke. Despite a relatively young age, mortality is a significant threat. At time of the ischemic stroke event, approximately half of the patients were on antithrombotic treatment.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
adult congenital heart disease, ischemic stroke, register, risk factors
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-230687 (URN)10.1161/JAHA.124.034206 (DOI)001325809100019 ()39291477 (PubMedID)2-s2.0-85205525252 (Scopus ID)
Funder
The Swedish Heart and Lung AssociationRegion VästerbottenNorrländska HjärtfondenVisare Norr
Available from: 2024-10-14 Created: 2024-10-14 Last updated: 2025-04-24Bibliographically approved
Rinnström, D. & Johansson, B. (2024). New findings on ascending aortic dilation in coarctation of the aorta: expanding perspectives. Journal of the American College of Cardiology, 83(12), 1147-1148
Open this publication in new window or tab >>New findings on ascending aortic dilation in coarctation of the aorta: expanding perspectives
2024 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 83, no 12, p. 1147-1148Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
bicuspid aortic valve, coarctation of aorta, thoracic aorta aneurysms
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-222432 (URN)10.1016/j.jacc.2024.02.011 (DOI)2-s2.0-85187014332 (Scopus ID)
Available from: 2024-03-19 Created: 2024-03-19 Last updated: 2025-02-10Bibliographically approved
Holstad, Y., Johansson, B., Lindqvist, M., Westergren, A., Sundström Poromaa, I., Christersson, C., . . . Bay, A. (2024). Self-rated health in primiparous women with congenital heart disease before, during and after pregnancy: a register study. Scandinavian Cardiovascular Journal, 58(1), Article ID 2295782.
Open this publication in new window or tab >>Self-rated health in primiparous women with congenital heart disease before, during and after pregnancy: a register study
Show others...
2024 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 58, no 1, article id 2295782Article in journal (Refereed) Published
Abstract [en]

Background: Poor maternal self-rated health in healthy women is associated with adverse neonatal outcomes, but knowledge about self-rated health in pregnant women with congenital heart disease (CHD) is sparse. This study, therefore, investigated self-rated health before, during, and after pregnancy in women with CHD and factors associated with poor self-rated health.

Methods: The Swedish national registers for CHD and pregnancy were merged and searched for primiparous women with data on self-rated health; 600 primiparous women with CHD and 3062 women in matched controls. Analysis was performed using descriptive statistics, chi-square test and logistic regression.

Results: Women with CHD equally often rated their health as poor as the controls before (15.5% vs. 15.8%, p = .88), during (29.8% vs. 26.8% p = .13), and after pregnancy (18.8% vs. 17.6% p = .46). None of the factors related to heart disease were associated with poor self-rated health. Instead, factors associated with poor self-rated health during pregnancy in women with CHD were ≤12 years of education (OR 1.7, 95%CI 1.2–2.4) and self-reported history of psychiatric illness (OR 12.6, 95%CI 1.4–3.4). After pregnancy, solely self-reported history of psychiatric illness (OR 5.2, 95%CI 1.1–3.0) was associated with poor self-rated health.

Conclusion: Women with CHD reported poor self-rated health comparable to controls before, during, and after pregnancy, and factors related to heart disease were not associated with poor self-rated health. Knowledge about self-rated health may guide professionals in reproductive counselling for women with CHD. Further research is required on how pregnancy affects self-rated health for the group in a long-term perspective.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Self-rated health, women, heart defects congenital, adult congenital heart disease (ACHD), pregnancy, reproductive health, chronic disease
National Category
Public Health, Global Health and Social Medicine Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-219014 (URN)10.1080/14017431.2023.2295782 (DOI)001129021600001 ()38130125 (PubMedID)2-s2.0-85180660455 (Scopus ID)
Funder
Swedish Heart Lung Foundation
Available from: 2024-01-05 Created: 2024-01-05 Last updated: 2025-02-20Bibliographically approved
Swahn, E., Sederholm Lawesson, S., Alfredsson, J., Fredrikson, M., Angerås, O., Duvernoy, O., . . . Jernberg, T. (2024). Sex differences in prevalence and characteristics of imaging-detected atherosclerosis: a population-based study. European Heart Journal Cardiovascular Imaging, 25(12), 1663-1672
Open this publication in new window or tab >>Sex differences in prevalence and characteristics of imaging-detected atherosclerosis: a population-based study
Show others...
2024 (English)In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 25, no 12, p. 1663-1672Article in journal (Refereed) Published
Abstract [en]

Aims: Men are more likely to suffer a myocardial infarction than women, but population-based studies on sex differences in imaging-detected atherosclerosis are lacking. The aims were to assess sex differences in the prevalence of imaging-detected coronary and carotid atherosclerosis, as well as multivariable adjusted associations between sex and atherosclerosis.

Methods and results: Participants aged 50-65, recruited from the general population to the Swedish Cardiopulmonary bioImage Study (SCAPIS), were included in this population-based cross-sectional study. Comprehensive diagnostics, including coronary computed tomography angiography and carotid ultrasound, were performed. The image findings were any coronary atherosclerosis, coronary stenosis >= 50%, segment involvement score (SIS) >= 4, coronary artery calcium score (CACS) > 100, and any ultrasound-detected carotid plaque. In 25 580 participants (50% women), men had more hypertension (20.3% vs. 17.0%), hyperlipidaemia (9.0% vs. 5.5%), and diabetes (8.5% vs. 4.7%). The prevalence was 56.2% vs. 29.5% for any coronary atherosclerosis (P < 0.01), 9.0% vs. 2.3% for coronary stenosis >= 50% (P < 0.01), 20.2% vs. 5.3% for SIS >= 4 (P < 0.01), 18.2% vs. 5.6% for CACS > 100 (P < 0.01), and 60.9% vs. 48.7% for carotid plaque (P < 0.01), in men vs. women, respectively. Multivariable adjustment only marginally changed these associations: odds ratios (ORs) (95% confidence interval): 2.75 (2.53-2.99) for coronary atherosclerosis, 2.88 (2.40-3.45) for coronary stenosis >= 50%, 3.99 (3.50-4.55) for SIS >= 4, 3.29 (2.88-3.75) for CACS > 100, and 1.57 (1.45-1.70) for carotid plaque.

Conclusion: Men had higher prevalence of imaging-detected carotid and coronary atherosclerosis with prevalence in women aged 65 corresponding to men 11-13 years younger. The associations remained after extensive multivariable adjustment.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
sex characteristics, coronary computed tomography angiography, atherosclerosis, coronary artery disease, carotid artery disease, ultrasonography
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-232544 (URN)10.1093/ehjci/jeae217 (DOI)001318889800001 ()39158095 (PubMedID)2-s2.0-85210956775 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 2021-0345Knut and Alice Wallenberg FoundationSwedish Research Council, 2018-02527VinnovaAFA Insurance, 160334
Available from: 2024-12-02 Created: 2024-12-02 Last updated: 2025-02-10Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-0976-6910

Search in DiVA

Show all publications