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Lönnberg, Göran
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Publications (10 of 10) Show all publications
Brunström, M., Dahlström, J., Lindholm, L. H., Lönnberg, G., Hallström, S., Norberg, M., . . . Carlberg, B. (2016). From efficacy in trials to effectiveness in clinical practice: The Swedish Stroke Prevention Study. Blood Pressure, 25(4), 206-211
Open this publication in new window or tab >>From efficacy in trials to effectiveness in clinical practice: The Swedish Stroke Prevention Study
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2016 (English)In: Blood Pressure, ISSN 0803-7051, E-ISSN 1651-1999, Vol. 25, no 4, p. 206-211Article in journal (Refereed) Published
Abstract [en]

Blood pressure treatment has shown great efficacy in reducing cardiovascular events in randomized controlled trials. If this is effective in reducing cardiovascular disease in the general population, is less studied. Between 2001 and 2009 we performed an intervention to improve blood pressure control in the county of Vasterbotten, using Sodermanland County as a control. The intervention was directed towards primary care physicians and included lectures on blood pressure treatment, a computerized decision support system with treatment recommendations, and yearly feed back on hypertension control. Each county had approximately 255000 inhabitants. Differences in age and incidence of cardiovascular disease were small. During follow-up, more than 400000 patients had their blood pressure recorded. The mean number of measurements was eight per patient, yielding a total of 3.4 million blood pressure recordings. The effect of the intervention will be estimated combining the blood pressure data collected from the electronic medical records, with data on stroke, myocardial infarction and mortality from Swedish health registers. Additional variables, from health registers and Statistics Sweden, will be collected to address for confounders. The blood pressure data collected within this study will be an important asset for future epidemiological studies within the field of hypertension.

Keywords
Blood pressure, clinical trials, hypertension, intervention
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-124833 (URN)10.3109/08037051.2015.1127556 (DOI)000380053800002 ()26854107 (PubMedID)
Available from: 2016-10-03 Created: 2016-08-26 Last updated: 2018-06-09Bibliographically approved
Ivarsson, A., Kinsman, J., Johansson, K., Mohamud, K. B., Weinehall, L., Freij, L., . . . Omar, S. (2015). Healing the health system after civil unrest. Global Health Action, 8, 1-4
Open this publication in new window or tab >>Healing the health system after civil unrest
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2015 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, p. 1-4Article in journal, Editorial material (Other academic) Published
Keywords
Diaspora, action, health systems, research collaboration, war and conflicts
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-103570 (URN)10.3402/gha.v8.27381 (DOI)000352006300001 ()25828070 (PubMedID)
Available from: 2015-05-25 Created: 2015-05-21 Last updated: 2018-06-07Bibliographically approved
Blomstedt, Y., Norberg, M., Stenlund, H., Nyström, L., Lönnberg, G., Boman, K., . . . Weinehall, L. (2015). Impact of a combined community and primary care prevention strategy on all-cause and cardiovascular mortality: a cohort analysis based on 1 million person-years of follow-up in Västerbotten County, Sweden, during 1990-2006. BMJ Open, 5(12), Article ID e009651.
Open this publication in new window or tab >>Impact of a combined community and primary care prevention strategy on all-cause and cardiovascular mortality: a cohort analysis based on 1 million person-years of follow-up in Västerbotten County, Sweden, during 1990-2006
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2015 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 12, article id e009651Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To evaluate the impact of the Västerbotten Intervention Programme (VIP) by comparing all eligible individuals (target group impact) according to the intention-to-treat principle and VIP participants with the general Swedish population.

DESIGN: Dynamic cohort study.

SETTING/PARTICIPANTS: All individuals aged 40, 50 or 60 years, residing in Västerbotten County, Sweden, between 1990 and 2006 (N=101 918) were followed from their first opportunity to participate in the VIP until age 75, study end point or prior death.

INTERVENTION: The VIP is a systematic, long-term, county-wide cardiovascular disease (CVD) intervention that is performed within the primary healthcare setting and combines individual and population approaches. The core component is a health dialogue based on a physical examination and a comprehensive questionnaire at the ages of 40, 50 and 60 years.

PRIMARY OUTCOMES: All-cause and CVD mortality.

RESULTS: For the target group, there were 5646 deaths observed over 1 054 607 person-years. Compared to Sweden at large, the standardised all-cause mortality ratio was 90.6% (95% CI 88.2% to 93.0%): for women 87.9% (95% CI 84.1% to 91.7%) and for men 92.2% (95% CI 89.2% to 95.3%). For CVD, the ratio was 95.0% (95% CI 90.7% to 99.4%): for women 90.4% (95% CI 82.6% to 98.7%) and for men 96.8% (95% CI 91.7 to 102.0). For participants, subject to further impact as well as selection, when compared to Sweden at large, the standardised all-cause mortality ratio was 66.3% (95% CI 63.7% to 69.0%), whereas the CVD ratio was 68.9% (95% CI 64.2% to 73.9%). For the target group as well as for the participants, standardised mortality ratios for all-cause mortality were reduced within all educational strata.

CONCLUSIONS: The study suggests that the VIP model of CVD prevention is able to impact on all-cause and cardiovascular mortality when evaluated according to the intention-to-treat principle.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2015
Keywords
Primary care, Epidemiology, Public health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-113605 (URN)10.1136/bmjopen-2015-009651 (DOI)000368839100125 ()26685034 (PubMedID)
Available from: 2015-12-21 Created: 2015-12-21 Last updated: 2018-06-07Bibliographically approved
Norberg, M., Blomstedt, Y., Lonnberg, G., Nystrom, L., Stenlund, H., Wall, S. & Weinehall, L. (2012). Community participation and sustainability: evidence over 25 years in the Vasterbotten Intervention Programme. Global Health Action, 5, 1-9
Open this publication in new window or tab >>Community participation and sustainability: evidence over 25 years in the Vasterbotten Intervention Programme
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2012 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 5, p. 1-9Article in journal (Refereed) Published
Abstract [en]

Background: Selection bias and declining participation rates are of concern in many long-term epidemiological studies. The Vasterbotten Intervention Programme (VIP) was launched in 1985 as a response to alarming reports on elevated cardiovascular disease (CVD) mortality in Vasterbotten County in Northern Sweden. The VIP invites women and men to a health examination and health counselling during the year of their 40th, 50th, and 60th birthdays. Objective: To evaluate trends in participation rates and determinants of participation in the VIP from 1990 to 2006. Design: Registry data on socio-economic status from Statistics Sweden, and mortality and hospitalisation data from the National Board of Health and Welfare, both covering the whole Swedish population, were linked to the VIP and analysed for participants and non-participants. Results: During 1990 - 2006, 117,710 individuals were eligible to participate in the VIP, and 40,472 of them were eligible to participate twice. There were 96,560 observations for participants and 61,622 for non-participants. The overall participation rate increased from 56 to 65%. Participants and non-participants had minimal differences in education and age. Initial small differences by sex and degree of urban residence decreased over time. Despite an increasing participation rate in all groups, those with low income or who were single had an approximately 10% lower participation rate than those with high or medium-income or who were married or cohabitating. Conclusion: Sustainability of the VIP is based on organisational integration into primary health care services and targeting of the entire middle-aged population. This enables the programme to meet population expectations of health promotion and to identify high-risk individuals who are then entered into routine preventive health care services. This has the potential to increase participation rates, to minimise social selection bias, and to reinforce other community-based interventions.

Keywords
health surveys, intervention, community participation, primary health care, selection bias
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-64974 (URN)10.3402/gha.v5i0.19166 (DOI)000312933200001 ()
Available from: 2013-02-06 Created: 2013-02-04 Last updated: 2018-06-08Bibliographically approved
Norberg, M., Lindvall, K., Jenkins, P. L., Emmelin, M., Lönnberg, G. & Nafziger, A. N. (2011). Self-rated health does not predict 10-year weight change among middle-aged adults in a longitudinal population study. BMC Public Health, 11(748), 9
Open this publication in new window or tab >>Self-rated health does not predict 10-year weight change among middle-aged adults in a longitudinal population study
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2011 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, no 748, p. 9-Article in journal (Refereed) Published
Abstract [en]

Background: There is a worldwide obesity epidemic, but lack of a simple method, applicable for research or clinical use, to identify individuals at high risk of weight gain. Therefore, the relationship of self-rated health and 10-year percent weight change was evaluated to determine if self-rated health would predict weight change.

Methods: From 1990 to 2008, adults aged 30, 40, 50 and 60 years were invited to health surveys that included self-rated health and measured weight and height. ANOVA was used to evaluate the relationship of 10-year percent weight change and self-rated health.

Results: The study population consisted of 29,207 participants (46.5% men). There was no relationship between baseline self-rated health and 10-year percent weight change for middle-aged men or women.

Conclusions: Self-rated health is not able to predict weight change over a 10-year period in this age group.

Place, publisher, year, edition, pages
London: BioMed Central, 2011
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-48355 (URN)10.1186/1471-2458-11-748 (DOI)21958199 (PubMedID)
Available from: 2011-10-18 Created: 2011-10-18 Last updated: 2018-06-08Bibliographically approved
Stenlund, H., Lönnberg, G., Jenkins, P., Norberg, M., Persson, M., Messner, T., . . . Weinehall, L. (2009). Fewer deaths from cardiovascular disease than expected from the Systematic Coronary Risk Evaluation chart in a Swedish population. European Journal of Cardiovascular Prevention & Rehabilitation, 16(3), 321-324
Open this publication in new window or tab >>Fewer deaths from cardiovascular disease than expected from the Systematic Coronary Risk Evaluation chart in a Swedish population
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2009 (English)In: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 16, no 3, p. 321-324Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Numerous equations to predict cardiovascular risk have been developed, but they differ in their ability to identify high-risk groups. In particular, concerns have been expressed that the Systematic Coronary Risk Evaluation (SCORE) equation may overestimate the risk of fatal myocardial infarction and stroke in certain European populations. METHODS: The SCORE guidelines were applied to a sample of 10,476 male and 11,874 female participants from the Västerbotten Intervention Program (VIP) of northern Sweden who were screened between 1990 and 1994, at the age of 40, 50, or 60 years, and followed up for at least 10 years or until death. RESULTS: The cohort experienced a total of 229 fatal cardiovascular events, 169 for men and 60 for women, during the course of follow-up, whereas 359 (266 for men and 93 for women) were predicted through application of the Swedish SCORE risk chart. CONCLUSION: Application of the SCORE guidelines resulted in substantial overestimation of the expected number of deaths from cardiovascular disease in a population from northern Sweden.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-25587 (URN)10.1097/HJR.0b013e328322c760 (DOI)19357519 (PubMedID)
Available from: 2009-08-21 Created: 2009-08-21 Last updated: 2018-06-08Bibliographically approved
Olsson, C., Hernell, O., Hörnell, A., Lönnberg, G. & Ivarsson, A. (2008). Difference in celiac disease risk between Swedish birth cohorts suggests an opportunity for primary prevention. Pediatrics, 122(3), 528-34
Open this publication in new window or tab >>Difference in celiac disease risk between Swedish birth cohorts suggests an opportunity for primary prevention
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2008 (English)In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 122, no 3, p. 528-34Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Sweden experienced a unique epidemic of celiac disease in children <2 years of age. The epidemic was partly explained by changes in infant feeding over time and indicated a multifactorial pathogenesis. The main aim of this study was to analyze celiac disease risk in epidemic and postepidemic birth cohorts up to preschool age, to explore further the opportunity for primary prevention. METHODS: A population-based incidence register of celiac disease in children covering the entire nation from 1998 to 2003 and part of the country back to 1973 was analyzed. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition diagnostic criteria for celiac disease were used. The annual incidence rate for each age group and the cumulative incidence according to age for each birth cohort were calculated. RESULTS: A considerable difference in cumulative incidences of celiac disease at comparable ages was demonstrated between birth cohorts from the epidemic and postepidemic periods. The difference persisted during the preschool years, although it decreased somewhat with age. During the last years of the follow-up period, there was again a successive increase in incidence rate among children <2 years of age. CONCLUSIONS: The difference in celiac disease risk between birth cohorts at comparable ages suggests an opportunity for primary prevention. This highlights the importance of further exploring the role of infant feeding and exogenous factors besides dietary gluten that might initiate or prevent disease development. Moreover, on the basis of postepidemic incidence trends, we speculate that the Swedish epidemic might not have been as unique as thought previously, although its magnitude was striking.

Keywords
celiac disease, children, incidence, infant
National Category
Pediatrics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-18942 (URN)10.1542/peds.2007-2989 (DOI)000258822600008 ()18762522 (PubMedID)
Projects
ETICS
Available from: 2009-03-01 Created: 2009-03-01 Last updated: 2018-06-09Bibliographically approved
Östman, J., Lönnberg, G., Arnqvist, H. J., Blohmé, G., Bolinder, J., Ekbom Schnell, A., . . . Nyström, L. (2008). Gender differences and temporal variation in the incidence of type 1 diabetes: results of 8012 cases in the nationwide Diabetes Incidence Study in Sweden 1983-2002.. Journal of internal medicine, 263(4), 386-94
Open this publication in new window or tab >>Gender differences and temporal variation in the incidence of type 1 diabetes: results of 8012 cases in the nationwide Diabetes Incidence Study in Sweden 1983-2002.
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2008 (English)In: Journal of internal medicine, ISSN 1365-2796, Vol. 263, no 4, p. 386-94Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To establish the gender difference amongst newly diagnosed type 1 diabetic patients aged 15-34 years, considering age at diagnosis, temporal trend and seasonal variation at time of diagnosis. STUDY DESIGN: A population-based prospective study with a mean annual population at risk of 2.3 million. SETTING: All departments of medicine, endocrinology and paediatrics and primary health care units in Sweden. SUBJECTS: Incident cases of diabetes aged 15-34 years at diagnosis 1983-2002. MEASURE INSTRUMENT: Basic characteristics of patients at diagnosis were reported by the diagnosing doctor on a standardized form. Level of ascertainment was estimated at 80-90%. RESULTS: Amongst all incident cases (n = 8012), 74% was diagnosed with type 1 diabetes. The mean annual incidence rate of type 1 diabetes was 12.7/100,000, in men 16.4/100,000 and in women 8.9/100,000. The incidence of type 1 diabetes decreased slowly by increasing age but was in all age groups higher in men, yielding an overall male/female ratio of 1.8. In both genders the incidence of type 1 diabetes decreased in average of 1.0% per year. A seasonal pattern with significantly higher incidence during January-March and lower during May-July was seen in both genders. CONCLUSIONS: A clear male predominance of type 1 diabetes was seen in all ages. The temporal trend and the seasonal pattern was similar in men and women. Hence, internal factors related to the gender rather than differences in the exposure to environmental factors seem to explain the consistent male-female bias in the postpubertal risk of developing type 1 diabetes.

Identifiers
urn:nbn:se:umu:diva-21824 (URN)10.1111/j.1365-2796.2007.01896.x (DOI)18205768 (PubMedID)
Available from: 2009-04-20 Created: 2009-04-20 Last updated: 2018-06-08
Olsson, C., Hörnell, A., Lönnberg, G., Hernell, O. & Ivarsson, A. (2006). The Swedish epidemic of celiac disease: a follow up. In: The XIIth International Celiac Disease Symposium.
Open this publication in new window or tab >>The Swedish epidemic of celiac disease: a follow up
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2006 (English)In: The XIIth International Celiac Disease Symposium, 2006Conference paper, Published paper (Other (popular science, discussion, etc.))
Identifiers
urn:nbn:se:umu:diva-13685 (URN)
Note
New York USA, 9-11 november 2006Available from: 2008-11-02 Created: 2008-11-02 Last updated: 2018-06-09Bibliographically approved
Eriksson, M. & Lönnberg, G. (2004). En pilotstudie om Hälsa och livskvalitet i Storuman: i en jämförelse med Västerbotten i stort.
Open this publication in new window or tab >>En pilotstudie om Hälsa och livskvalitet i Storuman: i en jämförelse med Västerbotten i stort
2004 (Swedish)Report (Other academic)
Abstract [sv]

I denna pilotundersökning har författarna, med hjälp av data från "Västerbottens hälsoundersökningar (VHU), tittat närmare på hur utfallet av hälsa och livskvalitet i Storumans kommun ser ut i en jämförelse med Västerbotten i stort. Bland de frågor som deltagarna fått svara på i VHU-materialet finns också upplysningar om socialt stöd, sociala nätverk och föreningsaktivitet - faktorer som ofta kopplas samman med begreppet socialt kapital. Dessa avser vi lyfta fram och diskutera som möjliga förklaringsfaktorer till utfallet av hälsa och livskvalitet. I studien finns också material från en intervju med en nyckelperson i Storuman, vilket bidrar till en subjektiv beskrivning av lokalsamhället Storuman. Utförd inom EU-projektet Urban Design.

Publisher
p. 13
Series
CERUM Working Paper, ISSN 1404-5362 ; 75
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-12240 (URN)
Available from: 2009-07-13 Created: 2009-07-09 Last updated: 2018-06-09Bibliographically approved
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