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Lundblad, Dan
Publications (10 of 17) Show all publications
Strömbäck, U., Engström, Å., Lundqvist, R., Lundblad, D. & Vikman, I. (2018). The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?. European Journal of Cardiovascular Nursing, 17(7), 652-659
Open this publication in new window or tab >>The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 7, p. 652-659Article in journal (Refereed) Published
Abstract [en]

Background: Knowledge is limited concerning the type of symptoms and the time from onset of symptoms to first medical contact at first and second myocardial infarction in the same patient. Aim: This study aimed to describe the type of symptoms and the time from onset of symptoms to first medical contact in first and second myocardial infarctions in men and women affected by two myocardial infarctions. Furthermore, the aim was to identify factors associated with prehospital delays 2 h at second myocardial infarction. Methods: A retrospective cohort study with 820 patients aged 31-74 years with a first and a second myocardial infarction from 1986 through 2009 registered in the Northern Sweden MONICA registry. Results: The most common symptoms reported among patients affected by two myocardial infarctions are typical symptoms at both myocardial infarction events. Significantly more women reported atypical symptoms at the second myocardial infarction compared to the first. Ten per cent of the men did not report the same type of symptoms at the first and second myocardial infarctions; the corresponding figure for women was 16.2%. The time from onset of symptoms to first medical contact was shorter at the second myocardial infarction compared to the first myocardial infarction. Patients with prehospital delay 2 h at the first myocardial infarction were more likely to have a prehospital delay 2 h at the second myocardial infarction. Conclusions: Symptoms of second myocardial infarctions are not necessarily the same as those of first myocardial infarctions. A patient's behaviour at the first myocardial infarction could predict how he or she would behave at a second myocardial infarction.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
First and second myocardial infarction, prehospital delay, typical and atypical symptoms
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
urn:nbn:se:umu:diva-152892 (URN)10.1177/1474515118777391 (DOI)000446099600011 ()29749753 (PubMedID)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2018-12-05Bibliographically approved
Forslund, A.-S., Jansson, J.-H., Lundblad, D. & Söderberg, S. (2017). A second chance at life: people's lived experiences of surviving out-of-hospital cardiac arrest. Scandinavian Journal of Caring Sciences, 31(4), 878-886
Open this publication in new window or tab >>A second chance at life: people's lived experiences of surviving out-of-hospital cardiac arrest
2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 4, p. 878-886Article in journal (Refereed) Published
Abstract [en]

Background: There is more to illuminate about people's experiences of surviving out-of-hospital cardiac arrest (OHCA) and how such an event affects people's lives over time. Aims: This study aimed to elucidate meanings of people's lived experiences and changes in everyday life during their first year after surviving OHCA. Methods: A qualitative, longitudinal design was used. Eleven people surviving OHCA from northern Sweden agreed to participate and were interviewed 6 and 12 months after the event. A phenomenological hermeneutic interpretation was used to analyse the transcribed texts. Findings: The structural analysis resulted in two themes: (i) striving to regain one's usual self and (ii) a second chance at life, and subthemes (ia) testing the body, (ib) pursuing the ordinary life, (ic) gratitude for help to survival, (iia) regaining a sense of security with one's body, (iib) getting to know a new self, and (iic) seeking meaning and establishing a future. Conclusion: To conclude, we suggest that people experienced meanings of surviving OHCA over time as striving to regain their usual self and getting a second chance at life. The event affected them in many ways and resulted in a lot of emotions and many things to think about. Participants experienced back-and-forth emotions, when comparing their present lives to both their lives before cardiac arrest and those lives they planned for the future. During their first year, participants' daily lives were still influenced by being dead' and returning to life. As time passed, they wanted to resume their ordinary lives and hoped for continued lives filled with meaning and joyous activities.

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
life experiences, out-of-hospital cardiac arrest, myocardial infarction, qualitative research, survival
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-143652 (URN)10.1111/scs.12409 (DOI)000416413000026 ()28156015 (PubMedID)
Available from: 2018-01-08 Created: 2018-01-08 Last updated: 2018-06-09Bibliographically approved
Strömbäck, U., Vikman, I., Lundblad, D., Lundqvist, R. & Engström, Å. (2017). The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men. The Northern Sweden MONICA study.. European Journal of Cardiovascular Nursing, 16(5), 418-424
Open this publication in new window or tab >>The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men. The Northern Sweden MONICA study.
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 5, p. 418-424Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Several studies have examined various parameters and experiences when patients suffer their first myocardial infarction (MI), but knowledge about when they suffer their second MI is limited.

AIM: To compare risk factors for MI, that is, diabetes, hypertension and smoking, for the first and second MI events in men and women affected by two MIs and to analyse the time intervals between the first and second MIs.

METHODS: A retrospective cohort study of 1017 patients aged 25-74 years with first and second MIs from 1990 through 2009 registered in the Northern Sweden MONICA registry.

RESULTS: More women than men have diabetes and hypertension and are smokers at the first MI. Similar differences between the genders remain at the time of the second MI for diabetes and hypertension, although both risk factors have increased. Smoking decreased at the second MI without any remaining difference between genders. Women suffer their second MI within a shorter time interval than men do. Within 16 months of their first MI, 50% of women had a second MI. The corresponding time interval for men was 33 months.

CONCLUSION: Patients affected by an MI should be made aware of their risk of recurrent MI and that the risk of recurrence is highest during the first few years after an MI. In patients affected by two MIs, women have a higher risk factor burden and suffer their second MI earlier than men do and thus may need more aggressive and more prompt secondary prevention.

Keywords
Modifiable risk factors, retrospective cohort study, self-management, time interval, second myocardial infarction
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-137157 (URN)10.1177/1474515116686229 (DOI)000402662800008 ()28029268 (PubMedID)
Available from: 2017-06-27 Created: 2017-06-27 Last updated: 2018-06-09Bibliographically approved
Strömbäck, U., Vikman, I., Lundblad, D., Lundqvist, R. & Engström, É. (2017). The second myocardial infarction: women have a higher risk factor burden and suffer a second myocardial infarction earlier than men do. The Northern Sweden MONICA study. European Journal of Cardiovascular Nursing, 16, S62-S63
Open this publication in new window or tab >>The second myocardial infarction: women have a higher risk factor burden and suffer a second myocardial infarction earlier than men do. The Northern Sweden MONICA study
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S62-S63Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-135975 (URN)000401775600104 ()
Note

Supplement: 1

Meeting Abstract: 165

Available from: 2017-06-26 Created: 2017-06-26 Last updated: 2018-06-09Bibliographically approved
Andersson, J., Wennberg, P., Lundblad, D., Escher, S. A. & Jansson, J.-H. (2016). Diabetes mellitus, high BMI and low education level predict sudden cardiac death within 24 hours of incident myocardial infarction. European Journal of Preventive Cardiology, 23(17), 1814-1820
Open this publication in new window or tab >>Diabetes mellitus, high BMI and low education level predict sudden cardiac death within 24 hours of incident myocardial infarction
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2016 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 23, no 17, p. 1814-1820Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: More than half of cardiovascular mortality occurs outside the hospital, mainly due to consistently low survival rates from out-of-hospital cardiac arrest.

METHODS: This is a prospective, nested, case-control study derived from the Västerbotten Intervention Programme and the World Health Organization's Multinational Monitoring of Trends and Determinants in Cardiovascular Disease study in northern Sweden (1986-2006). To determine predictors for sudden cardiac death risk factors for cardiovascular disease were compared between incident myocardial infarction with sudden cardiac death (n = 363) and survivors of incident myocardial infarction (n = 1998) using multivariate logistic regression analysis.

RESULTS: Diabetes had the strongest association with sudden cardiac death out of all evaluated risk factors (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.30-2.59), followed by low education (OR 1.55, 95% CI 1.19-2.01), high body mass index (OR 1.05, 95% CI 1.02-1.08) and male sex (OR 1.42, 95% CI 1.001-2.01).

CONCLUSIONS: The pattern of risk factors for incident myocardial infarction is different among survivors and those who die within 24 hours. The risk factors that contribute the most to death within 24 hours are diabetes mellitus, high body mass index and low education level, and can be addressed at both the public health level and by general practitioners.

Keywords
Sudden cardiac death, epidemiology, myocardial infarction, risk factors, prevention, prognosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-129017 (URN)10.1177/2047487316659574 (DOI)000387017100003 ()27435083 (PubMedID)
Available from: 2016-12-20 Created: 2016-12-20 Last updated: 2019-06-04Bibliographically approved
Höglund, H., Jansson, J.-H., Forslund, A.-S. & Lundblad, D. (2014). Prodromal symptoms and health care consumption prior to out-of-hospital cardiac arrest in patients without previously known ischaemic heart disease. Resuscitation, 85(7), 864-868
Open this publication in new window or tab >>Prodromal symptoms and health care consumption prior to out-of-hospital cardiac arrest in patients without previously known ischaemic heart disease
2014 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 85, no 7, p. 864-868Article in journal (Refereed) Published
Abstract [en]

Aims: To describe prodromal symptoms and health care consumption prior to an out-of-hospital cardiac arrest (OHCA) in patients without previously known ischaemic heart disease (IHD). Background: The most common lethal event of cardiovascular disease is sudden cardiac death, and the majority occur outside hospital. Little is known about prodromal symptoms and health care consumption associated with OHCAs. Design: Case-crossover study. Methods: Medical records of 403 OHCA cases without previously known IHD, age 25-74 years in the MONICA myocardial registry in Norrbotten County 2000-2008, were reviewed. Presenting symptoms and emergency visits at public primary care facilities and internal medicine clinics in Norrbotten County were analyzed from the week prior to the OHCA and from the same week one year previously, which served as a control week. Unlike most studies we included unwitnessed arrests and those where no cardiopulmonary resuscitation (CPR) was attempted. Results: Emergency visits were more common during the week prior to the OHCA than during the control week, both for visits to primary care (29 vs. 6, p < 0.001) and to internal medicine clinics (16 vs. 0, p < 0.001). Symptoms were more prevalent during the week prior to the OHCA (36.7 vs. 6.7%, p < 0.001). The most prevalent symptoms were chest pain (14.6 vs. 0%, p < 0.001), gastrointestinal symptoms (7.7 vs. 1.2%, p < 0.001) and dyspnoea/peripheral oedema (6.9 vs. 0.2%, p < 0.001). Conclusions: Patients who suffer an OHCA seek health care and present prodromal symptoms significantly more often the week prior to the event than the same week one year earlier.

Keywords
Out-of-hospital cardiac arrest, Prodromal symptoms, Sudden cardiac death, Health care consumption
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-91136 (URN)10.1016/j.resuscitation.2014.03.300 (DOI)000337329700014 ()
Available from: 2014-07-17 Created: 2014-07-15 Last updated: 2018-06-07Bibliographically approved
Forslund, A.-S., Lundblad, D., Jansson, J.-H., Zingmark, K. & Söderberg, S. (2013). Risk factors among people surviving out-of-hospital cardiac arrest and their thoughts about what lifestyle means to them: a mixed methods study. BMC Cardiovascular Disorders, 13, 62
Open this publication in new window or tab >>Risk factors among people surviving out-of-hospital cardiac arrest and their thoughts about what lifestyle means to them: a mixed methods study
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2013 (English)In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 13, p. 62-Article in journal (Refereed) Published
Abstract [en]

Background: The known risk factors for coronary heart disease among people prior suffering an out-of-hospital cardiac arrest with validated myocardial infarction aetiology and their thoughts about what lifestyle means to them after surviving have rarely been described. Therefore the aim of the study was to describe risk factors and lifestyle among survivors. Methods: An explanatory mixed methods design was used. All people registered in the Northern Sweden MONICA myocardial registry between the year 1989 to 2007 who survived out-of-hospital cardiac arrest with validated myocardial infarction aetiology and were alive at the 28th day after the onset of symptoms (n = 71) were included in the quantitative analysis. Thirteen of them participated in interviews conducted in 2011 and analysed via a qualitative manifest content analysis. Results: About 60% of the people had no history of ischemic heart disease before the out-of-hospital cardiac arrest, but 20% had three cardiovascular risk factors (i.e., hypertension, diabetes mellitus, total cholesterol of more or equal 5 mmol/l or taking lipid lowering medication, and current smoker). Three categories (i.e., significance of lifestyle, modifying the lifestyle to the new life situation and a changed view on life) and seven sub-categories emerged from the qualitative analysis. Conclusions: For many people out-of-hospital cardiac arrest was the first symptom of coronary heart disease. Interview participants were well informed about their cardiovascular risk factors and the benefits of risk factor treatment. In spite of that, some chose to ignore this knowledge to some extent and preferred to live a "good life", where risk factor treatment played a minor part. The importance of the support of family members in terms of feeling happy and having fun was highlighted by the interview participants and expressed as being the meaning of lifestyle. Perhaps the person with illness together with health care workers should focus more on the meaningful and joyful things in life and try to adopt healthy behaviours linked to these things.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-81009 (URN)10.1186/1471-2261-13-62 (DOI)000323924900002 ()
Available from: 2013-10-01 Created: 2013-09-30 Last updated: 2018-06-08Bibliographically approved
Forslund, A.-S., Söderberg, S., Jansson, J.-H. & Lundblad, D. (2013). Trends in incidence and outcome of out-of-hospital cardiac arrest among people with validated myocardial infarction. European Journal of Cardiovascular Prevention & Rehabilitation, 20(2), 260-267
Open this publication in new window or tab >>Trends in incidence and outcome of out-of-hospital cardiac arrest among people with validated myocardial infarction
2013 (English)In: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 20, no 2, p. 260-267Article in journal (Refereed) Published
Abstract [en]

Aims: To describe trends in incidence, outcome, and background characteristics among people who suffered an out-of-hospital cardiac arrest with validated myocardial infarction aetiology (OHCA-V).

Methods and results: People from the northern Sweden MONICA myocardial registry (1989-2007) with OHCA-V (n = 2977) were divided in two age groups (25-64 and 65-74 years). Both those who were resuscitated outside hospital and those who died before resuscitation was started were included in the study. The younger age group was studied during 1989-2007 and the older group during 2000-2007. The incidence of OHCA-V decreased in both the younger group (men p < 0.0001, women p = 0.04) and the older group (men p < 0.0001, women p < 0.0007, respectively). The proportion with a history of ischaemic heart disease prior to the event decreased (p < 0.0001). The proportion of previous myocardial infarction decreased (p < 0.0001), diabetes mellitus increased (p = 0.001), coronary interventions increased (p < 0.0001), and survival after OHCA-V increased (p < 0.0001) in the younger group but not in the older group. Long-term survival after OHCA-V was better in the younger than in the older group (p = 0.026).

Conclusion: The incidence of OHCA-V decreased in both sexes. The proportion surviving after OHCA-V was small but increased, and long-term survival (≥28 days) was better in the younger age group. Primary preventive measures may explain most of the improvements. However, the effects of secondary preventive measures cannot be excluded.

Place, publisher, year, edition, pages
London, England: Sage Publications, 2013
Keywords
incidence, myocardial infarction, out-of-hospital cardiac arrest, prevention, survival, trends
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-51146 (URN)10.1177/1741826711432032 (DOI)000318876700009 ()22131131 (PubMedID)
Available from: 2012-01-11 Created: 2012-01-11 Last updated: 2018-06-08Bibliographically approved
Isaksson, R.-M., Jansson, J.-H., Lundblad, D., Näslund, U., Zingmark, K. & Eliasson, M. (2011). Better long-term survival in young and middle-aged women than in men after a first myocardial infarction between 1985 and 2006. An analysis of 8630 patients in the Northern Sweden MONICA Study.. BMC Cardiovascular Disorders, 11, 1
Open this publication in new window or tab >>Better long-term survival in young and middle-aged women than in men after a first myocardial infarction between 1985 and 2006. An analysis of 8630 patients in the Northern Sweden MONICA Study.
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2011 (English)In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 11, p. 1-Article in journal (Refereed) Published
Abstract [en]

Age-adjusted survival was higher among women than men after a first MI and has improved markedly and equally in both men and women over a 23-year period. This difference was due to lower risk for women to die before reaching hospital.

Identifiers
urn:nbn:se:umu:diva-40632 (URN)10.1186/1471-2261-11-1 (DOI)21208409 (PubMedID)
Available from: 2011-03-03 Created: 2011-03-03 Last updated: 2018-06-08Bibliographically approved
Eriksson, M., Holmgren, L., Janlert, U., Jansson, J.-H., Lundblad, D., Stegmayr, B., . . . Eliasson, M. (2011). Large improvements in major cardiovascular risk factors in the population of northern Sweden: the MONICA study 1986–2009. Journal of Internal Medicine, 269(2), 219-231
Open this publication in new window or tab >>Large improvements in major cardiovascular risk factors in the population of northern Sweden: the MONICA study 1986–2009
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2011 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 269, no 2, p. 219-231Article in journal (Refereed) Published
Abstract [en]

Objectives. The incidence of cardiovascular disease has declined rapidly in Sweden since the 1980s. We explored changes in major cardiovascular risk factors in northern Sweden between 1986 and 2009.

Design. Since 1986, six population surveys have been carried out in northern Sweden using procedures of the World Health Organization MONICA project. The population age range was 25–64 years in 1986 and 1990, and 25–74 years from 1994. Trends were analysed using generalized linear models.

Results. A total of 10 586 subjects were included in the surveys. Blood pressure decreased by 4.9/3.9 mmHg in women and 1.8/1.5 mmHg in men aged 25–64 years between 1986 and 2009. In men and women aged 65–74 years, the decrease was 12.6/6.1 mmHg between 1994 and 2009. From 1994, the use of blood pressure‐lowering drugs increased, particularly among the older subgroup. The prevalence of smoking halved between 1986 and 2009; 11% of women and 9% of men were smokers in 2009. Cholesterol levels decreased by 0.9 mmol L−1 in the younger age group (25–64 years), and the use of lipid‐lowering agents increased from 1994. Among subjects aged 25–64 years, one in five was obese in 2009, which was twice as many as in 1986, and body mass index (BMI) increased by 1.5 kg m−2, corresponding to an increase in weight of 4 kg. There was no further increase in BMI from 2004. The prevalence of diabetes did not change between 1986 and 2009. The proportion that received a university education increased markedly in all age groups, especially in women, during the study period.

Conclusions. Significant improvements were observed in major cardiovascular risk factors in northern Sweden between 1986 and 2009.

Keywords
cardiovascular risk factors, cohort study, MONICA, trends
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-39567 (URN)10.1111/j.1365-2796.2010.02312.x (DOI)000286110100011 ()21158982 (PubMedID)2-s2.0-786510674342-s2.0-78651067434 (Scopus ID)
Available from: 2011-02-01 Created: 2011-02-01 Last updated: 2018-08-14Bibliographically approved
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