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Sundqvist, M. O., Svensson, P., Söderberg, S., Bergdahl, I. A., Wennberg, P., Tornvall, P., . . . Hofmann, R. (2025). Seroprevalence of Helicobacter pylori and incident myocardial infarction: a population-based Swedish nested case–control study. International Journal of Cardiology, 421, Article ID 132917.
Open this publication in new window or tab >>Seroprevalence of Helicobacter pylori and incident myocardial infarction: a population-based Swedish nested case–control study
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2025 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 421, article id 132917Article in journal (Refereed) Published
Abstract [en]

Aims: Helicobacter pylori (H. pylori) and its cytotoxin-associated gene A (CagA) have been associated with myocardial infarction (MI), but existing data are conflicting possibly due to limitations in study designs and lack of data on important confounders. The aim of this study was to determine whether H. pylori or CagA seropositivity is associated with incident MI, including MI phenotypes, and to describe temporal trends.

Methods: We used the Northern Sweden Health and Disease study, a prospective biobank with data from residents enrolled in a population-based cohort from health examinations between 1986 and 2006. A total of 826 first time MI cases with available blood samples from their index health examination were identified up to 2006. Each case was 1:2 matched with controls by age, sex, sample date and geographical area. Blood samples were analysed using ELISA to determine seroprevalence of H. pylori and CagA, which were then used to study the association with incident MI.

Results: The median age at baseline was 50 years, and 71% of participants were male. Seroprevalence of H. pylori and CagA was 46.5% and 32.1% in cases, respectively, compared to 43.7% and 30.6% in controls. Overall, H. pylori prevalence decreased over the study period. After multivariable adjustments, no significant association was observed between H. pylori seropositivity and incident MI (odds ratio: 1.15, 95% CI 0.94–1.42) nor between CagA-positive H. pylori and incident MI.

Conclusion: In a Swedish population-based cohort, no significant association was observed between H. pylori or CagA seropositivity and incidence of MI.

Place, publisher, year, edition, pages
Elsevier, 2025
Keywords
Coronary heart disease, Helicobacter pylori, Inflammation, Myocardial infarction
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-234027 (URN)10.1016/j.ijcard.2024.132917 (DOI)39689819 (PubMedID)2-s2.0-85212934155 (Scopus ID)
Funder
Region Stockholm, RS2021-0933Region Stockholm, RS2022-0674Region Stockholm, RS2020-0731Swedish Heart Lung Foundation, 20210273Swedish Heart Lung Foundation, 20210275Swedish Heart Lung Foundation, 20220554
Note

Available online 16 December 2024.

Available from: 2025-01-13 Created: 2025-01-13 Last updated: 2025-01-13Bibliographically approved
Higueras-Fresnillo, S., Herraiz-Adillo, Á., Ahlqvist, V. H., Öberg, R., Lenander, C., Wennberg, P., . . . Henriksson, P. (2024). Associations of psychological factors with atherosclerosis and cardiovascular health in middle-age: the population-based Swedish CArdioPulmonary bioImage study (SCAPIS). BMC Public Health, 24(1), Article ID 1455.
Open this publication in new window or tab >>Associations of psychological factors with atherosclerosis and cardiovascular health in middle-age: the population-based Swedish CArdioPulmonary bioImage study (SCAPIS)
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2024 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 24, no 1, article id 1455Article in journal (Refereed) Published
Abstract [en]

Background: Cardiovascular disease (CVD) is a major global health issue, primarily caused by atherosclerosis. Psychological factors may play a role in the development and progression of CVD. However, the relationship between psychological factors and atherosclerosis is complex and poorly understood. This study, therefore, aimed to examine the association of psychological factors with (i) coronary and carotid atherosclerosis and (ii) cardiovascular health according to Life’s Essential 8, in a large Swedish cohort.

Methods: This study utilized data from the Swedish CArdioPulmonary bioImage Study (SCAPIS), a large population-based project including individuals aged 50 to 65 years. Several psychological factors were analysed: general stress, stress at work, financial stress, major adverse life events, locus of control, feeling depressed, and depression. Coronary atherosclerosis was assessed as the degree of stenosis by coronary computed tomography angiography (CCTA) and coronary artery calcification (CAC) scores. Carotid atherosclerosis was examined using ultrasound. In addition, cardiovascular health was examined using the Life’s Essential 8 concept created by the American Heart Association, which includes four health behaviors and four health factors. Associations were examined through binomial logistic regression (atherosclerosis variables) and linear regression (Life’s Essential 8).

Results: A total of 25,658 participants were included in the study. The presence of financial stress, higher locus of control, and depression was weakly associated with increased odds of CCTA stenosis, CAC ≥ 1 and the presence of carotid plaques (all odds ratios: 1.10–1.21, 95% CI: 1.02–1.32) after adjusting for sex, age, and study site. However, these associations were attenuated and not statistically significant after additional adjustments for socioeconomic factors and health behaviors. Conversely, we observed inverse associations between the worst category for all psychological factors and cardiovascular health according to Life’s Essential 8 score (all standardized β-Coefficient ≤-0.033, p < 0.001).

Conclusion: While there were no strong and consistent associations between psychological factors and atherosclerosis, the consistent associations of psychological factors with cardiovascular health by Life’s Essential 8 may have relevance for future CVD risk. However, further studies are needed to elucidate the long-term effects of psychological factors on atherosclerosis development and cardiovascular health.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Atherosclerosis, Cardiovascular disease, Coronary artery calcification, Coronary computed tomography angiography, Life’s Essential 8, Middle-aged, Psychological factors, SCAPIS
National Category
Cardiology and Cardiovascular Disease Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-225954 (URN)10.1186/s12889-024-18924-w (DOI)001236172000004 ()38816713 (PubMedID)2-s2.0-85195013299 (Scopus ID)
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg FoundationSwedish Research CouncilVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala University
Available from: 2024-06-12 Created: 2024-06-12 Last updated: 2025-02-10Bibliographically approved
Waagaard, L., Herraiz-Adillo, Á., Ahlqvist, V. H., Higueras-Fresnillo, S., Berglind, D., Wennberg, P., . . . Henriksson, P. (2024). Body mass index and weight gain in pregnancy and cardiovascular health in middle age: A cohort study. British Journal of Obstetrics and Gynecology, 131(8), 1136-1145
Open this publication in new window or tab >>Body mass index and weight gain in pregnancy and cardiovascular health in middle age: A cohort study
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2024 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 131, no 8, p. 1136-1145Article in journal (Refereed) Published
Abstract [en]

Objective: To examine associations between body mass index (BMI) in early pregnancy and gestational weight gain (GWG) with cardiovascular health in middle age using the ‘Life's Essential 8’ (LE8) concept of the American Heart Association (AHA).

Design: Population-based cohort study.

Setting: Swedish CardioPulmonary bioImage Study (SCAPIS).

Population: A total of 8871 women from SCAPIS were included.

Methods: Information on cardiovascular health in middle age was collected from SCAPIS and linked to pregnancy weight data obtained from the Swedish Medical Birth Register, with an average follow-up time of 24.5 years. An LE8 score between 0 and 100 was determined, where a score under 60 points was defined as poor cardiovascular health. Binary logistic regression and restricted cubic splines were used.

Main outcome measures: Cardiovascular health according to LE8 in middle age.

Results: The odds of having poor cardiovascular health in middle age were significantly higher in women who had overweight (adjusted odds ratio, aOR 3.30, 95% CI 2.82–3.88) or obesity (aOR 7.63, 95% CI 5.86–9.94), compared with women classified as being of normal weight in pregnancy. Higher odds were also found for excessive GWG (aOR 1.31, 95% CI 1.09–1.57), compared with women who gained weight within the recommendations.

Conclusions: A high BMI in early pregnancy and excessive GWG were associated with greater odds of poor cardiovascular health in middle age. Although further studies are needed, our results highlight pregnancy as an important period to support long-term cardiovascular health.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
body mass index, gestational weight gain, Life's Essential 8, pregnancy, pregnancy as a window for future health
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-219064 (URN)10.1111/1471-0528.17740 (DOI)001132907500001 ()38149523 (PubMedID)2-s2.0-85180848848 (Scopus ID)
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg FoundationSwedish Research CouncilVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala University
Available from: 2024-01-11 Created: 2024-01-11 Last updated: 2024-06-19Bibliographically approved
Klompstra, L., Löf, M., Björkelund, C., Hellenius, M.-L., Kallings, L. V., Orho-Melander, M., . . . Bendtsen, M. (2024). Co-occurrence of unhealthy lifestyle behaviours in middle-aged adults: findings from the Swedish CArdioPulmonary bioImage Study (SCAPIS). Scientific Reports, 14(1), Article ID 22853.
Open this publication in new window or tab >>Co-occurrence of unhealthy lifestyle behaviours in middle-aged adults: findings from the Swedish CArdioPulmonary bioImage Study (SCAPIS)
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2024 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 14, no 1, article id 22853Article in journal (Refereed) Published
Abstract [en]

Middle-aged adults engaging in unhealthy lifestyle behaviors are at higher risk of chronic diseases. However, little is known about the co-occurrence of these behaviors and their determinants. This cohort study examined the co-occurrence of unhealthy lifestyle behaviors (alcohol consumption, diet, physical inactivity, and smoking) in 30,154 middle-aged adults and their associations with sociodemographic factors, social support, and disease history. Alcohol use was measured by the AUDIT, diet by the MiniMeal-Q, and physical inactivity and smoking by single questions. Participants had a mean age of 58 years, with 51% being female. Of them, 14% had no unhealthy behaviors, 38% had one, 36% had two, 10% had three, and 2% had all four. The most common co-occurrence was between physical inactivity and poor diet (38%). Higher education decreased the likelihood of having three or four unhealthy behaviors, while financial difficulties, having no one around who appreciated one's efforts, and suffering of a lung disease increased it. In conclusion, middle-aged adults exhibit varying levels of unhealthy lifestyle behaviors. Higher education is linked to reduced engagement in multiple unhealthy behaviors, whereas financial strain, lower quality of social support, and lung disease increase the risk.

Place, publisher, year, edition, pages
Springer Nature, 2024
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-230685 (URN)10.1038/s41598-024-71092-0 (DOI)39353999 (PubMedID)2-s2.0-85205527873 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018–01410Swedish Cancer Society, 20 0883
Available from: 2024-10-15 Created: 2024-10-15 Last updated: 2024-10-15Bibliographically approved
Andersson, E. M., Lindvall, K., Wennberg, P., Johansson, H. & Nordin, S. (2024). From risk communication about asymptomatic atherosclerosis to cognitive and emotional reactions and lifestyle modification. BMC Psychology, 12(1), Article ID 47.
Open this publication in new window or tab >>From risk communication about asymptomatic atherosclerosis to cognitive and emotional reactions and lifestyle modification
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2024 (English)In: BMC Psychology, E-ISSN 2050-7283, Vol. 12, no 1, article id 47Article in journal (Refereed) Published
Abstract [en]

Background: Non-adherence in the general population to preventive guidelines on cardiovascular disease calls for an interdisciplinary approach acknowledging psychological factors of relevance for risk communication and lifestyle modification. Evidence is building up regarding the advantage of sharing arterial imaging evidence of subclinical atherosclerosis with asymptomatic individuals, but there is limited understanding of how this relates to mechanisms of importance for behavioural change. Longitudinal studies on associations between patients’ reactions and lifestyle modification are missing. The population-based randomized controlled trial VIPVIZA investigates the impact of pictorial information about subclinical atherosclerosis, added to traditional risk factor-based communication. The intervention includes a personalized, colour-coded and age-related risk communication strategy and a motivational conversation, and has been shown to reduce cardiovascular disease risk. 

Methods: In the present study we assessed cognitive and emotional reactions to the intervention, and how these reactions are associated to lifestyle modification. The participants’ evaluation of the risk communication was assessed in the intervention group (n=1749). Lifestyle modification was assessed with a lifestyle index based on physical activity, diet, smoking and alcohol consumption at baseline and after 3 years. Associations between cognitive and emotional response and lifestyle modification were tested with analyses of covariance in a subset of participants (n=714-857).

Results: The intervention increased understanding of personal CVD risk, the possibility to influence the risk, and how to influence the risk. Severity of atherosclerosis was associated with emotional reactions, but emotions of strong negative valence were uncommon. Cognitive response and emotional arousal evoked by the intervention were positively associated with lifestyle modification, whereas negative emotions in isolation were not. High level of cognitive response in combination with high level of emotional arousal was found to be most beneficial for lifestyle modification.

Conclusions: The results demonstrate the potential of communicating asymptomatic atherosclerosis with a pictorial, colour-coded and age-related strategy, also including a motivational conversation. Furthermore, the results show the importance of CVD risk communication evoking engagement, and that an interaction between cognitive and emotional reactions might be central for sustained lifestyle modification. Our results also indicate that, in an asymptomatic population, atherosclerosis screening may strengthen disease prevention and health promotion.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Atherosclerosis, Lifestyle, Health behaviour, Prevention, Health promotion, Decision making, Cognition, Emotion 
National Category
Psychology Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-218585 (URN)10.1186/s40359-023-01467-x (DOI)001148313000002 ()38268015 (PubMedID)2-s2.0-85182977469 (Scopus ID)
Funder
Region Västerbotten, Central ALFRegion Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL- 643391Swedish Research Council, 521–2013-2708Swedish Research Council, 2016- 01891Swedish Research Council, 2017–02246Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481The Swedish Stroke AssociationSwedish Insurance SocietyVisare Norr
Available from: 2023-12-21 Created: 2023-12-21 Last updated: 2025-02-10Bibliographically approved
Herraiz-Adillo, Á., Ahlqvist, V. H., Daka, B., Wångdahl, J., Wennberg, P., Carlsson, J., . . . Henriksson, P. (2024). Life’s Essential 8 in relation to self-rated health and health-related quality of life in a large population-based sample: the SCAPIS project. Quality of Life Research, 33, 1003-1014
Open this publication in new window or tab >>Life’s Essential 8 in relation to self-rated health and health-related quality of life in a large population-based sample: the SCAPIS project
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2024 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 33, p. 1003-1014Article in journal (Refereed) Published
Abstract [en]

Purpose: To monitor cardiovascular health, in 2022, the American Heart Association (AHA) updated the construct “Life’s Simple 7” (LS7) to “Life’s Essential 8” (LE8). This study aims to analyze the associations and capacity of discrimination of LE8 and LS7 in relation to self-rated health (SRH) and health-related quality of life (HRQoL).

Methods: This study from the Swedish CArdioPulmonary bioImage Study (SCAPIS) included 28 731 Swedish participants, aged 50–64 years. Three different scores were derived from the SF-12 questionnaire: 1-item question SRH (“In general, would you say your health is …?”), mental-HRQoL and physical-HRQoL. Logistic regression, restricted cubic splines, and ROC analysis were used to study the associations between the AHA scores in relation to SRH and HRQoL.

Results: Compared to those with a LE8 score of 80, participants with a LE8 score of 40 were 14.8 times more likely to report poor SRH (OR: 14.8, 95% CI: 13.0–17.0), after adjustments. Moreover, they were more likely to report a poor mental-HRQoL (OR: 4.9, 95% CI: 4.2–5.6) and a poor physical-HRQoL (OR: 8.0, 95% CI: 7.0–9.3). Area under curves for discriminating poor SRH were 0.696 (95% CI: 0.687–0.704), 0.666 (95% CI: 0.657–0.674), and 0.643 (95% CI: 0.634–0.651) for LE8, LS7 (0–14), and LS7 (0–7), respectively, all p values < 0.001 in the DeLong’s tests.

Conclusion: LE8 and LS7 had strong and inverse associations with SRH, mental-HRQoL, and physical-HRQoL, though LE8 had a somewhat higher capacity of discrimination than LS7. The novel LE8, a construct initially conceived to monitor cardiovascular health, also conveys SRH and HRQoL.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Health-related quality of life, Ideal cardiovascular health, Life's Essential 8, Quality of life, Self-rated health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-220324 (URN)10.1007/s11136-023-03580-1 (DOI)001149863400001 ()38270740 (PubMedID)2-s2.0-85183002617 (Scopus ID)
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg FoundationVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetUmeå UniversityUppsala University
Available from: 2024-02-12 Created: 2024-02-12 Last updated: 2024-05-06Bibliographically approved
Hebib, L., Herraiz-Adillo, Á., Higueras-Fresnillo, S., Berglind, D., Daka, B., Wennberg, P., . . . Henriksson, P. (2024). Life’s Essential 8 is inversely associated with high-sensitivity C-reactive protein. Scientific Reports, 14(1), Article ID 15024.
Open this publication in new window or tab >>Life’s Essential 8 is inversely associated with high-sensitivity C-reactive protein
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2024 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 14, no 1, article id 15024Article in journal (Refereed) Published
Abstract [en]

Life’s Essential 8 (LE8) is a score that includes modifiable risk factors for cardiovascular disease. Four health behaviors (diet, physical activity, nicotine exposure and sleep health) and four health factors (non-HDL cholesterol, blood glucose, blood pressure and body mass index) are included. These modifiable risk factors promote inflammation, and inflammation is one of the biological mechanisms of cardiovascular disease development. Thus, we examined the relationship between cardiovascular health measured by LE8 and low-grade inflammation measured by high-sensitivity C-reactive protein (hs-CRP) in the cross-sectional population-based Swedish CArdioPulmonary bioImage Study (SCAPIS). The study consisted of 28,010 participants between 50 and 64 years (51.5% women, mean age 57.5 years). All individual LE8 components were assigned a score between 0 (unhealthy) and 100 (healthy) points, and a global score was calculated. The association between LE8 scores and high-risk hs-CRP (defined as > 3.0 mg/L) was analyzed using adjusted logistic regression with spline analyses. There was a strong, dose response and inverse association between LE8 scores and levels of hs-CRP. Thus, those with a low LE8 score (= 50.0 points) had 5.8 higher (95% confidence interval [CI] 5.2–6.4) odds ratio (OR) of having high hs-CRP as compared to those with a high LE8 score (= 80.0 points). In conclusion, our findings show strong inverse associations between LE8 scores and levels of hs-CRP.

Place, publisher, year, edition, pages
Springer Nature, 2024
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-227840 (URN)10.1038/s41598-024-65977-3 (DOI)38951604 (PubMedID)2-s2.0-85197267601 (Scopus ID)
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg FoundationSwedish Research CouncilVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala University
Available from: 2024-07-11 Created: 2024-07-11 Last updated: 2025-02-10Bibliographically approved
Ekblom-Bak, E., Börjesson, M., Ekblom, Ö., Angerås, O., Bergman, F., Berntsson, C., . . . Jernberg, T. (2023). Accelerometer derived physical activity and subclinical coronary and carotid atherosclerosis: cross-sectional analyses in 22 703 middle-aged men and women in the SCAPIS study. BMJ Open, 13(11), Article ID e073380.
Open this publication in new window or tab >>Accelerometer derived physical activity and subclinical coronary and carotid atherosclerosis: cross-sectional analyses in 22 703 middle-aged men and women in the SCAPIS study
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2023 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 11, article id e073380Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim included investigation of the associations between sedentary (SED), low-intensity physical activity (LIPA), moderate-to-vigorous intensity PA (MVPA) and the prevalence of subclinical atherosclerosis in both coronaries and carotids and the estimated difference in prevalence by theoretical reallocation of time in different PA behaviours.

Design: Cross-sectional.

Setting: Multisite study at university hospitals.

Participants: A total of 22 670 participants without cardiovascular disease (51% women, 57.4 years, SD 4.3) from the population-based Swedish CArdioPulmonary bioImage study were included. SED, LIPA and MVPA were assessed by hip-worn accelerometer.

Primary and secondary outcomes: Any and significant subclinical coronary atherosclerosis (CA), Coronary Artery Calcium Score (CACS) and carotid atherosclerosis (CarA) were derived from imaging data from coronary CT angiography and carotid ultrasound.

Results: High daily SED (>70% ≈10.5 hours/day) associated with a higher OR 1.44 (95% CI 1.09 to 1.91), for significant CA, and with lower OR 0.77 (95% CI 0.63 to 0.95), for significant CarA. High LIPA (>55% ≈8 hours/day) associated with lower OR for significant CA 0.70 (95% CI 0.51 to 0.96), and CACS, 0.71 (95% CI 0.51 to 0.97), but with higher OR for CarA 1.41 (95% CI 1.12 to 1.76). MVPA above reference level, >2% ≈20 min/day, associated with lower OR for significant CA (OR range 0.61-0.67), CACS (OR range 0.71-0.75) and CarA (OR range 0.72-0.79). Theoretical replacement of 30 min of SED into an equal amount of MVPA associated with lower OR for significant CA, especially in participants with high SED 0.84 (95% CI 0.76 to 0.96) or low MVPA 0.51 (0.36 to 0.73).

Conclusions: MVPA was associated with a lower risk for significant atherosclerosis in both coronaries and carotids, while the association varied in strength and direction for SED and LIPA, respectively. If causal, clinical implications include avoiding high levels of daily SED and low levels of MVPA to reduce the risk of developing significant subclinical atherosclerosis.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023
Keywords
cardiovascular imaging, epidemiology, public health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-217547 (URN)10.1136/bmjopen-2023-073380 (DOI)37996228 (PubMedID)2-s2.0-85177801853 (Scopus ID)
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg FoundationSwedish Research CouncilVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala UniversityRegion Västra Götaland, ALFGBG- 720691Swedish Heart Lung Foundation, 20180379
Available from: 2023-12-11 Created: 2023-12-11 Last updated: 2023-12-11Bibliographically approved
Byhamre, M. L., Eliasson, M., Söderberg, S., Wennberg, P. & Oskarsson, V. (2023). Association between snus use and lipid status in Swedish men. Scandinavian Journal of Clinical and Laboratory Investigation, 83(4), 241-250
Open this publication in new window or tab >>Association between snus use and lipid status in Swedish men
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2023 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 83, no 4, p. 241-250Article in journal (Refereed) Published
Abstract [en]

Snus is a common tobacco product in Sweden, but the cardiovascular risk profile for snus users is less known than for cigarette smokers. We examined the association of snus use with lipid status, particularly in comparison to non-tobacco use and cigarette smoking, using data from 5930 men in the Northern Sweden MONICA study. Tobacco use was self-reported in 1986 to 2014 (24.4% used snus) and blood samples were collected at the same time. Harmonized analyses on non-high-density lipoprotein (non-HDL) cholesterol, HDL cholesterol, and triglycerides were conducted in 2016 to 2018. Three hundred eighty-one snus users had also been examined more than once, allowing us to study the effect of discontinued use (achieved by 21.0%). In multivariable linear regression models, snus use was associated with higher HDL cholesterol and triglyceride concentrations compared to non-tobacco use (p values ≤ 0.04), and it was associated with higher HDL cholesterol concentrations and lower triglyceride concentrations compared to cigarette smoking (p values ≤ 0.02). Snus use was not associated with non-HDL cholesterol concentrations, irrespective of the comparison group (p values ≥ 0.07). There was no indication that higher intensity of snus use led to a worse lipid profile, given that high-consumers had higher HDL cholesterol concentrations than low-consumers (p value = 0.02), or that discontinuation of snus use led to a better lipid profile, given that continued users had lower triglyceride concentrations than discontinued users (p value = 0.03). Further studies are needed to confirm or refute our findings.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
apolipoproteins, cholesterol, cigarettes, lipids, smokeless tobacco, snus, Tobacco, triglycerides
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-209125 (URN)10.1080/00365513.2023.2209915 (DOI)000986159300001 ()2-s2.0-85159146553 (Scopus ID)
Funder
Norrbotten County CouncilRegion VästerbottenRegion VästernorrlandUmeå University
Available from: 2023-06-07 Created: 2023-06-07 Last updated: 2025-02-10Bibliographically approved
Nordin, S., Norberg, M., Braf, I., Johansson, H., Lindahl, B., Lindvall, K., . . . Näslund, U. (2023). Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age. Psychology and Health
Open this publication in new window or tab >>Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age
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2023 (English)In: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To test the hypothesis of low emotional support being associated with lifestyle and biomedical cardiovascular disease (CVD) risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults.

Methods and measures: Cross-sectional data were obtained from participants aged 40–60 years who had one or more conventional CVD risk factor. They underwent assessment based on questionnaires, clinical examination, blood sampling, and carotid ultrasound of plaque formation and carotid intima-media wall thickness (cIMT). Based on the Interview Schedule for Social Interaction, the participants were categorised as either low in emotional support (n = 884) or as a referent (n = 2570). Logistic regression analyses were conducted to study the associations.

Results: Logistic regression analyses showed that low emotional support was significantly associated with smoking, alcohol consumption and physical inactivity (OR = 1.53 − 1.94), estimated risk of CVD morbidity and mortality (OR = 1.56 − 1.68), and plaque formation (OR = 1.39). No significant associations were found regarding biomedical CVD risk factors or cIMT.

Conclusion: The findings suggest that low social support is associated with lifestyle CVD risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults, encouraging causal evaluation with longitudinal data investigating an impact of emotional support on mechanisms underlying CVD.

Place, publisher, year, edition, pages
Routledge, 2023
Keywords
Cardiovascular disease, cardiovascular risk score, carotid artery plaque, carotid vascular ultrasound, social support
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-217344 (URN)10.1080/08870446.2023.2286296 (DOI)37994844 (PubMedID)2-s2.0-85177567916 (Scopus ID)
Available from: 2023-12-01 Created: 2023-12-01 Last updated: 2025-02-10
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1617-6102

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