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Publications (10 of 17) Show all publications
Rietz, H., Pennlert, J., Nordström, P. & Brunström, M. (2023). Blood pressure level in late adolescence and risk for cardiovascular events: a cohort study. Annals of Internal Medicine, 176(10), 1289-1298
Open this publication in new window or tab >>Blood pressure level in late adolescence and risk for cardiovascular events: a cohort study
2023 (English)In: Annals of Internal Medicine, ISSN 0003-4819, E-ISSN 1539-3704, Vol. 176, no 10, p. 1289-1298Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Not enough is known about the association between blood pressure (BP) in adolescence and future cardiovascular events.

OBJECTIVE: To measure this association using the 2017 American College of Cardiology/American Heart Association guidelines for classifying BP elevation.

DESIGN: Cohort study.Sweden.

PARTICIPANTS: Males in late adolescence who were conscripted into the military from 1969 to 1997.

MEASUREMENTS: Baseline BP was measured at conscription. The primary outcome was a composite of cardiovascular death or first hospitalization for myocardial infarction, heart failure, ischemic stroke, or intracerebral hemorrhage.

RESULTS: The study included 1 366 519 males with a mean age of 18.3 years. The baseline BP was classified as elevated (120 to 129/<80 mm Hg) for 28.8% of participants and hypertensive (≥130/80 mm Hg) for 53.7%. During a median follow-up of 35.9 years, 79 644 had a primary outcome. The adjusted hazard ratio was 1.10 for elevated BP (95% CI, 1.07 to 1.13), 1.15 for stage 1 isolated systolic hypertension (ISH) (CI, 1.11 to 1.18), 1.23 for stage 1 isolated diastolic hypertension (IDH) (CI, 1.18 to 1.28), 1.32 for stage 1 systolic-diastolic hypertension (SDH) (CI, 1.27 to 1.37), 1.31 for stage 2 ISH (CI, 1.28 to 1.35), 1.55 for stage 2 IDH (CI, 1.42 to 1.69), and 1.71 for stage 2 SDH (CI, 1.58 to 1.84). The cumulative risk for cardiovascular events also increased gradually across BP stages, ranging from 14.7% for normal BP to 24.3% for stage 2 SDH at age 68 years.

LIMITATION: This was an observational study of Swedish men.

CONCLUSION: Increasing BP levels in late adolescence are associated with gradually increasing risks for major cardiovascular events, beginning at a BP level of 120/80 mm Hg.

Place, publisher, year, edition, pages
American College of Physicians, 2023
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-216130 (URN)10.7326/M23-0112 (DOI)001077947700001 ()37748180 (PubMedID)2-s2.0-85174751634 (Scopus ID)
Funder
Västerbotten County CouncilSwedish Society for Medical Research (SSMF)
Available from: 2023-11-06 Created: 2023-11-06 Last updated: 2023-11-06Bibliographically approved
Pennlert, J., Rosenqvist, M. & Kesek, M. (2022). Detection of paroxysmal atrial fibrillation in 994 patients with a cerebrovascular event by intermittent 21-day ECG-monitoring and 7-day continuous Holter-recording. Upsala Journal of Medical Sciences, 127, Article ID e8318.
Open this publication in new window or tab >>Detection of paroxysmal atrial fibrillation in 994 patients with a cerebrovascular event by intermittent 21-day ECG-monitoring and 7-day continuous Holter-recording
2022 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 127, article id e8318Article in journal (Refereed) Published
Abstract [en]

Background: The detection of paroxysmal atrial fibrillation (AF) is of importance in stroke care. The method used is continuous electrocardiogram (ECG)-monitoring or multiple short ECG-recordings during an extended period. Their relative efficiency is a matter of discussion. In a retrospective cohort study on 994 patients with an ischemic stroke or transient ischemic attack (TIA), we have compared continuous 7-day monitoring to intermittent recording 60 sec three times daily with a handheld device during 3 weeks. We related the result to subsequent occurrence of AF as detected in 12-lead ECG recordings.

Methods: The patients were identified in the local database of cardiovascular investigations. Their clinical profile and vital status during the follow-up were obtained from the Swedish Stroke Register and the Swedish general population registry. For comparison, we used an age- and sex-matched population with no known cerebrovascular event and a population with a cerebrovascular event that was not screened.

Results: AF was detected in 7.1% by continuous screening and in 5.1% by intermittent screening (P = 0.3). During follow-up of 32 months, AF in 12-lead ECG was found in 7.0%. In the subgroup with positive screening, 46.3% had AF compared with 6.7% in the subgroup with negative screening (P < 0.0001).

Conclusions: The two screening approaches had a similar yield of arrhythmia, in spite of the group with intermittent monitoring having a more favorable clinical profile. A positive screening was highly predictive of AF in ECG during the follow-up.

Place, publisher, year, edition, pages
Upsala Medical Society, 2022
Keywords
Arrhythmia, continuous ECG-monitoring, intermittent ECG-recordings, ischemic stroke, screening, TIA
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-196120 (URN)10.48101/ujms.v127.8318 (DOI)000811346800001 ()35722185 (PubMedID)2-s2.0-85130696110 (Scopus ID)
Available from: 2022-06-23 Created: 2022-06-23 Last updated: 2023-09-05Bibliographically approved
Meidell Blylod, V., Rinnström, D., Pennlert, J., Ostenfeld, E., Dellborg, M., Sörensson, P., . . . Johansson, B. (2022). Interventions in Adults With Repaired Coarctation of the Aorta. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 11(14), Article ID e023954.
Open this publication in new window or tab >>Interventions in Adults With Repaired Coarctation of the Aorta
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2022 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 11, no 14, article id e023954Article in journal (Refereed) Published
Abstract [en]

Background: Coarctation of the aorta coexists with other cardiac anomalies and has long-term complications, including recoarctation, which may require intervention after the primary coarctation repair. This study aims to clarify the prevalence of and risk factors for interventions related to the coarctation complex as well as late mortality in a large contemporary patient population.

Methods and Results: The Swedish National Register of Congenital Heart Disease was used, which comprised 683 adults with repaired coarctation of the aorta. Analysis was performed on freedom from intervention thereafter at the coarctation site, aortic valve, left ventricular outflow tract, or ascending aorta. One hundred ninety-six (29%) patients had at least 1 of these interventions. Estimated freedom from either of these interventions was 60% after 50 years. The risk of undergoing such an intervention was higher among men (hazard ratio, 1.6 [95% CI, 1.2-2.2]). Estimated freedom from another intervention at the coarctation site was 75% after 50 years. In women, there was an increase in interventions at the coarctation site after 45 years. Patients who underwent one of the previously mentioned interventions after the primary coarctation repair had poorer left ventricular function. Eighteen patients (3%) died during follow-up in the register. The standardized mortality ratio was 2.9 (95% CI, 1.7-4.3).

Conclusions: Interventions are common after coarctation repair. The risk for and time of interventions are affected by sex. Our results have implications for planning follow-up and giving appropriate medical advice to the growing population of adults with repaired coarctation of the aorta.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
adult congenital heart disease, coarctation of the aorta, intervention, mortality, risk factors
National Category
Cardiac and Cardiovascular Systems
Research subject
Clinical Physiology
Identifiers
urn:nbn:se:umu:diva-198330 (URN)10.1161/JAHA.121.023954 (DOI)000826949500025 ()35861813 (PubMedID)2-s2.0-85134855405 (Scopus ID)
Funder
Region VästernorrlandThe Kempe FoundationsSwedish Heart Lung FoundationRegion Västerbotten
Available from: 2022-08-03 Created: 2022-08-03 Last updated: 2023-09-05Bibliographically approved
Johansson, K., Johansson, L., Pennlert, J., Söderberg, S., Jansson, J.-H. & Lind, M. (2020). Phosphatidylethanol Levels, As a Marker of Alcohol Consumption, Are Associated With Risk of Intracerebral Hemorrhage. Stroke, 51(7), 2148-2152
Open this publication in new window or tab >>Phosphatidylethanol Levels, As a Marker of Alcohol Consumption, Are Associated With Risk of Intracerebral Hemorrhage
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2020 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 51, no 7, p. 2148-2152Article in journal (Refereed) Published
Abstract [en]

Background and Purpose: Previous observational studies have shown a moderately increased risk of intracerebral hemorrhage (ICH) with high self-reported alcohol consumption. However, self-reported data tend to underestimate alcohol consumption. Phosphatidylethanol is a specific biomarker reflecting alcohol intake during the last month and correlates with the amount of alcohol consumed. The present study aimed to investigate the association between phosphatidylethanol levels and the risk of future ICH.

Methods: This population-based nested case-referent study was conducted within the Northern Sweden Health and Disease Cohort. At baseline, all participants underwent a health examination, including a questionnaire with questions about alcohol consumption. A blood sample was collected and stored at −80°C, and phosphatidylethanol 16:0/18:1 levels were measured in packed erythrocytes. Cases (n=97) were diagnosed with a first-ever ICH between 1985 and 2007. Two referents (n=180) were matched to each case.

Results: The mean age at baseline was 55 years, 39% of participants were women, and the mean time from blood sampling to ICH was 7.3 years. Only phosphatidylethanol and hypertension remained independently associated with ICH in a multivariable model. Participants with phosphatidylethanol >0.30 μmol/L had an increased risk of ICH compared with those with phosphatidylethanol <0.01 μmol/L (odds ratio, 4.64 [95% CI, 1.49–14.40]).

Conclusions: High blood concentrations of phosphatidylethanol were associated with an increased risk of future ICH. This association was independent of hypertension and other risk factors for ICH. Our findings suggest that phosphatidylethanol, as a marker of alcohol consumption, may be used as a risk marker of future ICH.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2020
Keywords
alcoholic beverages, alcoholism, biomarkers, case-control study, cerebral hemorrhage, intracranial hemorrhages, stroke
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-173632 (URN)10.1161/STROKEAHA.120.029630 (DOI)000544979200045 ()32543974 (PubMedID)2-s2.0-85087114871 (Scopus ID)
Funder
Region VästerbottenNorrbotten County Council
Available from: 2020-07-21 Created: 2020-07-21 Last updated: 2023-03-24Bibliographically approved
Larsen, K. T., Forfang, E., Pennlert, J., Glader, E.-L., Kruuse, C., Wester, P., . . . Ronning, O. M. (2020). STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage: Protocol for a randomised controlled trial. European Stroke Journal, 5(4), 414-422
Open this publication in new window or tab >>STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage: Protocol for a randomised controlled trial
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2020 (English)In: European Stroke Journal, ISSN 2396-9873, E-ISSN 2396-9881, Vol. 5, no 4, p. 414-422Article in journal (Refereed) Published
Abstract [en]

Background and aims: Many patients with prior intracerebral haemorrhage have indications for antithrombotic treatment with antiplatelet or anticoagulant drugs for prevention of ischaemic events, but it is uncertain whether such treatment is beneficial after intracerebral haemorrhage. STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage will assess (i) the effects of long-term antithrombotic treatment on the risk of recurrent intracerebral haemorrhage and occlusive vascular events after intracerebral haemorrhage and (ii) whether imaging findings, like cerebral microbleeds, modify these effects.

Methods: STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage is a multicentre, randomised controlled, open trial of starting versus avoiding antithrombotic treatment after non-traumatic intracerebral haemorrhage, in patients with an indication for antithrombotic treatment. Participants with vascular disease as an indication for antiplatelet treatment are randomly allocated to antiplatelet treatment or no antithrombotic treatment. Participants with atrial fibrillation as an indication for anticoagulant treatment are randomly allocated to anticoagulant treatment or no anticoagulant treatment. Cerebral CT or MRI is performed before randomisation. Duration of follow-up is at least two years. The primary outcome is recurrent intracerebral haemorrhage. Secondary outcomes include occlusive vascular events and death. Assessment of clinical outcomes is performed blinded to treatment allocation. Target recruitment is 500 participants.

Trial status: Recruitment to STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage is on-going. On 30 April 2020, 44 participants had been enrolled in 31 participating hospitals. An individual patient-data meta-analysis is planned with similar randomised trials.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
Intracerebral haemorrhage, antithrombotic treatment, secondary prevention, ischaemic events, randomised controlled trial, antiplatelet, anticoagulant, atrial fibrillation, stroke
National Category
Neurology Neurosciences
Identifiers
urn:nbn:se:umu:diva-175444 (URN)10.1177/2396987320954671 (DOI)000566172200001 ()
Available from: 2020-10-06 Created: 2020-10-06 Last updated: 2021-05-04Bibliographically approved
Sundström, J., Söderholm, M., Söderberg, S., Alfredsson, L., Andersson, M., Bellocco, R., . . . Wiberg, B. (2019). Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults. International Journal of Epidemiology, 48(6), 2018-2025
Open this publication in new window or tab >>Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults
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2019 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 48, no 6, p. 2018-2025Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium.

METHODS: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries.

RESULTS: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH.

CONCLUSIONS: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.

Place, publisher, year, edition, pages
Oxford University Press, 2019
Keywords
Stroke, cohort study, epidemiology
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162427 (URN)10.1093/ije/dyz163 (DOI)000509522900035 ()31363756 (PubMedID)2-s2.0-85077223111 (Scopus ID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2020-05-15Bibliographically approved
Wange, N., Anan, I., Ericzon, B.-G., Pennlert, J., Pilebro, B., Suhr, O. B. & Wixner, J. (2018). Atrial Fibrillation and Central Nervous Complications in Liver Transplanted Hereditary Transthyretin Amyloidosis Patients. Transplantation, 102(2), e59-e66
Open this publication in new window or tab >>Atrial Fibrillation and Central Nervous Complications in Liver Transplanted Hereditary Transthyretin Amyloidosis Patients
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2018 (English)In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 102, no 2, p. e59-e66Article in journal (Refereed) Published
Abstract [en]

Background. Central nervous system (CNS) complications are increasingly noted in liver transplanted (LTx) hereditary transthyretin amyloid (ATTRm) amyloidosis patients; this suggests that the increased survival allows for intracranial ATTRm formation from brain synthesized mutant TTR. However, atrial fibrillation (AF), a recognised risk factor for ischemic CNS complications, is also observed after LTx. The aim of the study was to investigate the occurrence of CNS complications and AF in LTx ATTRm amyloidosis patients. Methods. The medical records of all LTx ATTRm amyloidosis patients in the county of Vasterbotten, Sweden, were investigated for information on CNS complications, AF, anticoagulation (AC) therapy, hypertension, cardiac ischemic disease, hypertrophy, and neurological status. Results. Sixty-three patients that had survived for 3 years or longer after LTx were included in the analysis. Twenty-five patients had developed 1 or more CNS complications at a median of 21 years after onset of disease. AF was noted in 21 patients (median time to diagnosis 24 years). Cerebrovascular events (CVE) developed in 17 (median time to event 21 years). CVEs occurred significantly more often in patients with AF (P < 0.002). AC therapy significantly reduced CVEs, including bleeding in patients with AF (P = 0.04). Multivariate analysis identified AF as the only remaining regressor with a significant impact on CVE (hazard ratio, 3.8; 95% confidence interval 1.1-9.5; P = 0.029). Conclusions. AF is an important risk factor for CVE in LTx ATTRm amyloidosis patients, and AC therapy should be considered. However, the increased bleeding risk with AC therapy in patients with intracranial amyloidosis should be acknowledged.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2018
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-144941 (URN)10.1097/TP.0000000000001975 (DOI)000424093400004 ()29019809 (PubMedID)2-s2.0-85041605016 (Scopus ID)
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2023-03-23Bibliographically approved
Pennlert, J., Overholser, R., Asplund, K., Carlberg, B., Van Rompaye, B., Wiklund, P.-G. & Eriksson, M. (2017). Optimal Timing of Anticoagulant Treatment After Intracerebral Hemorrhage in Patients With Atrial Fibrillation. Stroke, 48(2), 314-320
Open this publication in new window or tab >>Optimal Timing of Anticoagulant Treatment After Intracerebral Hemorrhage in Patients With Atrial Fibrillation
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2017 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 48, no 2, p. 314-320Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND PURPOSE: This study aims to provide observational data on the relationship between the timing of antithrombotic treatment and the competing risks of severe thrombotic and hemorrhagic events in a cohort of Swedish patients with atrial fibrillation and intracerebral hemorrhage (ICH).

METHODS: Patients with atrial fibrillation and a first-ever ICH were identified in the Swedish Stroke Register, Riksstroke, 2005 to 2012. Riksstroke was linked with other national registers to find information on treatment, comorbidity, and outcome. The optimal timing of treatment in patients with low and high thromboembolic risk was described through cumulative incidence functions separately for thrombotic and hemorrhagic events and for the combined end point vascular death or nonfatal stroke.

RESULTS: The study included 2619 ICH survivors with atrial fibrillation with 5759 person-years of follow-up. Anticoagulant treatment was associated with a reduced risk of vascular death and nonfatal stroke in high-risk patients with no significantly increased risk of severe hemorrhage. The benefit seemed to be greatest when treatment was started 7 to 8 weeks after ICH. For high-risk women, the total risk of vascular death or stroke recurrence within 3 years was 17.0% when anticoagulant treatment was initiated 8 weeks after ICH and 28.6% without any antithrombotic treatment (95% confidence interval for difference, 1.4%-21.8%). For high-risk men, the corresponding risks were 14.3% versus 23.6% (95% confidence interval for difference, 0.4%-18.2%).

CONCLUSIONS: This nationwide observational study suggests that anticoagulant treatment may be initiated 7 to 8 weeks after ICH in patients with atrial fibrillation to optimize the benefit from treatment and minimize risk.

Place, publisher, year, edition, pages
American Heart Association, 2017
Keywords
anticoagulants, atrial fibrillation, cerebral hemorrhage, ischemia, stroke
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-129335 (URN)10.1161/STROKEAHA.116.014643 (DOI)000394510300024 ()27999135 (PubMedID)2-s2.0-85007247841 (Scopus ID)
Note

Presented in part at the 2nd European Stroke Organisation Conference (ESOC 2016), Barcelona, Spain, May 10–12, 2016

Available from: 2016-12-22 Created: 2016-12-22 Last updated: 2023-03-24Bibliographically approved
Pennlert, J., Asplund, K. & Eriksson, M. (2017). Response by Pennlert et al to Letter Regarding Article, "Optimal Timing of Anticoagulant Treatment After Intracerebral Hemorrhage in Patients With Atrial Fibrillation". [Letter to the editor]. Stroke, 48(4), Article ID e116.
Open this publication in new window or tab >>Response by Pennlert et al to Letter Regarding Article, "Optimal Timing of Anticoagulant Treatment After Intracerebral Hemorrhage in Patients With Atrial Fibrillation".
2017 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 48, no 4, article id e116Article in journal, Letter (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-132525 (URN)10.1161/STROKEAHA.117.016838 (DOI)000398207000011 ()28283602 (PubMedID)2-s2.0-85015076952 (Scopus ID)
Available from: 2017-03-16 Created: 2017-03-16 Last updated: 2023-03-23Bibliographically approved
Pennlert, J., Asplund, K., Glader, E.-L., Norrving, B. & Eriksson, M. (2017). Socioeconomic Status and the Risk of Stroke Recurrence: Persisting Gaps Observed in a Nationwide Swedish Study 2001 to 2012.. Stroke, 48(6), 1518-1523
Open this publication in new window or tab >>Socioeconomic Status and the Risk of Stroke Recurrence: Persisting Gaps Observed in a Nationwide Swedish Study 2001 to 2012.
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2017 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 48, no 6, p. 1518-1523Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND PURPOSE: This nationwide observational study aimed to investigate how socioeconomic status is associated with risk of stroke recurrence and how possible associations change over time.

METHODS: This study included 168 295 patients, previously independent in activities of daily living, with a first-ever stroke in the Swedish Stroke Register (Riksstroke) 2001 to 2012. Riksstroke was linked with Statistics Sweden as to add individual information on education and income. Subdistribution hazard regression was used to analyze time from 28 days after first stroke to stroke recurrence, accounting for the competing risk of other causes of death.

RESULTS: Median time of follow-up was 3.0 years. During follow-up, 23 560 patients had a first recurrent stroke, and 53 867 died from other causes. The estimated cumulative incidence of stroke recurrence was 5.3% at 1 year, and 14.3% at 5 years. Corresponding incidence for other deaths were 10.3% and 30.2%. Higher education and income were associated with a reduced risk of stroke recurrence. After adjusting for confounding variables, university versus primary school education returned a hazard ratio of 0.902; 95% confidence interval, 0.864 to 0.942, and the highest versus the lowest income tertile a hazard ratio of 0.955; 95% confidence interval, 0.922 to 0.989. The risk of stroke recurrence decreased during the study period, but the inverse effect of socioeconomic status on risk of recurrence did not change significantly.

CONCLUSIONS: Despite a declining risk of stroke recurrence over time, the differences in recurrence risk between different socioeconomic groups remained at a similar level in Sweden during 2001 to 2012.

Keywords
education, incidence, income, recurrence, socioeconomic factors, stroke
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-134398 (URN)10.1161/STROKEAHA.116.015643 (DOI)000401819300027 ()28465458 (PubMedID)2-s2.0-85019646004 (Scopus ID)
Available from: 2017-05-04 Created: 2017-05-04 Last updated: 2023-03-24Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-1598-4690

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