Erik Bøg-Hansen

Risk factor clustering in patients with hypertension and non-insulin-dependent diabetes mellitus. The Skaraborg Hypertension Project

Abstract. Bøg‐Hansen E, Lindblad U, Bengtsson K, Ranstam J, Melander A, Råstam L (Skara Health Care Center, Skara; Malmö University Hospital, Malmö; Skaraborg Institute, Skövde; The NEPI Foundation, Malmö and Stockholm; and National Public Health Institute, Stockholm; Sweden). Risk factor clustering in patients with hypertension and non‐insulin‐dependent diabetes mellitus. The Skaraborg Hypertension Project.

Polymorphism in the angiotensin converting enzyme but not in the angiotensinogen gene is associated with hypertension and type 2 diabetes: the Skaraborg Hypertension and diabetes project.

OBJECTIVEnTo study the association between polymorphisms in the angiotensin converting enzyme (ACE) gene and angiotensinogen (AGT) gene and hypertension and/or type 2 diabetes in a community population.nnnPATIENTS AND METHODSnThe insertion (I)/deletion (D) polymorphism of the ACE gene and the M235T polymorphism of the AGT gene were genotyped in 773 nondiabetic individuals with hypertension, 193 normotensive patients with type 2 diabetes, 243 patients with type 2 diabetes and hypertension, and in 820 normotensive control individuals identified in a community-based study.nnnRESULTSnThe DD genotype was associated with hypertension in individuals less than 70 years [odds ratio (OR) = 1.54, confidence interval (CI) = 1.09-2.18] and remained so when patients with type 2 diabetes were excluded from the analysis (OR = 1.45, CI = 1.01-2.09). The strongest association was with the combination of type 2 diabetes and hypertension (OR = 2.19, CI = 1.09-4.38). There was no association with type 2 diabetes without hypertension. No association was observed between the M235T variant or the 3-microsatellite polymorphism of the AGT gene and hypertension.nnnCONCLUSIONnThe D-allele of the ACE gene ID polymorphism increases susceptibility to hypertension, particularly when associated with type 2 diabetes. No association was observed between the M235T variant or 3-microsatellite polymorphism of the AGT gene and hypertension.

Impaired glucose metabolism and obesity in Swedish patients with borderline isolated systolic hypertension: Skaraborg Hypertension and Diabetes Project

Summary

Low serum concentration of sulfatide and presence of sulfated lactosylceramid are associated with Type 2 diabetes. The Skaraborg Project

Aimsu2003 The glycosphingolipid sulfatide (sulfated galactosyl‐ceramide) increases exocytosis of β‐cell secretory granules, activates KATP‐channels and is thereby able to influence insulin secretion through its presence in the islets. A closely related compound, sulfated lactosylceramide (sulf‐lac‐cer), is present in the islets during fetal and neonatal life when, as in Type 2 diabetes, insulin is secreted autonomically without the usual first phase response to glucose. The aim was to examine whether serum concentrations of these glycolipids are associated with Type 2 diabetes.

Survival in patients with hypertension treated in primary care. A population-based follow-up study in the Skaraborg Hypertension and Diabetes Project.

Objective – To explore risk factors for all-cause mortality in patients with hypertension. Design – Community-based cohort study. Setting – Hypertension outpatient clinic in primary health care. Subjects – Hypertensive men and women who consecutively underwent an annual follow-up during 1992–1993 (n=894). Methods – Vital status was ascertained up to December 1999 by record linkage with national registers. Gender-specific predictors for mortality from baseline examination were analysed by Cox regression. Main outcome measure – All-cause mortality. Results – In both sexes all-cause mortality was predicted by fasting blood glucose (RR by 1 mmol L−1: 1.2, CI: 1.1–1.3 in men; 1.2, 1.1–1.4 in women), and known type 2 diabetes (RR: 1.9, CI: 1.3–2.9 in men; 2.5, 1.7–3.9 in women). In men, furthermore, mortality was predicted by previous cardiovascular disease, left ventricular hypertrophy and microalbuminuria, whilst in women mortality was predicted by high blood pressure and dyslipidemia. In patients without known diabetes male gender was a strong predictor of mortality (RR: 2.0, CI: 1.4–2.9), whereas in patients with hypertension and type 2 diabetes combined, male gender was not associated with increased mortality (RR: 1.4, CI: 0.9–2.2). Conclusion – Type 2 diabetes in hypertensive patients treated in primary care predicts mortality and dilutes gender difference in survival. For hypertensive patients general practitioners should be observant regarding disturbed glucose metabolism and regarding the associated major risk increase in women.

Residual risk for acute stroke in patients with type 2 diabetes and hypertension in primary care: Skaraborg Hypertension and Diabetes Project.

Aim:u2002 The aim of this study was to investigate the risk of acute stroke in subgroups of patients treated for hypertension and type 2 diabetes in primary care.