Per G. Lund-Larsen

Coffee consumption and death from coronary heart disease in middle aged Norwegian men and women.

OBJECTIVE--To study the association between number of cups of coffee consumed per day and coronary death when taking other major coronary risk factors into account. DESIGN--Men and women attending screening and followed up for a mean of 6.4 years. SETTING--Cardiovascular survey performed by ambulatory teams from the National Health Screening Service in Norway. PARTICIPANTS--All middle aged people in three counties: 19,398 men and 19,166 women aged 35-54 years who reported neither cardiovascular disease or diabetes nor symptoms of angina pectoris or intermittent claudication. MAIN OUTCOME MEASURE--Predictive value of number of cups of coffee consumed per day. RESULTS--At initial screening total serum cholesterol concentration, high density lipoprotein cholesterol concentration, blood pressure, height, and weight were measured and self reported information about smoking history, physical activity, and coffee drinking habits was recorded. Altogether 168 men and 16 women died of coronary heart disease during follow up. Mean cholesterol concentrations for men and women were almost identical and increased from the lowest to highest coffee consumption group (13.1% and 10.9% respectively). With the proportional hazards model and adjustment for age, total serum and high density lipoprotein cholesterol concentrations, systolic blood pressure, and number of cigarettes per day the coefficient for coffee corresponded to a relative risk between nine or more cups of coffee and less than one cup of 2.2 (95% confidence interval 1.1 to 4.5) for men and 5.1 (0.4 to 60.3) for women. For men the relative risk varied among the three counties. CONCLUSIONS--Coffee may affect mortality from coronary heart disease over and above its effect in raising cholesterol concentrations.

Population based study of health and living conditions in areas with both Sami and Norwegian populations--the SAMINOR study

Objectives. The overall aim of the SAMINOR project was to study health and diseases in relation to living conditions among the Sami population and to compare these with the Norwegian population in the same area. This article provides an overview of the background of the study and a description of the methods employed for the data collection. We give sample characteristics and elaborate on different definitions of ethnicity. Study Design. Cross-sectional, population-based study, including questionnaires, a clinical examination and analyses of blood samples. Methods. All individuals 30 or 36 to 79 years of age who were living in defined municipalities or specified local areas with a known Sami population were invited to a cardiovascular screening program. The data were collected during 2003–2004. The questionnaires focused on living conditions, health, Sami traditions and ethnicity. The eligible population consisted of 27,987 individuals and 16,865 (60.6%) participated by answering at least one questionnaire. Analyses were restricted to the 36 to 79 year-old age group which had 16,538 participants. The screening program comprised a blood sample, measurements of blood pressure, height, weight, and waist and hip ratio. Different definitions of Sami ethnicity were explored. Results. Of the sample, 35.6% reported Sami background, and 13.2% reported that they, their parents and their grandparents had Sami as their domestic language. This stringent definition of Sami produced clearer differences between Sami and Norwegians, as shown for some measures of socioeconomic status. Conclusions. The findings that are related to more strict definitions of Sami ethnicity have important implications for the interpretation of earlier works and for future studies.

Serum glucose levels during long-term observation of treated and untreated men with mild hypertension: The Oslo study

Serum glucose levels, triglyceride levels, and body weight are reported from a controlled drug trial in men, aged 40 to 49, with uncomplicated mild hypertension. The drug treatment started with hydrochlorothiazide alone, and methyldopa was added when necessary. If side effects occurred, methyldopa was replaced by propranolol. No detailed advice about diet, smoking, or weight reduction was given to any group. The untreated control subjects had a small increase in serum glucose levels during five years, from 6.08 to 6.21 mmol/liter. Those treated with hydrochlorothiazide alone and those treated with hydrochlorothiazide plus methyldopa had a small increase in serum glucose levels of the same order as that in the control subjects. However, those receiving the thiazide/propranolol combination experienced a sizeable increase in glucose levels, from 5.96 to 6.53 mmol/liter (p less than 0.001). This increase was significantly greater than the increase in the other groups (p less than 0.001). The thiazide/propranolol group also showed a significant increase in serum triglyceride levels (p less than 0.05). There was no difference in serum potassium levels in the different drug groups. The results indicate that moderate thiazide doses do not have significant effects on serum glucose levels in this age group. Propranolol in combination with thiazide seems to increase the level of serum glucose.

Promoting physical activity in a multi-ethnic district - methods and baseline results of a pseudo-experimental intervention study.

Background and design A combined community and high-risk intervention study of three years duration started in one district in Oslo after a baseline health survey in two multi-ethnic and low socio-economic status (SES) districts, using a pseudo-experimental design with an age-matched sample from the other district as controls. The intervention focused on promoting physical activity to reduce the burden of type 2 diabetes and cardiovascular disease (CVD). Methods A total of 6140 subjects were invited to participate (age group: 31-67). Data on health status and health-related behaviours, collected via standardized questionnaires, physical examinations and blood sample analyses, were available for 2950 persons (attendance rate 48%), whereas official statistics were available for the invited population. Results The prevalence of self-reported diabetes was 5.1% in men and 3.5% in women, but the total diabetes prevalence was 9% for men and 5.1% for women. One-third of the population were sedentary in their leisure time, men more than women (38% versus 29%). The prevalence of obesity did not differ between the genders (21% had BMI 30 kg/m2). The relatively high mean scores on most psychosocial variables related to physical activity, especially among women, indicate a high motivational readiness for increase in physical activity behaviour. The baseline data, for example on the prevalence of chronic diseases were similar in the two districts. Conclusion The prevalence of self-reported diabetes is remarkably higher than reported from other studies in Norway. The proportion of undiagnosed diabetes was higher than anticipated, and constituted 39% of all those categorized as diabetics.

Serum Lipids in Postmenopausal or Perimenopausal Women Using Estrogen Alone, Estrogen with Levonorgestrel, or Estrogen with Norethisterone, Compared with Nonusers: Results from a Cross- Sectional Study in Two Norwegian Counties 1985-1988

The aim of this study was to compare, in a population setting of postmenopausal or perimenopausal women aged 40 to 54, the levels of serum lipids in women using different hormone replacement therapy (HRT) regimens with women using no sex hormones. There was no unequivocal tendency of a more healthy lifestyle among those using HRT than among nonusers. Any type of regimen was associated with a lower mean level of total and calculated low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol was 0.08 mmol/L (5.2%) higher in those using estrogen alone, 0.07 mmol/L (4.5%) higher in users of HRT with norethisterone, and 0.07 mmol/L (4.5%) lower in users of HRT with levonorgestrel, compared with nonusers. The ratio of total-to-HDL cholesterol was lower by 0.37 (6.1%) in those using estrogen alone, by 0.65 (12.3%) in those using HRT with norethisterone, and by 0.24 (5.3%) in those using estrogen with levonorgestrel. There was no association between body mass index and HDL-cholesterol among women who used HRT with norethisterone, whereas an inverse relationship was present in those using estrogen alone and in nonusers (P [interaction] < 0.05).

Intervention on Cardiovascular Disease Risk Factors in Finnmark County: Changes after a Period of Three Years: The Cardiovascular Disease Study in Finnmark County, Norway

In Finnmark county in Norway, 12329 males and females aged 20–49 years participated in two screening examinations with an interval of 3 years. The primary health service attempted, without receiving any extra resources, to reduce the risk of cardiovascular disease by means of a personal intervention programme among high-risk individuals and a health education programme directed at all residents in the county. During these 3 years the serum total-cholesterol (cross-sectionally) level decreased on average by about 0.3 mmol/l due to: firstly, a decrease among persons recommended a follow-up examination and secondly a decrease among household members of persons followed-up. The effect of a recommendation to attend a follow-up examination because of high blood pressure was doubtful. Cigarette consumption (cross-sectionally) decreased 12% for males and 4% for females. The joint decrease (improvement) in risk factors indicates a possible health benefit of about 20%, calculated in terms of myocardial infarction over 10 years.

Blood Lipids and Antihypertensive Drugs: The Oslo Study

The treatment of hypertension has failed to achieve a reduction of the incidence of coronary heart disease. Recently, attention has been drawn to the effects of antihypertensive drugs on the metabolism of lipoproteins. Of the beta-blockers only pindolol was lipid neutral while propranolol, atenolol and oxprenolol lowered cholesterol and increased serum triglycerides. Hydrochlorothiazide did not influence blood lipids. Prazosin lowered serum LDL + VLDL cholesterol and total triglycerides. The combination of pindolol + prazosin lowered LDL + VLDL cholesterol and increased triglycerides. Propranolol + prazosin lowered HDL cholesterol, methyldopa + hydrochlorothiazide and hydrochlorothiazide + amiloride had no effect on blood lipids.