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The validity of a diagnosis of heart failure in a hospital discharge register
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
2005 In: Eur J Heart Fail, ISSN 1388-9842, Vol. 7, no 5, 787-791 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2005. Vol. 7, no 5, 787-791 p.
Identifiers
URN: urn:nbn:se:uu:diva-93267OAI: oai:DiVA.org:uu-93267DiVA: diva2:166698
Available from: 2005-09-01 Created: 2005-09-01Bibliographically approved
In thesis
1. Insulin Resistance and Inflammation as Risk Factors for Congestive Heart Failure
Open this publication in new window or tab >>Insulin Resistance and Inflammation as Risk Factors for Congestive Heart Failure
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Congestive heart failure (CHF) is a major cause of morbidity and mortality and the identification of modifiable risk factors is crucial in order to diminish suffering of this common disease.

The primary aim of this thesis was to investigate novel metabolic risk factors for CHF, with a focus on insulin resistance and inflammation. The secondary aim was to examine the validity of the CHF diagnosis in the Swedish hospital discharge register.

This thesis was based on the Uppsala Longitudinal Study of Adult Men (ULSAM) cohort, a community-based prospective study started in 1970. The participants were examined at age 50 and 70 and the data was completed with annual updates on mortality and in-hospital morbidity using national registers.

We showed that insulin resistance predicts CHF incidence independently of established risk factors in both middle-aged and elderly men. The previously described association between obesity and subsequent CHF may be mediated partly by insulin resistance. Moreover, it was established that inflammation, measured as erythrocyte sedimentation rate is a significant predictor of CHF, independent of established risk factors including an interim myocardial infarction. Furthermore, a low beta-carotene level, as well as an increased apolipoprotein B/A-I-ratio was found to predict CHF independently of established risk factors.

We also showed that the validity of the CHF diagnosis in the Swedish hospital discharge register appears less precise than for other recently investigated cardiovascular diagnoses. However, when including only cases from selected clinics or cases with a primary diagnosis of CHF, the validity is comparable to the above diagnoses.

In conclusion, insulin resistance and inflammation are strong independent risk factors for the development of CHF, and seem to be involved in the early process leading to CHF. If confirmed, our observations could have large clinical implications as they may offer new approaches in the prevention of CHF.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2005. 77 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 55
Keyword
Geriatric nursing, congestive heart failure, insulin resistance, inflammation, obesity, blood sedimentation, apolipoproteins, antioxidants, beta carotene, oxidative stress, registries, epidemiology, risk factors, Äldrevård
National Category
Other Social Sciences not elsewhere specified
Identifiers
urn:nbn:se:uu:diva-5879 (URN)91-554-6296-0 (ISBN)
Public defence
2005-10-01, Auditorium Minus, Museum Gustavianum, Akademigatan 3, 753 10 Uppsala, 13:15
Opponent
Supervisors
Available from: 2005-09-01 Created: 2005-09-01Bibliographically approved

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