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Risk factors for ischaemic heart disease mortality among men with different occupational physical demands. A 30-year prospective cohort study.

ABSTRACT: Objectives Men with high physical work demands have elevated cardiovascular strain, which may lead to enhanced atherosclerosis. Theoretically, the impact of risk factors for ischaemic heart disease (IHD) may thus depend on physical work demands. The authors investigated this hypothesis. Design Prospective 30-year follow-up. Setting The Copenhagen Male Study. Participants 5249 gainfully employed men aged 40-59 years; 311 men with cardiovascular disease/diabetes were excluded. Primary and secondary outcome measures IHD and all-cause mortality. Results 579 men (11.8%) died due to IHD and 2628 (53.7%) from all-cause mortality. Similarities and differences in risk predictors were found between men with low (n=1219), medium (n=2636) and high (n=846) physical work demands. After control for potential confounders, high physical fitness conferred a reduced risk of IHD mortality only among men with high physical work demands (HR: 0.48, 95% CI 0.24 to 0.96), a moderate/high level of leisure-time physical activity was associated with reduced risk of IHD mortality only among men with moderate and high physical work demands. High systolic blood pressure and smoking were risk factors in all groups. Similar, but less pronounced differences in risk factors for all-cause mortality between groups were found. Conclusions The risk factors for IHD and all-cause mortality, low physical fitness and low leisure-time physical activity are not identical for men with different physical work demands. Preventive initiatives for IHD should be tailored to the physical work demands.

SUBMITTER: Holtermann A

PROVIDER: S-EPMC3253417 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Risk factors for ischaemic heart disease mortality among men with different occupational physical demands. A 30-year prospective cohort study.

Holtermann Andreas A Mortensen Ole Steen OS Søgaard Karen K Gyntelberg Finn F Suadicani Poul P

BMJ open 20120104 1

Objectives Men with high physical work demands have elevated cardiovascular strain, which may lead to enhanced atherosclerosis. Theoretically, the impact of risk factors for ischaemic heart disease (IHD) may thus depend on physical work demands. The authors investigated this hypothesis. Design Prospective 30-year follow-up. Setting The Copenhagen Male Study. Participants 5249 gainfully employed men aged 40-59 years; 311 men with cardiovascular disease/diabetes were excluded. Primary and seco ...[more]

PMID: 22218719

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Project description:BackgroundIschaemic heart disease (IHD) often develops after decades of preceding subclinical coronary atherosclerosis. Biomarkers are useful prognostic predictors of IHD, but their long-term predictive value in a general population has not been adequately studied.PurposeTo investigate the early predictive value of multi-modality biomarkers in addition to clinical risk factors in incident IHD in a random male general population sample followed from 50 to 71 years of age.Method"The Study of Men Born in 1943" is a longitudinal cohort study during follow-up. All the men underwent a baseline examination in 1993, where a panel of biomarkers were analysed and incident IHD was registered during 21-year follow-ups.ResultsOf 739 participants, 97 men (13.1%) developed an IHD event. For time to first occurrence of IHD, univariable analyses showed that elevated levels of high sensitivity troponin T (hs-TNT), high sensitivity-C reactive protein (hs-CRP) and interleukin-6 (IL-6) were significant predictors of IHD. In addition, a high number of biomarkers with elevated levels (hs-TNT?>?10 ng/L, hs-CRP?>?1 mg/L, IL-6?>?8 ng/L and N-terminal pro b-type natriuretic peptide (NT-proBNP)?>?100 pg/mL) increased predictive ability. In univariable and multivariable analysis high-density lipoprotein-cholesterol (HDL-C) had the highest predictive ability. Hs-TNT provided better predictive ability than smoking, body mass index and glucose, and was an independent significant predictor when adjusted for HDL-C, total cholesterol and hypertension. Addition of biomarkers on top of clinical risk factors provided significantly better prediction as tested by likelihood ratio test (p?=?0.033), but did not significantly enhance the model's discriminative ability However, it appeared contributing to higher sensitivity in the late phase of follow-up.ConclusionIn this random, middle-aged male population sample, the addition of biomarker hs-TNT was an independent significant predictor of IHD and significantly improved prediction, indicating the probability of a better prediction of long-term risk of IHD in a low-risk population.Trial registrationThe study is registered at Clinical Trials.gov Identifier number: NCT03138122.

Dataset Information

Risk factors for ischaemic heart disease mortality among men with different occupational physical demands. A 30-year prospective cohort study.

Publications

Risk factors for ischaemic heart disease mortality among men with different occupational physical demands. A 30-year prospective cohort study.

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