Alcoholic intemperance, coronary heart disease and mortality in middle-aged Swedish men

High alcohol consumption is one of the major risk indicators for premature death in middle-aged men. An indicator of alcohol abuse--registration with the social authorities for alcoholic problems--was used to evaluate the role of alcohol in relation to general and cause-specific mortality in a general population sample. Altogether 1,116 men (11%) out of a total population of 10,004 men were registered for alcoholic problems. Total mortality during 11.8 years' follow-up was 10.4% among the non-registered men, compared to 20.5% among men with occasional convictions for drunkenness and 29.6% among heavy abusers. Fatal cancer as a whole was not independently associated with alcohol abuse, but oropharyngeal and oesophageal cancers together were seven times more common in the alcohol-registered groups. Total coronary heart disease (CHD) was significantly and independently associated with alcohol abuse, but nearly all the excess CHD mortality among the alcohol-registered men could be attributed to sudden coronary death. Cases with definite recent myocardial infarction were not more common in the alcoholic population. A combined effect of coronary arteriosclerosis and heart muscle damage secondary to alcohol abuse is suggested. Other causes of death strongly associated with registration for alcohol abuse include pulmonary embolism, pneumonia and peptic ulcer, as well as death from liver cirrhosis and alcoholism. Of the excess mortality among alcohol-registered subjects, 20.1% could be attributed to CHD, 18.1% to violent death, 13.6% to alcoholism without another diagnosis and 11.1% to liver cirrhosis.     

Social isolation and mortality in ischemic heart disease. A 10-year follow-up study of 150 middle-aged men

The effects of psychosocial and clinical factors on mortality in ischemic heart disease (IHD) were examined in a 10-year follow-up of 150 middle-aged men. Three groups of men were included: men with clinically manifest IHD, men with risk factors and healthy men. Psychosocial factors were assessed by means of standardized questionnaires. They comprised educational level, social class, marital status and a comprehensive assessment of the daily rounds of life of these men. Furthermore, a subjective rating of the own general health status was obtained. The clinical investigation included a standard physical examination, fasting serum lipids, glucose and urate, a frontal and sagittal chest X-ray and a 24-hour ambulatory ECG monitoring. During follow-up 37 men died, 20 of them from IHD. Non-survivors were discriminated from survivors by the following factors: older age, lower education, lower social class, higher systolic blood pressure, increased ventricular irritability and cardiac enlargement. Furthermore, a relative social isolation as indicated by a low social activity level and a poor self-rated general health status was characteristic of non-survivors. In multivariate analyses three factors emerged as the equally strong predictors of mortality, both from all causes and from IHD: social isolation, a poor self-rated health status and ventricular irritability. The psychosocial mortality predictors were independent of and of similar strength as the clinical predictors.     

Genetics of verbal working memory processes: a twin study of middle-aged men

Genetic and environmental influences on cognitive components of reading span in 345 middle-aged male twin pairs were examined. Shared variance among word recognition (reading only), digits forward (short-term memory only), and reading span (concurrent reading plus memory) was almost entirely mediated by common genetic influences. Overall heritability was .52 for word recognition, .27 for digits forward, and .51 for reading span. All of the genetic influences on word recognition and digits forward, but only about one-half of the genetic influences on reading span, came from a common latent phenotype. The genetic influences that were specific to reading span were concluded to most likely reflect an executive function component. Implications for genetic studies of aging and prefrontal brain function are discussed.     

Dietary folate and the risk of depression in Finnish middle-aged men. A prospective follow-up study

BACKGROUND: Several cross-sectional studies have focused on the low blood folate levels of depressive patients. Nevertheless, no prospective studies have been published on the association between dietary folate and depression. METHODS: We studied the association between dietary folate and cobalamin and receiving a discharge diagnosis of depression in a prospective follow-up setting. Our cohort was recruited between 1984 and 1989 and followed until the end of 2000, and it consisted of 2,313 men aged between 42 and 60 years from eastern Finland. RESULTS: The mean intake of folate in the whole cohort was 256 microg/day (SD=76). Those below the median of energy-adjusted folate intake had higher risk of getting discharge diagnosis of depression (RR 3.04, 95% CI: 1.58, 5.86) during the follow-up period than those who had a folate intake above the median. This excess risk remained significant after adjustment for current socioeconomic status, the baseline HPL depression score, the energy-adjusted daily intake of fibre and vitamin C, and the total fat intake. CONCLUSIONS: A low dietary intake of folate may be a risk factor for severe depression. This also indicates that nutrition may have a role in the prevention of depression.     

Smoking, lung function, physical performance and latent coronary heart disease in presumably healthy middle-aged men

During a cardiovascular survey comprising 2014 presumably healthy men aged 40-59 years, latent (previously undetected) coronary heart disease (CHD), lung function and physical performance were related to differences in smoking habits. The survey examination classified 1 832 individuals as "normals" (without clinical signs/symptoms of CHD). Among the others, a strong supicion of CHD was found in 115, of whom 105 had diagnostic coronary angiography. No angiography was performed in another 35 individuals with slight, albeit typical angina pectoris. The remaining 42 men were excluded from this presentation for various reasons. The following findings were obtained: 1) in the 69 men with positive coronary angiography, the extent of coronary atheromatosis was positively related to the number of cigarettes smoked. 2) The smoking habits of the 35 individuals with slight angina pectoris but no angiography did not differ from those of the "normals". 3) Physical performance during a near maximal bicycle exercise test and lung function according to spirometry were strongly and negatively related to smoking (in "normals"). 4) Previous smokers and never-smokers among "normals" had almost identical lung function and physical performance.     

Back-neck pain and symptoms of anxiety and depression: a population-based twin study

BACKGROUND: Clinical and epidemiological studies have shown an association between anxiety and depression and pain in the back and neck. The nature of this relationship is not clear. This study aimed to investigate the extent to which common genetic and environmental aetiological factors contribute to the covariance between symptoms of anxiety and depression and back-neck pain. METHODS: Measures of back-neck pain and symptoms of anxiety and depression were part of a self-report questionnaire sent in 1992 to twins born in Norway between 1967 and 1974 (3996 pairs). Structural equation modelling was applied to determine to what extent back-neck pain and symptoms of anxiety and depression share genetic and environmental liability factors. RESULTS: The phenotypic correlation between symptoms of anxiety and depression and back-neck pain was 0.31. Individual differences in both anxiety and depression and back-neck pain were best accounted for by additive genetic and individual environmental factors. Heritability estimates were 0.53 and 0.30 respectively. For back-neck pain, however, a model specifying only shared- and individual environmental effects could not be rejected. Bivariate analyses revealed that the correlation between back-neck pain and symptoms of anxiety and depression was best explained by additive genetic and individual environmental factors. Genetic factors affecting both phenotypes accounted for 60% of the covariation. There were no significant sex differences. CONCLUSION: The results support previous findings of a moderate association between back-neck pain and symptoms of anxiety and depression, and suggest that this association is primarily due to common genetic effects.     

Dietary zinc intake and the risk of depression in middle-aged men: A 20-year prospective follow-up study

Background

Zinc is an immunomodulatory trace element suggested to be beneficial in the augmentation of antidepressant therapy. Cross-sectional studies have also suggested an association between low dietary zinc and depression. This study examined the association between dietary zinc intake and depression in a prospective setting in initially depression-free men during a 20-year follow-up.

Methods

The study formed a part of the population-based Kuopio Ischemic Heart Disease Risk Factor (KIHD) Study, and comprised 2317 Finnish men aged 42–61 years. Zinc intake was assessed at baseline by a 4-d food record. Baseline depression severity was recorded with the Human Population Laboratory Depression Scale. In the prospective setting, depression was defined as having received a hospital discharge diagnosis of unipolar depressive disorder. Individuals who at baseline had elevated depressive symptoms were excluded (n=283).

Results

Altogether, 60 (2.7%) individuals received a hospital discharge diagnosis of depression during the 20-year follow-up. In Cox regression analysis adjusted for age, baseline depression severity, smoking, alcohol use, physical exercise and the use of dietary supplements, belonging to the lowest tertile of energy-adjusted zinc intake was not associated with an increased depression risk (RR 1.06, 95% CI 0.59–1.90).

Limitations

These observations may not be generalizable to women, or to individuals with a depression level not warranting hospitalization.

Conclusions

Our findings suggest that a low dietary zinc intake may not longitudinally precede depression in men. Dietary zinc intake may not have relevance for the prevention of depression in middle-aged men with a sufficient dietary zinc intake.     

Nature, nurture and depression: a twin study

We studied a series of twins systematically ascertained through 214 probands (84 monozygotic, 130 dizygotic) who had had one or more episodes of hospital-treated major depression. A variety of definitions of depression were applied to the co-twins all of which resulted in (a) markedly higher rates of disorder than are found in the general population, (b) significantly higher monozygotic than dizygotic concordance. The results of applying a simple additive model in which depression is considered as a threshold trait suggested that both genetic factors and shared family environment make substantial and significant contributions to the familiality of depression.     

Social support, AIDS-related symptoms, and depression among gay men.

This study examined the impact of social support and HIV-related conditions on depression among 508 gay men participating in the San Francisco Men's Health Study, a population-based prospective study of single men aged 25-54 years. The number of HIV-related symptoms experienced significantly predicted depression cross-sectionally and 1 year later. Satisfaction with each of three types of social support (emotional, practical, informational) was inversely correlated with depression. Men who were more satisfied with the social support they received were less likely to show increased depression 1 year later. Degree of satisfaction with informational support appeared especially critical in buffering the stress associated with experiencing HIV symptoms. These findings offer valuable insight in understanding the psychological needs of gay men confronting the AIDS crisis and have important practical implications for designing mental health services to meet those needs.     

Anxiety,depression, and heart disease in women

This is an extension of previous research that has reported on psychosocial risk factors in women participants in the Recurrent Coronary Prevention Project (RCPP). The RCPP women (N = 83) were under 65 years of age, non-diabetic, non-smoking and had experienced a myocardial infarction (MI) at least 6 months prior to the study. Baseline data was available on 80 RCPP subjects. Seventy three non-smoking, coronary disease-free women participants in the Stanford-Sunnyvale Health Improvement Project (SSHIP) served as a control-comparison group. Women with coronary heart disease had higher serum cholesterol than controls. There were no case-control differences in marital status, occupation, or number of children. RCPP women had Videotaped Structured Interview (VSI) Type A scores comparable to those of the SSHIP women, but had significantly higher VSI-hostility scores (p < .01). In addition. the post-MI women were rated more anxious and depressed, and had more avoidance symptoms than controls ( p < .01). Additional analyses involved the 65 RCPP women located at 8.5-year follow-up. In these women, univariate predictors of coronary recurrence (N = 13) were body mass index (kg/m)2. Peel Index, low time urgency (VSI) and high anxiety ( p < .05). Employment status, marital status, and education were not associated with subsequent cardiac events. These exploratory analyses suggest that the relations between heart disease and hostility, anxiety, and depression in women deserve further investigation.     

Depressive symptoms, cynical hostility, and weight change: A 3-year follow-up among middle-aged men and women

In this article we examine, in a 3-year follow-up, whether depressive symptoms and cynical hostility predict weight change. A cardiovascular risk factor survey was carried out for a stratified random sample of a population aged between 45 to 64 years in 1992. A follow-up survey was conducted three years later for 119 male and 166 female participants of the baseline survey. Using similar methodology, body mass index (BMI), depression (Beck depression inventory), cynical hostility (cynical distrust scale), and several health-related factors were measured in both surveys. Higher depression scores at the baseline predicted both weight gain (> 2 BMI units) and weight loss (> 1 BMI unit) during the follow-up. Cynical hostility did not predict weight change. An increase in depression scores predicted weight loss. Women with depressive symptoms in the least educated group lost weight, and women with depressive symptomsin the most educated group gained weight. These results emphasize the assessment of depressive symptoms in a normal population that is interested in losing weight or preventing obesity.     

Major depression and life satisfaction: A population-based twin study

BackgroundThe extent to which positive and negative indicators of mental health share etiological influences has been studied to a limited degree only. This study examines the genetic and environmental influences on association between liability to lifetime DSM-IV Major Depressive Disorder (MDD) and dispositional life satisfaction (LS).MethodsTwo-wave questionnaire data on LS (assessed 6 years apart) and lifetime MDD obtained by structured clinical interviews in a population-based sample of adult twins were analysed using structural equation modelling in Mx.ResultsThe prevalence of lifetime MDD was estimated to be 11.1% and 15.8% in males and females, respectively. Individuals fulfilling the criteria for MDD reported significantly lower levels of LS. The co-variation in MDD and dispositional LS was found to be accounted for by genetic and unique environmental influences only. The phenotypic correlation was estimated to be 0.36, of which genetic influences accounted for 74% and environmental factors the remaining 26%. The correlation between genetic factors for MDD and LS was estimated to be ?0.55 and the correlation between unique environmental factors to be ?0.22. Heritability was estimated to 0.34 and 0.72 for MDD and LS, respectively.LimitationsThe sample consists of twins only and there are limitations associated with the twin design.ConclusionsWhereas genetic influences on vulnerability to lifetime MDD are considerably shared with liability to (low) LS, environmental influences are more distinct. Thus, environmental factors associated with risk of MDD do not strongly impact on dispositional LS, and conversely, environmental factors influencing dispositional LS do not strongly buffer against MDD.     

A nested case-control study on the high-normal blood pressure as a risk factor of hypertension in Korean middle-aged men

The aim of this study was to identify the 'high-normal blood pressure' as a risk factor of hypertension for applying primary prevention strategy in Korean people. To keep time sequence of events, and to prevent information bias, nested case control study was chosen for avoiding measurement errors because hypertension is a benign disease. Source population consisted of the 'Seoul Cohort' participants and follow-up was done by using Korea Medical Insurance Corporation's database on the utilization of health services from January 1, 1993 to June 30, 1997. Incidence cases were ascertained through the chart review, telephone contacts, and direct blood pressure measurements. Controls included the pairing of 4 individuals to each case on the basis of age. The statistically significant risk factors of hypertension were body mass index, dietary fiber, alcohol consumption, weekly activity, and history of quitting smoking as well as high-normal blood pressure (p<0.05). The multivariate odds ratio of high-normal blood pressure adjusted for all risk factors was 1.84 (95% CI, 1.31-2.56). Thus, the 'high-normal blood pressure' is considered as a risk factor for hypertension in Korean middle-aged men, which suggests that the vigorous lifestyle modification for persons with 'high-normal blood pressure' is needed.