Heterogeneity of cardiovascular risk among smokers is related to degree of carbon monoxide exposure.

Background: Between smokers matched for daily tobacco consumption there are marked variations of the cardiovascular risk. This follow up of the population based cohort “Men born in 1914” from Malmö, Sweden, explored whether this is accounted for by the levels of carbon monoxide (CO). Methods: Three hundred and sixty-five men without history of cardiovascular disease (CVD) were followed over 27 years. Leg artery disease was defined as a systolic ankle–arm pressure ratio (ABPI) below 0.9 in either leg. Incidence of myocardial infarction (MI), stroke and deaths is based on linkage with regional and national registers. The distribution of CO in blood and expired air, respectively, was divided into quartiles. Results: There was a significant inverse relation between ABPI and CO in blood and expired air. Incidence of CVD events and deaths increased progressively with degree of CO exposure. Men with CO in the top quartile had significantly increased risks of CVD events (RR: 2.2; 95% CI: 1.00–4.6) and cardiovascular deaths (RR: 3.2, CI: 1.2–8.3), adjusted for daily tobacco consumption and other potential confounders. Conclusions: In smokers, the prevalence of leg atherosclerosis and incidence of cardiovascular disease is related to the amount of carbon monoxide in blood or expired air

Prognosis in elderly men with screening-detected abdominal aortic aneurysm

OBJECTIVES: To study the natural course of screening-detected symptomless abdominal aortic aneurysm (AAA) in elderly men. SETTING: Malmo, a city in southern Sweden with 230,000 inhabitants and a single referral hospital. MATERIALS: 423 seventy-four-year-old men, randomly selected from the population and belonging to the prospective population study "Men born in 1914", were invited. 343 underwent AAA screening, whereas 80 declined or had moved. CHIEF OUTCOME MEASURES: Five year all cause mortality in relation to participation in and findings at ultrasound screening for AAA. MAIN RESULTS: An abdominal aortic aneurysm was present in 38 (11%) out of 340 men who underwent screening and who had a native aorta. During 5 years of follow-up, one third (13/38) of these men died; 7 from myocardial infarction and 3 from stroke. The mortality rate in men with AAA was 80.2/1000 person years; twice as high as it was in men without AAA (39.4/1000 person years; p = 0.018). Six men underwent AAA surgery. None of them died from aneurysm rupture. However, aneurysm surgery did not reduce the total mortality rate in these men. The highest mortality rate, 91.9/1000 person years, was found in the men who did not participate in the screening. CONCLUSIONS: It is our conclusion that screening for early detection and intervention is of questionable value from a public health perspective

Gårdar anses för små – men gör stor nytta

De små gårdarna är allvarligt hotade och därmed också mosaiklandskapet och den gastronomiska mångfalden. Det skriver flera debattörer