Anxiety and depression lowers blood pressure: 22-year follow-up of the population based HUNT study, Norway

<p>Abstract</p> <p>Background</p> <p>For decades, symptoms of anxiety and depression have been included among psychological factors associated with development of hypertension. Although this has been questioned in recent studies, most findings have been based on a single assessment of mental distress at baseline. We examined these associations using repeated assessments of anxiety, depression and blood pressure.</p> <p>Methods</p> <p>Data on 17,410 men and women aged 20 to 67 participating in the Nord-Trøndelag Health Study (HUNT) in Norway in 1984-86 were re-examined 11 and 22 years later. The main outcome was change in mean blood pressure (mm Hg) during follow-up.</p> <p>Results</p> <p>We found that a high symptom level score (≥80^thpercentile) of combined anxiety and depression at baseline, as compared to a lower symptom level, was associated with lower mean systolic (-0.67 mm Hg, p <it>= </it>0.044) and diastolic (-0.25 mm Hg, p <it>= </it>0.201) blood pressure at year 22. A high symptom level present at all three examinations was associated with a stronger decrease in mean systolic (-1.59 mm Hg, p <it>= </it>0.004) and diastolic (-0.78 mm Hg, p <it>= </it>0.019) blood pressure and with a 20% (p = 0.001) lower risk of developing hypertension (BP ≥140/90 mm Hg) at year 22. The associations were only slightly attenuated in multivariate analyses, with no evidence of a mediating effect of alteration in heart rate.</p> <p>Conclusions</p> <p>This study do not support previous hypothesis that emotional stress may be a cause of hypertension. Our findings indicate that symptoms of anxiety and depression are associated with decrease in blood pressure, particularly when a high symptom level can be detected over decades.</p

Being Normal Weight but Feeling Overweight in Adolescence May Affect Weight Development into Young Adulthood—An 11-Year Followup: The HUNT Study, Norway

Objectives. To explore if self-perceived overweight in normal weight adolescents influence their weight development into young adulthood and if so, whether physical activity moderates this association. Methods. A longitudinal study of 1196 normal weight adolescents (13–19 yrs) who were followed up as young adults (24–30 yrs) in the HUNT study. Lifestyle and health issues were assessed employing questionnaires, and standardized anthropometric measurements were taken. Chi square calculations and regression analyses were performed to investigate the associations between self-perceived overweight and change in BMI or waist circumference (WC) adjusted for age, age squared, sex, and other relevant cofactors. Results. Adolescents, defined as being normal weight, but who perceived themselves as overweight had a larger weight gain into young adulthood than adolescents who perceived themselves as normal weight (difference in BMI: 0.66 units [CI95%: 0.1, 1.2] and in WC: 3.46 cm [CI95%: 1.8, 5.1]). Level of physical activity was not found to moderate this association. Conclusions. This study reveals that self-perceived overweight during adolescence may affect development of weight from adolescence into young adulthood. This highlights the importance of also focusing on body image in public health interventions against obesity, favouring a “healthy” body weight taking into account natural differences in body shapes

Estimating the high risk group for cardiovascular disease in the Norwegian HUNT 2 population according to the 2003 European guidelines: modelling study.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldOBJECTIVE: To estimate the high risk group for cardiovascular disease in a well defined Norwegian population according to European guidelines and the systematic coronary risk evaluation system. DESIGN: Modelling study. SETTING: Nord-Tröndelag health study 1995-7 (HUNT 2), Norway. PARTICIPANTS: 5548 participants of the Nord-Tröndelag health study 1995-7, aged 40, 50, 55, 60, and 65. MAIN OUTCOME MEASURES: Distribution of risk categories for cardiovascular disease, with emphasis on the high risk group. MAIN RESULTS: At age 40, 22.5% (95% confidence interval 19.3% to 25.7%) of women and 85.9% (83.2% to 88.6%) of men were at high risk of cardiovascular disease. Corresponding numbers at age 50 were 39.5% (35.9% to 43.1%) and 88.7% (86.3% to 91.0%) and at age 65 were 84.0% (80.6% to 87.4%) and 91.6% (88.6% to 94.1%). At age 40, one out of 10 women and no men would be classified at low risk for cardiovascular disease. CONCLUSION: Implementation of the 2003 European guidelines on prevention of cardiovascular disease in clinical practice would classify most adult Norwegians at high risk for fatal cardiovascular disease

Body mass index and mortality in elderly men and women: the Tromsø and HUNT studies

The impact of body mass index (BMI; kg/m2) and waist circumference (WC) on mortality in elderly individuals is controversial and previous research has largely focused on obesity. With special attention to the lower BMI categories, associations between BMI and both total and cause-specific mortality were explored in 7604 men and 9107 women aged ≥65 years who participated in the Tromsø Study (1994–1995) or the North-Trøndelag Health Study (1995–1997). A Cox proportional hazards model adjusted for age, marital status, education and smoking was used to estimate HRs for mortality in different BMI categories using the BMI range of 25–27.5 as a reference. The impact of each 2.5 kg/m2 difference in BMI on mortality in individuals with BMI<25.0 and BMI≥25.0 was also explored. Furthermore, the relations between WC and mortality were assessed. We identified 7474 deaths during a mean follow-up of 9.3 years. The lowest mortality was found in the BMI range 25–29.9 and 25–32.4 in men and women, respectively. Mortality was increased in all BMI categories below 25 and was moderately increased in obese individuals. U-shaped relationships were also found between WC and total mortality. About 40% of the excess mortality in the lower BMI range in men was explained by mortality from respiratory diseases. BMI below 25 in elderly men and women was associated with increased mortality. A modest increase in mortality was found with increasing BMI among obese men and women. Overweight individuals (BMI 25–29.9) had the lowest mortality

Basic lifestyle advice to individuals at high risk of type 2 diabetes : a 2-year population-based diabetes prevention study. The DE-PLAN intervention in the HUNT Study, Norway

Objective Among individuals at high risk for diabetes identified through a population survey, we performed an intervention study with basic lifestyle advice aiming to prevent diabetes. Research design and methods Among 50 806 participants in the HUNT3 Survey (2006-2008), 5297 individuals with Finnish Diabetes Risc Score (FINDRISC >= 15 were invited to an oral glucose tolerance test (OGTT) and an education session with lifestyle advice, and 2634 (49.7%) attended. Among them, 2380 people without diabetes were included in the prevention study with repeated examinations and education sessions after 6, 12, and 24 months. We examined participation, diabetes incidence, glycemia, and adiposity during follow-up. Results Of 2380 participants, 1212 (50.9%) participated in >= 3 of the four examinations. Diabetes was detected in 3.5%, 3.1%, and 4.0% of individuals at the 6-month, 12-month, and 24-month examinations, respectively, indicating a 10.3% 2-year diabetes incidence. Mean (95% CI) increases from baseline to 2-year follow-up were 0.30 (0.29 to 0.32) percentage points (3.3 (3.2 to 3.5) mmol/mol) for Hemoglobin A 1c, 0.13 (0.10 to 0.16) mmol/L for fasting serum-glucose, 0.46 (0.36 to 0.56) mmol/L for 2-hour OGTT s-glucose, 0.30 (0.19 to 0.40) kg/m(2) forbody mass index (BMI) (all p 5% weight loss during follow-up; their fasting and 2-hour s-glucose did not increase, and HbA 1c increased less than in other participants. Conclusion Basic lifestyle advice given to high-risk individuals during three group sessions with 6-month intervals was not effective in reducing 2-year diabetes risk.Peer reviewe

Kultur og helse i HUNT – En metodeevaluering

Flere studier har indikert at det er sammenheng mellom kulturdeltagelse og helse, men mange av studiene har vesentlige svakheter. Befolkningsstudier med et stort antall deltagere har flere fordeler, bl.a. er det mulig å kontrollere for konfunderende faktorer. Men i slike undersøkelser må antall spørsmål ofte begrenses, og det kan derfor stilles spørsmål ved hvor presis og relevant informasjonen blir. Ved HUNT3 (2006-08) ble to spørsmål om kulturdeltagelse inkludert: «Hvor mange ganger har du i løpet av de siste 6 måneder vært på/i: Museum, kunstutstilling/konsert, teater, kino/kirke, bedehus/idrettsarrangement", og «Hvor mange ganger har du løpet av de siste 6 måneder selv drevet med: Foreningsvirksomhet/musikk, sang, teater/menighetsarbeid/friluftsliv/dans/trening, idrett». Målet med denne studien var å undersøke hvordan spørsmålene ble oppfattet og tolket. Var informasjonen relevant til bruk i en epidemiologisk studie som HUNT? Det ble gjennomført tre fokusgruppeintervjuer med til sammen 17 deltakere i alderen 20 til 80 år. Flertallet hadde høyere utdanning. Tema som gikk igjen ble gruppert i kategorier, som bestod av beskrivelser over informantenes synspunkter og meninger. Hovedinntrykket fra fokusgruppeintervjuene var at informantene mente at spørsmålene i HUNT3 ga et grovt estimat på kulturaktivitetene i befolkningen. Vår konklusjon er at spørsmålene var tilstrekkelig presise til å bruke i analyser på gruppenivå

Jakten på helsefremmende faktorer i epidemiologisk forskning : Eksempler fra Helseundersøkelsen i Nord-Trøndelag (HUNT)

Epidemiologisk forskning har tradisjonelt hatt fokus på å studere utbredelsen av sykdommer, risikofaktorer og årsaksfaktorer, og med forebygging som et hovedmål. Forskning på helsefremming har som hensikt å undersøke hvilke faktorer som er vesentlige for å styrke helsa til enkeltmennesker og befolkninger, og undersøke hvilke ressurser som kjennetegner mennesker og samfunn som utmerker seg med god helse. Kunnskapen fra forsking om helsefremmende faktorer skal brukes til å styrke folks helse og mestringsfølelse, enten de i utgangspunktet er friske eller syke. Det er derfor vesentlige forskjeller på både tenkning og empiri knyttet til helsefremming sammenlignet med forebygging. Helsefremming er i dag blitt en viktig innfallsvinkel til helseutfordringer verden over, og i helsefremmende arbeid er politiske beslutninger og policyarbeid en viktig del av prosessene. Men helsefremmende tenkning har enda ikke fått ordentlig fotfeste innen epidemiologien. Målet med denne artikkelen er å beskrive mulighetene for å finne ny kunnskap om helsefremmende faktorer i norske befolkningsdatabaser, med Helseundersøkelsen i Nord-Trøndelag (HUNT) som et eksempel. I HUNT er det allerede samlet ei rekke helsefremmende faktorer, som fysisk aktivitet, kosthold, sans for humor, sosial kapital, livssyn og deltakelse i kulturaktiviteter, og flere studier er publisert. Opplevelse av sammenheng (sense of coherence) og engasjement er andre viktige helsefremmende faktorer. Sammenhengen mellom musikk og helse har vært kjent lenge, og ei rekke studier har vist både nevrologiske, hormonelle, immunologiske, psykiske og sosiale effekter av musikk. Også for flere av de andre helsefremmende faktorene er det beskrevet biologiske effekter, og to oppfølgingsstudier av sans for humor har vist tydelig effekt på dødelighet. Konklusjonen er at epidemiologiske studier kan være viktige kilder til kunnskap om helsefremmende faktorer, og slike studier kan dermed gi vesentlige bidrag til folkehelsearbeidet. Det aller beste vil være å satse på triangulering av kvalitative (intervju), deskriptive (kvantitativ kartlegging/tverrsnittsstudier) og eksperimentelle (kausale) metoder, alle med fokus på utvikling av kunnskap om en bestemt faktor basert på data fra en og samme populasjon.publishedVersio

May telephone surveys provide reliable public health surveillance data for municipalities? Mode effects differ between categories of questions. The HUNT Study, Norway

Background: Availability of data on health and its determinants at the local area level is a prerequisite for developing interventions and public health campaigns locally. Collecting self-reported data by means of telephone interviews may rapidly provide relevant data. The reliability of such data may be questioned. In this study, we sought to compare exact similar questions addressed by a recent telephone survey with a previous large scale and very comprehensive population health survey (The Nord-Trøndelag Health Study 2006-08 – HUNT3), conducted a few years earlier in the same geographical region. This was done in order to examine the reliability of telephone interviews as a method to provide data on health and determinants to enable municipal authorities to get a sufficient overview. Methods: One rural and one urban municipality covered by HUNT3 using paper questionnaires were resurveyed through computer assisted telephone interviews. The weighted results for 34 dichotomized variables were compared using chi square tests. Results: The comparison of results between the rural and the urban samples and HUNT3 involved 68 chi square tests, 25 of which (38%) displayed significant differences. The ability of the telephone survey to replicate the results from HUNT3 was only moderate, but with differences between survey themes. Comparability was poor for adverse life events and mental health factors, fair for behavioural and risk factors, and skewed for general health and life satisfaction. The replication was good for reports on the less sensitive and subjective theme of cultural participation. Conclusion: The comparability of the data differed between themes. The differences may be ascribed to mode effects and to some extent the time lag between the surveys. Because replicability on issues that may be more embarrassing or stressful to recall appears to be poorer, and the more subjective self-assessments of health and well-being appear skewed, it is reasonable to conclude that there is an interviewer effect in the telephone survey. The use of a questionnaire through mail or web to monitor public health in municipalities should be considered as an alternative