Total sitting time and risk of myocardial infarction, coronary heart disease and all-cause mortality in a prospective cohort of Danish adults

BACKGROUND: Evidence suggests that sitting time is adversely associated with health risks. However, previous epidemiological studies have mainly addressed mortality whereas little is known of the risk of coronary heart disease. This study aimed to investigate total sitting time and risk of myocardial infarction, coronary heart disease incidence and all-cause mortality. METHODS: In the Danish Health Examination Survey (DANHES) conducted in 2007-2008 we tested the hypothesis that a higher amount of daily total sitting time is associated with greater risk of myocardial infarction, coronary heart disease and all-cause mortality. The study population consisted of 71,363 men and women aged 18-99 years without coronary heart disease. Participants were followed for myocardial infarction, coronary heart disease and mortality in national registers to August 10, 2012. Cox regression analyses were performed with adjustment for potential confounders and multiple imputation for missing values. RESULTS: During a mean follow-up period of 5.4 years 358 incident cases of myocardial infarction, 1,446 of coronary heart disease, and 1,074 deaths from all causes were registered. The hazard ratios associated with 10 or more hours of daily sitting compared to less than 6 hours were 1.38 (95% CI: 1.01, 1.88) for myocardial infarction, 1.07 (95% CI: 0.91, 1.27) for coronary heart disease and 1.31 (95% CI: 1.09, 1.57). Compared to sitting less than 6 hours per day and being physically active in leisure time, the hazard ratios of sitting more than 10 hours per day and also being physically inactive in leisure time were 1.80 (95% CI: 1.15, 2.82) for myocardial infarction, 1.42 (95% CI: 1.11, 1.81) for coronary heart disease, and 2.29 (95% CI: 1.82, 2.89) for all-cause mortality. CONCLUSIONS: The results suggest that a higher amount of daily total sitting time is associated with all-cause mortality, particularly among inactive adults. In relation to coronary heart, disease results were less clear. This paper adds new evidence to the limited data on the evidence of sitting time and cardiovascular disease and mortality

Number of hospital contacts with alcohol problems predicts later risk of alcoholic liver cirrhosis.

AIMS: Alcoholic liver cirrhosis is usually preceded by years of heavy drinking. We investigated whether the risk of alcoholic liver cirrhosis increases as the number of hospital contacts with alcohol problems goes up. METHODS: This was a supplementary analysis on a nationwide register-based cohort study. All patients in Denmark with an initial hospital contact with alcohol problems (alcohol intoxication, harmful alcohol use or alcohol dependence) 1998-2002, free of liver disease, were followed for diagnosis of alcoholic liver cirrhosis. The number of subsequent hospital contacts with alcohol problems was estimated as a time-dependent variable for each patient. RESULTS: In all, 36,044 hospital patients with an initial hospital contact with alcohol problems were included. These patients had 301,525 subsequent hospital contacts with alcohol problems. Risk of alcoholic liver cirrhosis increased ( p < 0.0001) with number of alcohol hospital contacts in both men and women for up to nine contacts. CONCLUSIONS: The number of prior hospital contacts with alcohol problems might provide clinicians with a helpful metric in deciding whether to offer preventive interventions for alcoholic liver cirrhosis

Long-Term Cardiovascular Health After Pregnancy in Danish Women With Congenital Heart Disease. A Register-Based Cohort Study Between 1993 and 2016

Background Little is known about the impact of pregnancy on long‐term cardiovascular health in individuals with congenital heart disease (CHD). We aimed to determine if giving birth in patients with CHD is associated with higher risk of long‐term cardiovascular morbidity. Methods and Results We studied a cohort of 1262 individuals with CHD giving birth (live or still) from 1993 to 2015 using Danish nationwide registers. We randomly sampled a comparison cohort matched on age of women with CHD who had not given birth at the time. We balanced the 2 cohorts on baseline demographic (eg, education) and clinical variables (eg, CHD severity) using inverse probability of treatment weighting. Individuals were followed for critical (eg, heart failure), other cardiovascular morbidity (eg, arrhythmia), and cardiac surgery/interventions after pregnancy. Individuals were followed for median 6.0 years (interquartile range 3.2–9.2). Among individuals giving birth the incidence rate per 1000 person‐years was 1.6, 10.0, and 6.0 for critical and other cardiovascular morbidity and cardiac surgery, respectively. There was no overall difference in risk of neither critical and other cardiovascular morbidity nor cardiac surgery among individuals who gave birth and individuals who did not; adjusted hazard ratios (aHR) were 0.74 (95% CI, 0.37–1.48), 0.88 (95% CI, 0.65–1.19), and 0.78 (95% C,I 0.54–1.12), respectively. However, individuals with obstetric complications had a higher long‐term risk of other cardiovascular morbidity (aHR, 1.85; 95% CI, 1.07–3.20). Conclusions Giving birth seemed not to be associated with a higher risk of long‐term cardiovascular morbidity among women with CHD. However, individuals having obstetric complications had a higher risk of other cardiovascular morbidity in the long term

Hospital contacts with alcohol problems prior to liver cirrhosis or pancreatitis diagnosis.

AIM: To evaluate prior hospital contacts with alcohol problems in patients with alcoholic liver cirrhosis and pancreatitis. METHODS: This was a register-based study of all patients diagnosed with alcoholic liver cirrhosis or pancreatitis during 2008-2012 in Denmark. Hospital contacts with alcohol problems (intoxication, harmful use, or dependence) in the 10-year period preceding the diagnosis of alcoholic liver cirrhosis and pancreatitis were identified. RESULTS: In the 10 years prior to diagnosis, 40% of the 7719 alcoholic liver cirrhosis patients and 40% of the 1811 alcoholic pancreatitis patients had at least one prior hospital contact with alcohol problems. Every sixth patient (15%-16%) had more than five contacts. A similar pattern of prior hospital contacts was observed for alcoholic liver cirrhosis and pancreatitis. Around 30% were diagnosed with alcohol dependence and 10% with less severe alcohol diagnoses. For the majority, admission to somatic wards was the most common type of hospital care with alcohol problems. Most had their first contact with alcohol problems more than five years prior to diagnosis. CONCLUSION: There may be opportunities to reach some of the patients who later develop alcoholic liver cirrhosis or pancreatitis with preventive interventions in the hospital setting

Time trends in incidence and prevalence of chronic pancreatitis:A 25-year population-based nationwide study

BACKGROUND: Updated population‐based estimates on incidence and prevalence of chronic pancreatitis are scarce. METHODS: We used nationwide healthcare registries to identify all Danish patients diagnosed with chronic pancreatitis and computed crude and standardised incidence rates and prevalence estimates in 1994–2018. Incidence and prevalence were evaluated in relation to patients age and gender, aetiology (alcoholic vs. non‐alcoholic) and smoking and alcohol consumption in the general Danish population. RESULTS: The mean incidence rate of chronic pancreatitis during the study period was 12.6 per 100,000 person years for the total population, for women it was 8.6 per 100,000 person years and for men it was 16.7 per 100,000 person years. The standardised incidence rate was stable from 1994 to 2018, remaining at 12.5 per 100,000 person years in the last observation period (2014–2018). The point prevalence of chronic pancreatitis in 2016 was 153.9 per 100,000 persons. A gradual increase in standardised prevalence estimates was observed during the study period from 126.6 in 1996 to 153.9 in 2016. The mean age at chronic pancreatitis diagnosis increased from 52.1 to 60.0 years during the study period. CONCLUSION: The prevalence of chronic pancreatitis is increasing in the Danish population despite a stable incidence level. Improved management strategies and changes in the underlying patient population may explain these observations