Helgi Sigvaldason

Objective: We estimated the prevalence and incidence of left ventricular hypertrophy (LVH) in this large prospective cohort study of almost 20,000 participants and identified risk factors in them. Predictive factors of its appearance were evaluated along with morbidity and mortality calculations. Material and methods: LVH was defined as Minnesota Code 310 on ECG. Everyone with this code at first visit was defined as a prevalence case and those who developed it between subsequent visits were incidence cases. Risk factors at the time of the diagnosis of LVH were determined with logistic regression. Predictive factors for acquiring this ECG abnormality were determined by Poisson regression. The comparison cohort were all other participants in the Reykjavík Study stages I-V. Results: Two hundred ninety-seven men and 49 women were found to have LVH or 3.2% and 0.5%, respectively. The incidence was 25/1000/year among men and 6/1000/ year among women. Prevalence in both genders increased with increasing age. Risk factors at the time of diagnosis were systolic blood pressure (odds ratio pr. mmHg (OR) 1.02; 95% confidence interval (CI): 1.01-1.03), age (OR pr. year: 1.04; 95% CI: 1.02-1.05), silent myocardial infarction (MI) (OR: 3.18; 95% CI: 1.39-7.27) and ST-T changes (OR: 3.06; 95% CI: 2.14-4.38) among men and systolic blood pressure and age for women with similar odds ratio. Predictive factors for acquiring LVH were systolic blood pressure (incidence ratio (IR): 1.01; 95% CI: 1.01-1.02) and angina with ECG changes (IR: 2.33; 95% CI: 1.08-5.02) among men and systolic blood pressure among women (IR: 1.03; 95% CI: 1.01-1.04). In men severe smoking seemed to have a protective effect against developing LVH (IR: 0.36; 95% CI: 0.18-0.71). The risk for coronary mortality was significantly increased among women with hypertrophy (hazard ratio (HR): 3.07; 95% CI: 1.5-6.31) and their total survival was poorer with increasing time from diagnosis of LVH (HR: 2.17; 95% CI: 1.36-3.48). Conclusions: We conclude that the presence of LVH and its appearance is associated with age and increased blood pressure among both genders. Women with LVH have poorer survival than other women and they are at threefold risk of dying of ischemic heart disease. This could indicate that criteria for detecting LVH on ECG detect both mild and severe hypertrophy among men but only the severe hypertrophy cases among women. More sensitive ECG methods may have to be used to detect mild, moderate and severe LVH among both genders in order to differentiate the severity of LVH based on the ECG diagnosis.

This study is based on the Reykjavik Study, a long-term prospective cardiovascular survey, which included a representative population of 9135 men and 9627 women, 33-79 years old, who were invited to participate during the years 1967-91. Right bundle branch block (RBBB) was found in 126 men and 67 women. The prevalence increased with age, from 0% among men and women 30-39 years of age to 4.1% and 1.6% in men and women, respectively, who where 75-79 years old. The incidence increased with age. In men younger than 60 years RBBB had a significant relationship with hypertension (P < 0.05), elevated fasting blood glucose (P = 0.05), and increased heart size (P < 0.05). In men with RBBB regardless of age, an association was found with cardiomegaly (P < 0.05), ischaemic heart disease (P < 0.05), arrhythmias (P < 0.001) and bradycardia (P < 0.01). A higher mortality from heart disease (P < 0.01) was found in men with RBBB compared to the control population. This was not significant when risk factors of heart disease were taken into account by multivariate Cox analysis. There was a relationship (P < 0.05) between hypertension and RBBB in women younger than 60 years. RBBB in women younger than 60 years is often associated with hypertension and in men younger than 60 it is often associated with an underlying cardiovascular disease, hypertension, cardiomegaly and elevated blood glucose.

Studies on coronary risk factors in men and women are mainly based on mortality data and few compare results of both sexes with consistent study design and diagnostic criteria. This study assesses the major risk factors for coronary events in men and women from the Reykjavik Study. Within a prospective, population-based cohort study individuals without history of myocardial infarction were identified and the relative risk of baseline variables was assessed in relation to verified myocardial infarction or coronary death during follow-up. Of the 9681 women and 8888 men who attended risk assessment from 1967-1991, with follow-up period of up to 28 years, 706 women and 1700 men suffered a non-fatal myocardial infarction or coronary death. Serum cholesterol was a significant risk factor for both sexes, with hazard ratios (HR) decreasing with age. Systolic blood pressure was a stronger risk factor for women as was ECG-confirmed left ventricular hypertrophy (women HR 2.89, 95% confidence interval [CI] 1.67-5.01; men HR 1.11 [CI 0.86-1.43]). Fasting blood glucose > or =6.7 mmol/L identified significantly higher risk for women (HR 2.65) than men (HR 2.08) as did self-reported diabetes. Triglyceride risk was significantly higher for women and decreased significantly with age. Smoking increased risk two- to five-fold, increasing with dose, for women, which was significantly higher than the doubling in risk for men. This large study of the major risk factors compared between the sexes demonstrates similar relative risk of myocardial infarction associated with cholesterol for both sexes, however, the relative risk is higher in women for many other risk factors such as smoking, diabetes, elevated triglycerides and left ventricular hypertrophy.

Evidence about the influence of hypertension in pregnancy on later health and in particular the risk of cardiovascular disorders is conflicting, although a link has been suggested. In a population-based study with a long follow-up time the potential association between hypertension in pregnancy, preeclampsia and eclampsia with increased death rates from ischemic heart disease (IHD) was investigated. All 7543 case records at the main maternity hospital in Iceland during 1931-1947 were reviewed to identify women with hypertension in pregnancy, subdivided by parity and severity of disease into those with eclampsia, preeclampsia and hypertension alone. Information on those who had died was obtained from death certificates, supplemented by autopsy reports and hospital records. Death rates from IHD were compared to population data from public health and census reports during corresponding periods and between study groups. Of 374 hypertensive women 177 had died. The death rate was slightly higher among women with any hypertension in pregnancy than in the reference population (RR = 1.20; 95% CI 1.01-1.42). About half of the increase was attributed to excess mortality from IHD with a relative risk of dying of 1.47 (95% CI 1.05-2.02). The relative risk of dying from IHD was significantly higher among eclamptic women (RR = 2.61; 95% CI 1.11-6.12) and those with preeclampsia (RR = 1.90; 95% CI 1.02-3.52) than those with hypertension alone. Parous women at the index pregnancy had a twofold higher risk of dying from IHD than primigravid women (RR = 2.05; 95% CI 1.19-3.55; p = 0.01). There is an indication of increased death rates among women with a history of hypertension in pregnancy, where ischemic heart disease may be more common than in the general population.

The prevalence of coronary heart disease (CHD) was determined in a general population sample of 9141 Icelandic men aged 34-79 years, and the prevalence of four different forms of CHD was estimated separately: symptomatic infarction fulfilling WHO-MONICA criteria for definite myocardial infarction; myocardial infarction detected by ECG changes only (unrecognized, silent infarction); angina pectoris detected by the Rose questionnaire and associated with ECG manifestations of myocardial ischaemia, either at rest or during exercise, but no manifestations of myocardial infarction; angina pectoris without ECG changes indicative of myocardial ischaemia. The study was conducted in five stages allowing evaluation of trends from 1968-1986. Age was a major determinant of the prevalence of all forms of CHD. Thus, the prevalence of myocardial infarction (symptomatic or silent) rose from undetectable levels in the youngest age group (30-34 years) to around 12% (7% symptomatic and 5% silent) in the oldest group (75-79 years) and the prevalence of all forms of CHD rose from 4% in the youngest age group to 23% in the age group 70-74 years. Age-standardized comparison was carried out on the prevalence of the different forms of CHD at different stages of the study in 50-64-year-old men who were represented in all stages of the study. There was a gradual increase in the prevalence of myocardial infarction from 3% (symptomatic and silent combined, CI 1.9-4.8) in 1968 to 4.9% in 1986 (CI 3.9-6.1) (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Prediction of the future number of cancer cases is of great interest to society. The classical approach is to use the age‐period‐cohort model for making cancer incidence predictions. We made an empirical comparison of different versions of this model, using data from cancer registries in the Nordic countries for the period 1958–1997. We have applied 15 different methods to 20 sites for each sex in Denmark, Finland, Norway and Sweden. Median absolute value of the relative difference between observed and predicted numbers of cases for these 160 combinations of site, sex and country was calculated. The medians varied between 10.4 per cent and 15.3 per cent in predictions 10 years ahead, and between 15.1 per cent and 32.0 per cent for 20 year predictions. We have four main conclusions: (i) projecting current trends worked better than assuming that future rates are equal to present rates; (ii) the method based on the multiplicative APC model often overestimated the number of cancer cases due to its exponential growth over time, but using a power function to level off this growth improved the predictions; (iii) projecting only half of the trend after the first 10 years also gave better long‐term predictions; (iv) methods that emphasize trends in the last decade seem to perform better than those that include earlier time trends. Copyright © 2003 John Wiley & Sons, Ltd.

1Rannsóknarstöð Hjarta-verndar, Holtasmára 1, 201 Kópavogi, 2Innkirtla-og efnaskiptasjúkdómadeild Landspítala Fossvogi, 108 Reykjavík. Fyrirspurnir og bréfaskipti: Nikulás Sigfússon, Rannsókn-arstöð Hjartaverndar, Holta-smára 1, 201 Kópavogi. Sími: 535 1800, ...

... bréfaskipti: Jonas Hailgrímsson, pósthólf 1465, 121 Reykjavik. ... Krabbameinsskrá Krabbameinsfélags Islands geymir upplysingar um 1437 karla og 766 konur sem greindust meõ illkynja aexli f maga á tímabilinu 1955-1984 (tafia I). Vefjafraõilegar greiningar eru til fyrir 1170 ...

In 1982 a multifactorial population health survey of people aged 80 years and older and living in the community, was carried out. The mortality registry was examined up to the end of year 1988. By this time 67% had died and the mortality was assessed by Cox's regression analysis on serum cholesterol as one of the main variables included in the survey. The original sample contained 170 persons and 148 were alive at the time of examination. Participation rate of sample is 72%. By end of 1988, 35 persons were alive and 71 dead. Excluded were 22 dead before entry. Serum cholesterol was found to be negatively predictive of mortality in both univariate (p < 0.01) and multivariate analysis when triglycerides, age and smoking were also included (p < 0.01). There was a 0.9% decrease in relative risk for each mg/dl increase of serum cholesterol. Ten persons had serum cholesterol of 160 mg/dl or less and they all died within 10 years from the examination, one of disseminated carcinom...

Background: Nosocomial infections are common in intensive care units (ICU). The objectives of this study were to determine risk factors of ICU‐acquired infections, and potential mortality attributable to such infections.Methods: An observational study was performed in a 10‐bed multidisciplinary ICU. For a period of 27 months, all patients admitted for ≥48 h were included. Infections were diagnosed according to Centers for Disease Control and Prevention definitions. Airway colonization was explored by molecular typing. Risk factors for infection were determined by multivariable logistic regression. Survival was analyzed with time‐varying proportional hazards regression.Results: Of 278 patients, 81 (29%) were infected: urinary tract infections in 39 patients (14%), primary bloodstream infections in 25 (9%), surgical site infections in 22 (8%) and pneumonia in 21 (8%). Of the total of 147 episodes, Gram‐negative bacilli were isolated in 90, Gram‐positive cocci in 49 and Candida sp. in ...

Inngangur Undanfarna áratugi hafa hjartasjúkdómar verið al-gengasta dánarorsök Íslendinga. Þannig má sjá í ... 1Rannsóknarstöð Hjarta-verndar, 2Landspítali Fossvogi. Fyrirspurnir, bréfaskipti: Nikulás Sigfússon, Rannsóknarstöð Hjarta-verndar, Lágmúla 9, ...

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenThe objective was to investigate the changes in incidence and mortality from malignant diseases over the period from 1955 to 1989 in Iceland. The results are presented as number of cases and incidence rates in five age groups and seven time periods, males and females. The same is presented for mortality. There was an increase in incidence rates in all age groups except the youngest (0-19 years). Overall there was a decrease in mortality rate, ten per cent for females and five per cent for males. In the youngest age group this decrease in mortality was more than fifty per cent for both sexes.Í þessari grein er lýst breytingum á nýgengihlutfalli og dánartíðni illkynja sjúkdóma á Íslandi 1955-1989. Niðurstöðurnar eru sýndar sem nýgengihlutfall í fimm aldurshópum og sjö fimm ára tímabilum fyrir karla og konur. Sömu upplýsingar eru um dánartíðni. Nýgengihlutfall hækkaði í öllum aldurshópum nema þeim yngstu (10-19 ára). Dánartíðni lækkaði um 10% hjá konum og um 5% hjá körlum. í yngsta aldurshópnum var lækkun á dánartíðni meira en 50% hjá báðum kynjum

L/EKNABLADID 1991; 77: 49-58. 49 Nikulás Sigfússon 1), Helgi Sigvaldason 1), Inga Ingibjörg Guomundsdóttir 1), Ingibjörg Stefánsdóttir 1), Laufey Steingrímsdóttir 2), Porsteinn Porsteinsson 1) Gunnar Sigurösson 3) BREYTINGAR Á TÍONS KRÂNS/EDASTÍFLU OG KRÂNS/ ...

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenThe prospective Reykjavik study gave an opportunity to monitor secular trends from 1968-1986 of clinical intermittent claudication amongst Icelandic males, age 34-80 (n=9.141), and to assess the importance of possible risk factors. Both prevalence and incidence of intermittent claudication decreased sharply after 1970 in all age groups, and this decline (more than 50%) occurred a few years earlier than the decline of coronary heart disease in Iceland. The only significant risk factors for intermittent claudication, in addition to age, were smoking which increased the risk 8-10-fold and serum cholesterol level. This decline in prevalence and incidence of intermittent claudication can largely be explained by decreased smoking and cholesterol levels amongst Icelandic' men. A follow-up study verified that patients with intermittent claudication stood twice the risk of cardiovascular and total mortality as non-intermittent claudication patients, indicating that this is a high risk group which should receive all possible preventive measures.Í hóprannsókn Hjartaverndar mætti 9141 karl á aldrinum 34-80 ára einu sinni eða oftar 1968-1986. Gögn sem þar hefur verið aflað um blóðþurrðarhelti gefa gott tækifæri til að kanna algengi og nýgengi sjúkdómsins og tengsl við áhættuþætti. Lækkun algengis frá 1968-1986 var 55%. Meðal sjötugra karlmanna lækkaði algengið úr 6,7% í 3,1% og meðal sextugra karla úr 3,2% í 1,4%. Algengið óx mjög hratt frá fimmtugsaldri fram undir sjötugt en þá dró úr aukningunni. Nýgengið lækkaði enn meira á tímabilinu (66%). Af samtímaþáttum var marktæk fylgni við aldur, ártal, reykingar, kólesteról, slagbilsþrýsting og hlébilsþrýsting. En aðeins aldur, reykingar og kólesteról höfðu marktækt forspárgildi um blóðþurrðarhelti á rannsóknartímabilinu. Áhættan á blóðþurrðarhelti var átt- til tíföld meðal þeirra sem reyktu 15 sígarettur eða meira á dag. Aldur, reykingar, slagbilsþrýstingur og kólesteról í blóði höfðu sterkari fylgni við blóðþurrðarhelti en kransæðasjúkdóma. Hlutfallslega fleiri voru með blóðþurrðarhelti eftir því sem kransæðasjúkdómurinn varð verri. Blóðþurrðarhelti hafði marktækt forspárgildi um heildardánartíðni og dánartíðni af völdum kransæðasjúkdóma og heilablóðfalls eftir að búið var að leiðrétta fyrir mörgum þekktum áhættuþáttum. Minnkandi reykingar og lækkandi meðalgildi kólesteróls í blóði skýra mestan hluta þeirrar lækkunar sem varð á algengi og um helminginn af lækkuðu nýgengi

The records of a cohort of 11,580 females and 11,366 males participating in an Icelandic cardiovascular risk factor study were linked with the Icelandic Cancer Registry, identifying 1,785 males and 1,490 females who had been registered with neoplastic diseases from 1968 to 1995. The interval between the time of measurement of the variables and the diagnosis of the malignancy ranged from 4 to 27 years. The variables consisted of answers from a questionnaire on smoking and the use of hypertensive drugs and anthropometric and biochemical measurements. Cox's regression was applied to analyze the predictive power of the variables on the risk of cancer after the first examination at the Heart Preventive Clinic, Reykjavík. Univariate analyses, adjusted for age, were performed for each variable and each major site. Within each major site, multivariate regression analysis was applied for variables that were found significantly (10% level in univariate analysis) positive or negative as ri...

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)In 161 patients who received conventional external radiation treatment, during 1920-1950, before age 15 for benign conditions of the head, neck, and upper thoracic area, the later development of cancer was investigated. Twenty one patients were diagnosed with cancer during the period 1955 to 1987. The estimated relative risk for the whole group was 1.3 (95 percent confidence interval, 0.8-2.0). Increased risk was apparent only for CNS tumours (relative risk 10.0, n=4). In three out of four patients the histological diagnosis was meningioma.Skjaldkirtilskrabbamein hefur nokkra sérstöðu á Íslandi vegna þess hversu algengur sjúkdómurinn er hér á landi. Í nýútkominni bók um nýgengi krabbameina sést að nýgengi þessa sjúkdóms er hæst á Íslandi af Evrópulöndunum og með því hæsta sem gerist í heiminum (1). Um orsakir skjaldkirtilskrabbameins er lítið vitað en þeir þættir sem best eru þekktir eru jónandi geislun, erfðir, saga um góðkynja sjúkdóma í skjaldkirtli og joðmagn í fæðu (2). Þessi athugun beinist að því að athuga hvort geislameðferð vegna góðkynja sjúkdóma meðal barna á fyrri hluta þessarar aldar geti skýrt háa tíðni skjaldkirtilskrabbameins á Íslandi

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenIn the third stage of the »Health survey in the Reykjavik area« 1974-'76 resting heart rate was recorded under standardized conditions in 5565 males aged 41-68 years, a representative sample of men in that age range living in the Reykjavik area. The correlation to other known risk factors was estimated by the T-test and stepwise multiple regression. The independent effect of heart rate as a risk factor for cardiovascular and some other diseases was estimated using Cox's proportional hazard model. Heart rate was positively correlated to body mass index, skinfold thickness, serum total cholesterol, serum triglycerides, fasting blood glucose, hemoglobine, hematocrit and ESR but most strongly to systolic and diastolic blood pressure. In this study resting heart rate was found to be an independent and significant risk factor for total mortality in the whole cohort, an increase in mean heart rate by one beat a minute increasing the risk by about 1%. In cigarette-smokers heart rate was also a strong risk factor for coronary heart disease death (CHD), an increase in mean heart rate increasing the risk by about 2%. In ex-smokers and non-smokers heart rate was not a risk factor for CHD. Heart rate was not a significant risk factor for cerebrovascular disease irrespective of smoking habits.Mæling á hjartsláttartíðni er ein algengasta athugun, sem gerð er við klíníska skoðun. Mikilvægi þessa þáttar í mati á heilsufari er að vissu leyti þekkt, sérstaklega þegar ýmsir sjúkdómar raska líkamsstarfsemi, til dæmis efnaskiptasjúkdómar, blóðsjúkdómar, sýkingar og hjarta- og lungnasjúkdómar. Um áhrif og forspárgildi hjartsláttartíðni á heilsufar, þegar til lengri tíma er litið, er hins vegar minna vitað. Þó hafa verið gerðar ýmsar rannsóknir erlendis á undanförnum árum sem beinast að þessu (1-3). Í þessum rannsóknum hefur jafnframt verið kannað samband hjartsláttartíðni við þekkta áhættuþætti hjarta- og æðasjúkdóma. Í rannsókn Hjartaverndar eru stórir hópar sem fylgt hefur verið lengi eftir, og gefur því rannsóknin tækifæri til að kanna þessa þætti. Í þeirri athugun sem hér er kynnt, á rúmlega fimm þúsund íslenskum körlum, er kannað samband hjartsláttartíðni við áhættuþætti hjarta- og æðasjúkdóma í mismunandi hópum eftir reykingavenjum og samband hjartsláttartíðni við dánarorsakir

Objective: The connection between socioeconomic status and mortality is well known in Western countries. Educational level has frequently been used as a socioeconomic indicator. In a recent Icelandic prospective study, an inverse relationship between educational level and mortality was shown. The objective of the present study is to consider possible explanatory factors. Material and methods: This study was a part of the Reykjavík Study. A stratified sample of 400 people was taken from one of six study groups. The sample was equally divided between the sexes and four educational levels. Mean age of the sample was 72.7 years. Participants completed a questionnaire concerning knowledge of risk factors for coronary heart disease, expected response to symptoms of cardiac infarction, social network and use of health care. Response rate was 78.5%. The relationship between answers and educational level was assessed with logistic regression. Results: People with higher education were more l...

Markmið: Tilgangur þessarar rannsoknar var að kanna ýmsa meinafraeðilega þaetti krabbameins i ristli a 35 ara timabili með tilliti til ahrifa þeirra a lifun sjuklinga. Efni og aðferðir: Oll vefjasýni ur sjuklingum sem greindust með ristilkrabbamein a Islandi a arunum 1955-1989 voru endurskoðuð og metin með tilliti til eftirfarandi meinafraeðilegra þatta: staerð aexlis, utlit, vefjagerð, graða, Dukes-flokkun, sogaeðaog eða bloðaeðaiferð, aexli með tilliti til hliðarbrunar skurðsýnis, Jass-flokkar, eitilfrumuiferð i umhverfi aexlis, hvort aexli var innan ristilveggjar eða vaxið ut fyrir hann, meinvorp i eitla, vaxtarhattur aexlisjaðars og slimaexlisutlit. Auk þessa var eftirfarandi athugað: aldur við greiningu, kyn, greiningarar og staðsetning aexlis innan ristils. Allir þessir þaettir voru metnir með tilliti til lifunar sjuklinga. Niðurstoður: Alls greindust 1265 einstaklingar a rannsoknartimabilinu með ristilkrabbamein samkvaemt Krabbameinsskra Krabbameinsfelags Islands, en eftir en...

. A retrospective study was carried out on the incidence of thyroid cancer in Iceland from 1955 to 1984. During this 30-year period 406 cases of thyroid cancer were registered. The incidence of 9.5 for females and 3.4 for males per 100 000 per year is at least twice as high as in the other Nordic countries and among the highest incidence figures reported anywhere. A considerable increase in the reported incidence of thyroid cancer was noted around 1965. The mean size of the cancer nodules at diagnosis decreased at the same time and survival rates of patients improved. The incidence decreased again during the last 5 years of the study period. Mortality rates remained similar during this 30-year period. The survival rate corrected for intercurrent death was similar for both papillary and follicular carcinomas. All patients with anaplastic carcinomas died within one year of diagnosis. Cox's regression analysis with multiple covariates revealed that age at diagnosis, anaplastic and medullary history type as compared with papillary type, pathological evaluation of tumour extent, and calendar period of diagnosis had significant prognostic power. Sex and follicular vs papillary histology type were not significant prognostic factors.

In a previous prospective study we showed elevated risks for breast cancer in nulliparous women compared to parous women, in those having their first pregnancy at a higher age, and those with few children. This was based on 216 women diagnosed with breast cancer during 1965 to 1975 among 34,525 women having attended the cervix cancer detection clinic in Iceland by the end of 1974, and born between 1906 and 1945. The present investigation on 848 cases, diagnosed among 61,040 women attending the cervix cancer detection clinic during 1964 to 1984 and born between 1901 and 1960, shows the same risk factors to be significant. The relative risks are, however, smaller. The reasons for the difference in relative risks are discussed. We find that the effect of age at first birth is significant for women up to the age of 65 and not for older women. In both cohorts, women older than 55 are underrepresented and more so in the earlier report. In addition, the small number of cases in the reference group with age at first birth below 20 appears to have made the figures of our earlier report unreliable.

Evidence about the influence of hypertension in pregnancy on later health and in particular the risk of cardiovascular disorders is conflicting, although a link has been suggested. In a population-based study with a long follow-up time the potential association between hypertension in pregnancy, preeclampsia and eclampsia with increased death rates from ischemic heart disease (IHD) was investigated. All 7543 case records at the main maternity hospital in Iceland during 1931-1947 were reviewed to identify women with hypertension in pregnancy, subdivided by parity and severity of disease into those with eclampsia, preeclampsia and hypertension alone. Information on those who had died was obtained from death certificates, supplemented by autopsy reports and hospital records. Death rates from IHD were compared to population data from public health and census reports during corresponding periods and between study groups. Of 374 hypertensive women 177 had died. The death rate was slightly higher among women with any hypertension in pregnancy than in the reference population (RR = 1.20; 95% CI 1.01-1.42). About half of the increase was attributed to excess mortality from IHD with a relative risk of dying of 1.47 (95% CI 1.05-2.02). The relative risk of dying from IHD was significantly higher among eclamptic women (RR = 2.61; 95% CI 1.11-6.12) and those with preeclampsia (RR = 1.90; 95% CI 1.02-3.52) than those with hypertension alone. Parous women at the index pregnancy had a twofold higher risk of dying from IHD than primigravid women (RR = 2.05; 95% CI 1.19-3.55; p = 0.01). There is an indication of increased death rates among women with a history of hypertension in pregnancy, where ischemic heart disease may be more common than in the general population.

Objective - To investigate whetherthe riskofcanceratallsites, andatindividual sites otherthanbreast, prostate, ovaries, andendometrium, isincreased amongrelatives ofbreast cancerpatients comparedwiththegeneral population. Design-A cohort offamilymembersof breastcancerpatients wasestablished. The probandswerechosenby yearof birth ortimeofdiagnosis. Anyinfluence ofknowledge ofthecancerexperience of therelatives hasbeenavoided. Therisk estimates arebasedonexpected numbers computedfrom ageandtimespecific incidence ratesfortheIcelandic population. Setting -Iceland. Subjects -Thepopulation ofIceland. Mainoutcomemeasures -Relative risks bydegree ofrelatedness andageofproband. -Therelative riskofcancer atall sites israised formalesandfemales. This ismore thanexpectedbasedon the knownfamilial risk ofbreast cancer, prostate, andovarian cancer. Theexcessrisk ofbreast, prostate, andovarian canceris confirmed, butnotthatofcancerofthe endometrium. Theriskofcancerofthe pancreas inbothsexesandthest...

OBJECTIVE During the last thirty years the Research Clinic of the Icelandic Heart Association has been engaged in several extensive cardiovascular population surveys. Smoking habits have been assessed by a questionnaire and the purpose of the present study is to describe the changes in smoking habits during the period 1967-2001, their causes and the reliability of the information gathered. MATERIAL AND METHODS The subjects were participants in four population surveys: The Reykjavik Study 1967-1996, Survey of "Young People" 1973-1974 and 1983-1985, MONICA Risk Factor Surveys 1983, 1988-1989 and 1993-1994 and the "Reykjavik Offspring Study" 1997-2001. The age of participants was 30-88 years and 26,311 examinations of males and 26,222 of females were performed, a number of individuals attending more often than once. A standardized smoking questionnaire was used and the reliability was assessed. RESULTS Smoking prevalence decreased substantially in both sexes during ...

The paper relates how some key IT applications were developed in Iceland following the introduction of the first computers in 1964. The key applications treated are the National Reg- ister of Persons, real estate assessment, financial systems, centralised processing of bank checks, fish stock abundance computations, IT in fish processing plants, the control of hydroelectric power stations, and the challenge of adopting the Icelandic alphabet to the use of computers.

Objective: We estimated the prevalence and incidence of left ventricular hypertrophy (LVH) in this large prospective cohort study of almost 20,000 participants and identified risk factors in them. Predictive factors of its appearance were evaluated along with morbidity and mortality calculations. Material and methods: LVH was defined as Minnesota Code 310 on ECG. Everyone with this code at first visit was defined as a prevalence case and those who developed it between subsequent visits were incidence cases. Risk factors at the time of the diagnosis of LVH were determined with logistic regression. Predictive factors for acquiring this ECG abnormality were determined by Poisson regression. The comparison cohort were all other participants in the Reykjavik Study stages I-V. Results: Two hundred ninety-seven men and 49 women were found to have LVH or 3.2% and 0.5%, respectively. The incidence was 25/1000/year among men and 6/1000/ year among women. Prevalence in both genders increased w...

Objective: Third degree atrioventricular block is considered present when none of the atrial impulses are conducted to the ventricles because of a disruption in the conducting system. Third degree atrioventricular block is usually considered a serious sign but most studies have been performed on hospitalized patients or certain professional groups. The objective of this study was to find the prevalence of third degree atrioventricular block in a representative population sample and estimate its prognostic significance. Material and methods: In the Reykjavik Study, a prospective cardiovascular population study, 9139 men and 9773 women aged 33-79 years were exam notined in 1967-1991. A standard electrocardiogram was taken from all persons examined and coded according to the Minnesota code. Results: Third degree atrioventricular block was found in 11 persons, seven males and four females, an overall prevalence of 0.04%. All these individuals had signs of arrythmia on electrocardiograms taken later, and in addition some other heart disease. The heart block was temporary in seven individuals (64%) but six (55%) needed a pacemaker. Conclusions: The prevalence of third degree atrioventricular block in this general population was low but nevertheless considerably higher than previously reported. The block was temporary in the majority of subjects. All had some underlying heart disease which seemed to affect the prognosis more than the heart block. In this survey fewer subjects than expected were found to need a pacemaker.

Objectives: The relationship between educational level and mortality is well known. This has been shown in the Reykjavik Study and was only partly accounted for by unequal distribution of known risk factors. The objective of the present study was to explore the relationship between educational level and physical activity and whether that relationship could partly explain differences in mortality. Material and methods: This is a part of the Reykjavik Study. Presented is data from 18,912 participants, divided into four groups by educational level. Physical activity was assessed by questionnaire. The relationship between physical activity and educational level was assessed by logistic regression and between mortality and educational level by Cox regression analysis. Adjustments were made for age, year of examination, known risk factors (serum lipids, blood pressure, height, weight, smoking, use of anti-hyertensive drugs and 90 min glucose tolerance) and physical activity. Results: There was a positive relationship between physical activity and educational level (p<0.001). By adding adjustments for physical activity to a multiple regression analysis containing other known risk factors the relationship between total mortality and educational level was reduced. For highest versus lowest educational group hazard ratio was elevated from 0.77 to 0.80 for men and from 0.91 to 0.93 for women. Same trend existed for cardiovascular mortality and to a less extent for cancer mortality. Conclusion: The association between educational level and mortality can be partly explained by differences in leisure-time physical activity. In spite of adjustments for known risk factors and physical activity there remains a statistically significant relationship between educational level and mortality.