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Aims To rank psychosocial and traditional risk factors by importance for coronary heart disease. Methods and results The Copenhagen City Heart Study is a prospective cardiovascular population study randomly selected in 1976. The third examinationwas carried out from 1991 to 1994, and 8882 men andwomen free of cardiovascular diseases were included in this study. Events were assessed until April 2013. Forward selection, population attributable fraction, and gradient boosting machine were used for determining ranks. The importance of vital exhaustion for risk prediction was investigated by C-statistics and net reclassification improvement. During the follow-up, 1731 non-fatal and fatal coronary events were registered. In men, the highest ranking risk factors for coronary heart disease were vital exhaustion [high vs. low; hazard ratio (HR) 2.36; 95% confidence interval (CI), 1.70-3.26; P , 0.001] and systolic blood pressure (≥160 mmHg or blood pressure medication vs. ,120 mmHg; HR 2.07; 95% CI, 1.48-2.88; P , 0.001). In women, smoking was of highest importance (≥15 g tobacco/day vs. never smoker; HR 1.74; 95% CI, 1.43-2.11; P , 0.001), followed by vital exhaustion (high vs. low; HR 2.07; 95% CI, 1.61-2.68; P , 0.001). Vital exhaustion ranked first in women and fourth in men by population attributable fraction of 27.7% (95% CI, 18.6-36.7%; P , 0.001) and 21.1% (95% CI, 13.0-29.2%; P , 0.001), respectively. Finally, vital exhaustion significantly improved risk prediction. Conclusion Vital exhaustion was one of the most important risk factors for coronary heart disease, our findings emphasize the importance of including psychosocial factors in risk prediction scores. [ABSTRACT FROM AUTHOR]

Aims To determine the prevalence, predictors of newly acquired, and the prognostic value of right bundle branch block (RBBB) and incomplete RBBB (IRBBB) on a resting 12-lead electrocardiogram in men and women from the general population. Methods and results We followed 18 441 participants included in the Copenhagen City Heart Study examined in 1976–2003 free from previous myocardial infarction (MI), chronic heart failure, and left bundle branch block through registry linkage until 2009 for all-cause mortality and cardiovascular outcomes. The prevalence of RBBB/IRBBB was higher in men (1.4%/4.7% in men vs. 0.5%/2.3% in women, P < 0.001). Significant predictors of newly acquired RBBB were male gender, increasing age, high systolic blood pressure, and presence of IRBBB, whereas predictors of newly acquired IRBBB were male gender, increasing age, and low BMI. Right bundle branch block was associated with significantly increased all-cause and cardiovascular mortality in both genders with age-adjusted hazard ratios (HR) of 1.31 [95% confidence interval (CI), 1.11–1.54] and 1.87 (95% CI, 1.48–2.36) in the gender pooled analysis with little attenuation after multiple adjustment. Right bundle branch block was associated with increased risk of MI with an HR of 1.67 (95% CI, 1.16–2.42) and pacemaker insertion with an HR of 2.17 (95% CI, 1.22–3.86), but not with chronic heart failure (HR 1.37; 95% CI, 0.96–1.94), atrial fibrillation (HR 1.10; 95% CI, 0.73–1.67), or chronic obstructive pulmonary disease (HR 0.99; 95% CI, 0.60–1.62). The presence of IRBBB was not associated with any adverse outcome. Conclusion In this cohort study, RBBB and IRBBB were two to three times more common among men than women. Right bundle branch block was associated with increased cardiovascular risk and all-cause mortality, whereas IRBBB was not. Contrary to common perception, RBBB in asymptomatic individuals should alert clinicians to cardiovascular risk. [ABSTRACT FROM PUBLISHER]

Aims: The prevalence of the Brugada-type electrocardiogram (ECG) in the Danish population is not known. [ABSTRACT FROM PUBLISHER]

Background Chronic stress may affect morbidity and mortality through neuroendocrine changes, and the ratio of cortisol to sex steroid hormones has been suggested as a biomarker of stress. We aim to address a relation between the ratio of cortisol to estrogens (C/E) and risk of ischaemic heart disease (IHD), hormone-dependent cancers and all-cause mortality among postmenopausal women. [ABSTRACT FROM PUBLISHER]

BackgroundLeptin and adiponectin are hormones secreted by adipose tissue, and both hormones are candidate intermediaries between adipose tissue and overweight-related diseases. So far, no prospective study has been published where the independent effects of these two hormones on the development of hypertension have been directly compared. The objective of this study was to investigate the relationships between plasma levels of leptin and adiponectin and new-onset hypertension in the Copenhagen City Heart Study (CCHS).MethodsIn a prospective study design, we examined new-onset hypertension in 620 women and 300 men who were normotensive in the third CCHS examination, which was performed in 1991–1994.ResultsBetween the third and the fourth CCHS examination, which was performed in 2001–2003, 254 had developed hypertension, defined as systolic blood pressure (SBP) ≥140 mm Hg, or diastolic blood pressure (DBP) ≥90 mm Hg, or use of antihypertensive medication. Using logistic regression analysis, adjusting for age, sex, estimated glomerular filtration rate, triglycerides, high-density lipoprotein cholesterol (HDL-C), fibrinogen, and glucose, and with leptin and adiponectin included in the same model, leptin was significantly associated with new-onset hypertension with an odds ratio (95% confidence interval) of 1.28 (1.08–1.53; P < 0.005) for 1 s.d. higher level of log-transformed leptin, whereas adiponectin was not significantly associated with new-onset hypertension having an odds ratio of 1.02 (0.84–1.24; P = 0.83) for 1 s.d. higher level of log-transformed adiponectin.ConclusionsIn the CCHS, leptin, but not adiponectin, was a significant independent predictor of new-onset hypertension.American Journal of Hypertension 2010; doi:10.1038/ajh.2009.244 [ABSTRACT FROM AUTHOR]

BackgroundLow-grade chronic inflammation has been proposed to play a major role in the pathogenesis of hypertension. Low-grade chronic inflammation is also closely associated with obesity, an established causative factor in the development of hypertension. The purpose of this study was to investigate the relationship between two markers of inflammation, C-reactive protein (CRP) and fibrinogen, and blood pressure (BP) and other hemodynamic variables in obese subjects.MethodsFrom a large cardiovascular study based in the general population, we selected subjects with a body mass index (BMI) ≥30 kg/m2, free of major cardiovascular diseases, not taking BP-lowering or lipid-lowering drugs (n = 487; women = 51.1%; median (5th to 95th percentile) age = 62 years (36–80)). The cardiovascular study included measurements of traditional and new risk factors, including ankle brachial BP index, a measure of subclinical atherosclerosis. CRP was determined by a high-sensitive assay.ResultsIn partial Spearman rank correlation analysis, adjusted for age and sex, we found no significant relationships between either CRP or fibrinogen and systolic BP, diastolic BP, pulse pressure, or ankle brachial index (ρ: −0.057 to 0.068; P > 0.13). However, fibrinogen and CRP were found to be significantly related to heart rate (ρ: 0.127–0.169; P < 0.01).ConclusionsIn this study of generally healthy obese subjects from the general population, we found no significant relationships between markers of inflammation and systolic BP or diastolic BP, showing that obese subjects with higher levels of inflammatory markers do not have higher BP levels than their obese counterparts with lower levels of inflammatory markers.American Journal of Hypertension 2009; doi:10.1038/ajh.2009.1American Journal of Hypertension (2009); 22, 4, 451–456. doi:10.1038/ajh.2009.1 [ABSTRACT FROM AUTHOR]

Presents a study which analyzed the association between social factors and low leisure-time physical activity in young adults of Denmark. Role of parental physical activity; Association of education and smoking history with low leisure-time physical activity; Sex differences in the determinants of leisure-time physical activity.