Difference in carotid artery wall structure between Swedish and French men at low and high coronary risk.

BACKGROUND AND PURPOSE: We attempted to detect a group-specific north-south difference in carotid artery intima-media thickness (IMT), a marker of subsequent cardiovascular complication, by means of a case (high risk)-control (low risk) study in French and Swedish men. METHODS: The selection of high-risk and low-risk subjects was performed within the lower and upper percentiles of the Framingham risk distribution of 2 samples of 1000 white, male auto workers (45 to 50 years of age) in France (Renault) and Sweden (Volvo). In total, 299 men at low risk (79 French, 76 Swedish) and high risk (61 French, 83 Swedish), free from sustained hypertension, definite hypercholesterolemia, and cardiovascular disease, were included. Both common carotid arteries, by ultrasonography and central off-line computerized analysis, provided measurements of far wall media thickness, lumen diameter, and cross-sectional area IMT (CSA-IMT). RESULTS: As compared with low-risk status, high-risk status was associated with higher IMT (P<0.001), diameter (P<0.01), and CSA-IMT (P<0.001) in French men and higher CSA-IMT (P<0.05) in Swedish men. IMT, diameter, and CSA-IMT were higher in Swedish than in French men in the low-risk group (P<0.001) and in the high-risk group (P<0.01, P<0.001, P<0.001). The multivariate analysis of the whole population showed that IMT, diameter, and CSA-IMT were associated with risk status (P<0.01, P<0.01, P<0.001) and geographic status (P<0.001). CONCLUSIONS: These findings show that the geographic status influences carotid artery structure independent of traditional cardiovascular risk factors and that this may affect the mortality and morbidity gradient between Northern and Southern Europe.

Marital status and cardiovascular risk in French and Swedish automotive industry workers--cross sectional results from the Renault-Volvo Coeur study.

OBJECTIVES: To compare the coronary risk profiles in a sample of the French and Swedish automotive industry employees who were married/cohabitant, divorced or single (never married). DESIGN: A cross-sectional study comparison from biological and questionnaire data between the French and Swedish samples. SETTING: Occupational health departments at Renault (employees from the north-west of France) and Volvo (employees from the south-west of Sweden). SUBJECTS: Two random samples of males aged between 45 and 50 years were examined in 1993, from Renault 1000, and from Volvo 1000. MAIN OUTCOME MEASURES: Biological data including cholesterol, blood pressure as well as the Framingham risk index. Self reported information regarding marital status, smoking, exercise, alcohol habits, and work stress assessed by the Karasek method, private social support indices, and type A behaviour according to the Bortner scale. RESULTS: More employees were married/cohabitant and fewer divorced or single at Renault. Apart from waist/hip ratio being marginally lower in Swedish single men, compared with married and divorced, no significant difference in biological cardiac risk factors (total cholesterol, blood pressure or Framingham risk index) was seen between the subgroups from any of the two countries. Compared with married/cohabitant men, it was shown that in men living alone smoking was more prevalent at Renault and Volvo. These men also showed less type A behaviour, a lower work control and a lower work support and fewer close friends. Alcohol consumption was reported in smaller amounts for Volvo employees living alone compared with married or divorced employees. Married/cohabitant and divorced staff showed similar values regarding all measured variables when compared within each country. CONCLUSIONS: Employees living alone in both France (Renault) and Sweden (Volvo) automotive companies seem to have increased nontraditional cardiac risk factors pertaining to life style and social network compared with married or divorced men. These results, in combination with the finding that more Volvo than Renault employees were living alone, suggest a higher risk for coronary heart disease amongst Volvo employees. This hypothesis will be evaluated in the 5 and 10 years follow up study.

Life events, mood, mental strain and cardiovascular risk factors in Swedish middle-aged men. Data from the Swedish part of the Renault/Volvo Coeur Study.

The associations between life events, mood, mental strain and cardiovascular risk factors were investigated in the Renault/Volvo Coeur Study. About 1,000 men, blue-collar and white-collar workers, were asked by means of interview-administered questionnaires about life events experienced during the year preceding the screening, about mood and mental strain and about smoking, alcohol consumption and exercise habits. Blood pressure, concentration of serum lipids and blood glucose, and anthropometric measures were determined in a screening procedure. Negative life events, especially work-related, were associated with depressed mood and mental strain but not with elevation of biological risk factors such as elevated blood pressure and serum lipids. Depressed mood and mental strain were related to increased tobacco consumption in blue-collar workers and increased alcohol consumption in white-collar workers.

Comparison of cardiovascular risk profile between male employees of two automotives companies in France and Sweden. The Coeur Project Group.

To determine whether or not the lower rate of coronary disease in France, in comparison with Sweden, might be explained by different cardiovascular risk profiles, a cross-sectional analysis (first step of a longitudinal study) of comparable samples of automotive workers was carried out in corporate occupational health clinics of Renault and Volvo. Traditional cardiovascular risk factors were evaluated and the Framingham coronary risk was estimated for 1000 randomly selected 45-50 years old Caucasian males from each company. Compared with the Frenchmen, the Swedish men consisted of more white collar workers and were slightly older. After adjustment for age and blue/white collar status, the Swedish men showed lower body mass indexes, waist to hip rations and heart rates, lower frequency of treatment of hypercholesterolemia and diabetes than the Frenchmen. The Swedish males also exhibited higher averages of blood cholesterol, low density lipoprotein (LDL) cholesterol and glucose, but lower frequencies of hypercholestrolemia and diabetes, and a higher frequency of family histories of cardiovascular disease. Blood pressure, hypertension prevalence, triglycerides level, and high density lipoprotein (HDL) did not differ between the groups. The average number of traditional risk factors was 1.1/person for the Frenchmen and 0.8/person for the Swedes. However, the coronary risk as estimated using the Framingham index was not different between the groups. This, together with the more frequent family history of cardiovascular disease in Swedish men, suggests a lower susceptibility to risk factors as a possible explanation for the lower cardiovascular disease prevalence reported in France, and/or the possibility that factors not measured were involved.