Prevalent migraine as a predictor of incident hypertension.

BACKGROUND: Migraine has been associated with several diseases. This population-based prospective Finnish postal survey Health and Social Support Study explored whether self-reported migraine predicted incident hypertension independently in a working-age population by utilizing two data sources: the baseline survey from the year 1998 in combination with the follow-up survey data from the years 2003 and 2012 with linkage to the national Social Insurance Institution registry data of the special reimbursement medication for hypertension from 1999 to 2013. The survey follow-up reached until the second follow-up in the year 2012. The register follow-up also included the year 2013. METHODS: The present population-based prospective cohort study, utilizing two different data sources, included 8593 respondents (22.7% response rate) who participated in 1998, 2003, and 2012 but who did not report hypertension at the baseline in 1998, and whose responses could be linked with the Social Insurance Institution registry data from the beginning of 1999 to the end of 2013. The multivariable logistic regression analysis was based on the combined two data sets. RESULTS: A significant association of self-reported migraine and incident hypertension (odds ratio 1.37; 95% confidence interval 1.20-1.57) prevailed in the multiple logistic regression analysis adjusted for central socio-demographic and health behaviour variables. CONCLUSION: Extra attention should be paid to prevention and control of hypertension in working-age migraine patients.

Migraine predicts hypertension--a cohort study of the Finnish working-age population.

BACKGROUND: Migraine has been suggested to be associated with hypertension. The aim of the present 5-year prospective cohort study was to examine whether self-reported migraine in 1998 predicted hypertension in 2003 in a Finnish working-age population. METHODS: This cohort study consisted of 13 454 randomly selected initially non-hypertensive working-age participants of the prospective postal survey of the Health and Social Support. A total of 13 426 responses of the initial participants were linked with the register data of the Social Insurance Institution on the special reimbursement medication for hypertension. The outcome variable, hypertension, was determined according to the survey data and the register data of the Social Insurance Institution. The statistical analysis was carried out using logistic regression. RESULTS: In a multivariate model adjusted for gender, age, occupational training, living alone, metabolic equivalent of task, body mass index and alcohol consumption, self-reported migraine predicted hypertension (odds ratio 1.39; 95% confidence interval 1.19-1.64) for the self-reported and (odds ratio 1.42; 95% confidence interval 1.13-1.77) for the register data of the Social Insurance Institution. CONCLUSION: The findings may indicate a focus on hypertension screening for the working-age population with migraine.

Does farm environment protect against type 1 diabetes mellitus?

AIMS/HYPOTHESIS: Hygiene hypothesis has been shown valid in respect of allergies and asthma but has not been, however, sufficiently studied in relation to type 1 diabetes mellitus. This study investigates the effect of childhood farm environment on the prevalence of type 1 diabetes mellitus in Finnish children and young adults. METHODS: Data come from a questionnaire study carried out in 2007 (N = 5805). Prevalence of type 1 diabetes mellitus was analysed according to the type of the rural exposure below the age of 18 years. Associations were estimated and tested using Bayesian methods. RESULTS: Consistent suggestive evidence of the inverse association of childhood's farm environment with the occurrence of type 1 diabetes mellitus was shown, even though conclusive results were not reached. CONCLUSION/INTERPRETATION: Exposure to a broad variety of non-pathogenic environmental microorganisms during childhood might have a protective effect on type 1 diabetes mellitus. Results clearly suggest that further research is well grounded with larger samples.

Peptic ulcer and childhood adversities experienced by working-aged people.

AIM: To study the association between self-reported peptic ulcer and childhood adversities. METHODS: The Health and Social Support Study (HeSSup) population consisted of a stratified random sample drawn from the Finnish Population Register in four age groups: 20-24, 30-34, 40-44 and 50-54. The survey was carried out by postal questionnaire during 1998, with a response rate of 40.0%. A follow-up questionnaire was sent during 2003 to all those who responded to the first. Altogether 19,626 individuals returned the follow-up questionnaire; a response rate of 75.8%. The subjects were asked whether a doctor had told them that they have or have had peptic ulcer. The analyses covered those who responded affirmatively to both the baseline and the follow-up enquiries (n = 718). Those not reporting a peptic ulcer in either of the two questionnaires (n = 17,677) were taken as controls. The subjects were further requested (through six questions) to think about their childhood adversities. RESULTS: The most common adversities mentioned were long-lasting financial difficulties in the family, serious conflicts in the family, and a family member seriously or chronically ill. All the adversities reported, except parental divorce, were more common among peptic ulcer patients than among controls (P values varied between < 0.001 and 0.003). Age- and sex-adjusted odds ratios (OR) of childhood adversities in the multivariate logistic analysis for self-reported peptic ulcer varied between 1.45 and 2.01. Adjusting for smoking, heavy drinking, stress and nonsteroidal anti-inflammatory drug use had no further influence (ORs between 1.22 and 1.73). CONCLUSION: Our findings suggest that childhood adversities maintain a connection with and have a predictive role in the development of peptic ulcer.

Occurrence of symptoms and depressive mood among working-aged coronary heart disease patients.

BACKGROUND: The typical symptoms of coronary heart disease (CHD), chest pain and breathlessness, are well-known. They are considered quite dramatic, and can thus be fairly reliably mapped by a survey. However, people might have other clearly unpleasant symptoms impairing quality of life. The aim of this study is to evaluate the appearance of these complaints of working-aged people with self-reported CHD. METHODS: The study consists of a postal questionnaire of randomly selected Finns in age groups 30-34, 40-44 and 50-54, a response rate of 39% (N = 15,477). The subjects were asked whether or not a doctor had told them that they had angina pectoris or had had myocardial infarction. Four randomly selected age and sex matched controls were chosen for every patient. The occurrence of self-reported dyspnoea, chest pain during anger or other kind of emotion, palpitation and perspiration without physical exercise, irregular heartbeats, flushing, trembling of hands and voice, jerking of muscles, depression and day-time sleepiness were examined. Odds ratios (OR) with 95% confidence intervals (CI), between occurrence of symptoms and CHD with and without heart infarction, were computed by multivariate logistic regression analysis. RESULTS: The sample eventually comprised 319 CHD patients. Dyspnoea, chest pain during anger or other kind of emotion, palpitation, perspiration without physical exercise, irregular heartbeats daily or almost daily, trembling of hands and voice, and jerking of muscles occurred statistically significantly more frequently among CHD patients than among controls. The CHD patients also reported more depressive mood according to Beck's inventory scores and poorer sleep and more frequent day-time sleepiness than controls. In the multivariate logistic regression analysis chest pain during anger or other kind of emotion (ORs 4.12 and 3.61) and dyspnoea (ORs 2.33 and 3.81) were the symptoms most associated with CHD. CONCLUSIONS: Working-aged people with self-reported coronary heart disease evince a number of symptoms limiting the quality of their every day life. This aspect should be paid attention to when evaluating functional capacity of these patients.

The epidemiology and genetics of smoking initiation and persistence: crosscultural comparisons of twin study results.

We examined whether there are crosscultural differences in the magnitude of genetic and environmental contributions to risk of becoming a regular smoker and of persistence in smoking in men and women. Standard methods of epidemiologic and genetic analysis were applied to questionnaire data on history of cigarette use obtained from large samples of male and female like-sex twins from three different countries: Australia (N = 2284 pairs), Sweden (N = 8651 pairs), and Finland (N = 10,948 pairs). Samples were subdivided into three age groups (AG), 18-25 years, 26-35 years, and 36-46 years of age. The magnitude of genetic influence for lifetime smoking was found to be consistent across country and AG for women (46%) and men (57%), and estimates of the contribution from environmental influences shared by twin and co-twin could be equated across all countries by AG for the women (from youngest to oldest AG: 45%, 35%, and 26%), but not for men, with separate estimates obtained for the Scandinavian (33%, 29%, and 19%) and the Australian men (26%, 9%, and 11%). There was no evidence for an important role for shared environmental influences on persistent smoking, and the genetic contribution was found to be consistent in magnitude in men and women, and the same across country and AG (52%). There are strong genetic influences on smoking behavior, and that risk of becoming a smoker (but not persistence in smoking) may be modified by experiences shared by twins that differ by AG and, at least for men, cultural background.