Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease. An 8-Year Follow-up of a Community-Based Swedish Sample
Background A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources. Purpose The major aim of this study was to investi...
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| Veröffentlicht in: | International journal of behavioral medicine 2015-02, Vol.22 (1), p.77-84 |
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| creator | Lundgren, Oskar Garvin, Peter Jonasson, Lena Andersson, Gerhard Kristenson, Margareta |
| description | Background
A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources.
Purpose
The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort.
Methods
The cohort consisted of 484 men and 497 women, aged 45–69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms.
Results
A total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery (HR 0.62 per SD,
p
= 0.003), self-esteem (HR 0.64,
p
= 0.004), and sense of coherence (HR 0.70,
p
= 0.031). An increased risk of CHD was found for vital exhaustion (HR 1.46,
p
= 0.014), hopelessness (HR 1.59,
p
= 0.003), and depressive symptoms (HR 1.45,
p
= 0.009). After further adjustment for depressive symptoms, significant associations remained for mastery (HR 0.67,
p
= 0.034), self-esteem (HR 0.69,
p
= 0.048), and hopelessness (HR 1.48,
p
= 0.023).
Conclusions
The psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts. |
| doi_str_mv | 10.1007/s12529-014-9387-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_524349</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1652445970</sourcerecordid><originalsourceid>FETCH-LOGICAL-c616t-6a079d0f167b99f9fc5fd9909d72c5274a309b5f595fcf29347e531e3172ccaa3</originalsourceid><addsrcrecordid>eNp9ksFuEzEQhlcIREvhAbggS1y4uIzX63V8QQoppZUqgSggcbIc72zislkHe5cob8EjM1FC1SLByeOZb8Yz478ongs4FQD6dRalKg0HUXEjJ5qrB8WxULLkWqnJQ7JBA1cK5FHxJOcbAFBaw-PiqKwqCULCcfHrY976ZeziInjXsU-Y45g8ZuYSsmnO0Qc3YMM2YVhStBk9XS57HxrsPbLYsllMsXdpyy7QpYGdhYwu4ymb9mzCv5GPnceuixs-rne4o4TVauzDsOVvCWzY9QabkJfs2q3WHT4tHrWuy_jscJ4UX87ffZ5d8KsP7y9n0yvua1EPvHagTQOtqPXcmNa0XrWNMWAaXXpV6spJMHPVKqNa35ZGVhqVFCgFxb1z8qTg-7p5g-txbtcprGgKG12wB9d3stCqspKV-S9_Fr5ObUwL24XRCpiouib-zZ4neIWNx35IrruXdj_Sh6VdxJ-2kkJALajAq0OBFH-MmAe7Ctlj17ke45itqKmzShkNhL78C72hX-xpfURVBmoJsiRK7CmfYs4J29tmBNidnuxeT5b0ZHd6sopyXtyd4jbjj4AIKA9roVC_wHTn6X9W_Q1NS9eU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1649063032</pqid></control><display><type>article</type><title>Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease. An 8-Year Follow-up of a Community-Based Swedish Sample</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>SWEPUB Freely available online</source><creator>Lundgren, Oskar ; Garvin, Peter ; Jonasson, Lena ; Andersson, Gerhard ; Kristenson, Margareta</creator><creatorcontrib>Lundgren, Oskar ; Garvin, Peter ; Jonasson, Lena ; Andersson, Gerhard ; Kristenson, Margareta</creatorcontrib><description>Background
A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources.
Purpose
The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort.
Methods
The cohort consisted of 484 men and 497 women, aged 45–69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms.
Results
A total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery (HR 0.62 per SD,
p
= 0.003), self-esteem (HR 0.64,
p
= 0.004), and sense of coherence (HR 0.70,
p
= 0.031). An increased risk of CHD was found for vital exhaustion (HR 1.46,
p
= 0.014), hopelessness (HR 1.59,
p
= 0.003), and depressive symptoms (HR 1.45,
p
= 0.009). After further adjustment for depressive symptoms, significant associations remained for mastery (HR 0.67,
p
= 0.034), self-esteem (HR 0.69,
p
= 0.048), and hopelessness (HR 1.48,
p
= 0.023).
Conclusions
The psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts.</description><identifier>ISSN: 1070-5503</identifier><identifier>ISSN: 1532-7558</identifier><identifier>EISSN: 1532-7558</identifier><identifier>DOI: 10.1007/s12529-014-9387-5</identifier><identifier>PMID: 24430130</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Aged ; Cardiovascular disease ; Cohort Studies ; Coronary Disease - epidemiology ; Coronary Disease - psychology ; Coronary heart disease ; Depression - epidemiology ; Family Medicine ; Female ; Follow-Up Studies ; General Practice ; Health Psychology ; Heart attacks ; Hopelessness ; Hostility ; Humans ; Incidence ; Male ; Mastery ; Medicine ; Medicine & Public Health ; Middle Aged ; Myocardial infarction ; Proportional Hazards Models ; Psychology ; Psychosocial ; Risk Factors ; Self Concept ; Self esteem ; Sense of coherence ; Sweden - epidemiology</subject><ispartof>International journal of behavioral medicine, 2015-02, Vol.22 (1), p.77-84</ispartof><rights>The Author(s) 2014</rights><rights>International Society of Behavioral Medicine 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c616t-6a079d0f167b99f9fc5fd9909d72c5274a309b5f595fcf29347e531e3172ccaa3</citedby><cites>FETCH-LOGICAL-c616t-6a079d0f167b99f9fc5fd9909d72c5274a309b5f595fcf29347e531e3172ccaa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12529-014-9387-5$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12529-014-9387-5$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24430130$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-108566$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:130615320$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Lundgren, Oskar</creatorcontrib><creatorcontrib>Garvin, Peter</creatorcontrib><creatorcontrib>Jonasson, Lena</creatorcontrib><creatorcontrib>Andersson, Gerhard</creatorcontrib><creatorcontrib>Kristenson, Margareta</creatorcontrib><title>Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease. An 8-Year Follow-up of a Community-Based Swedish Sample</title><title>International journal of behavioral medicine</title><addtitle>Int.J. Behav. Med</addtitle><addtitle>Int J Behav Med</addtitle><description>Background
A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources.
Purpose
The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort.
Methods
The cohort consisted of 484 men and 497 women, aged 45–69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms.
Results
A total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery (HR 0.62 per SD,
p
= 0.003), self-esteem (HR 0.64,
p
= 0.004), and sense of coherence (HR 0.70,
p
= 0.031). An increased risk of CHD was found for vital exhaustion (HR 1.46,
p
= 0.014), hopelessness (HR 1.59,
p
= 0.003), and depressive symptoms (HR 1.45,
p
= 0.009). After further adjustment for depressive symptoms, significant associations remained for mastery (HR 0.67,
p
= 0.034), self-esteem (HR 0.69,
p
= 0.048), and hopelessness (HR 1.48,
p
= 0.023).
Conclusions
The psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts.</description><subject>Aged</subject><subject>Cardiovascular disease</subject><subject>Cohort Studies</subject><subject>Coronary Disease - epidemiology</subject><subject>Coronary Disease - psychology</subject><subject>Coronary heart disease</subject><subject>Depression - epidemiology</subject><subject>Family Medicine</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>General Practice</subject><subject>Health Psychology</subject><subject>Heart attacks</subject><subject>Hopelessness</subject><subject>Hostility</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Mastery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Myocardial infarction</subject><subject>Proportional Hazards Models</subject><subject>Psychology</subject><subject>Psychosocial</subject><subject>Risk Factors</subject><subject>Self Concept</subject><subject>Self esteem</subject><subject>Sense of coherence</subject><subject>Sweden - epidemiology</subject><issn>1070-5503</issn><issn>1532-7558</issn><issn>1532-7558</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>D8T</sourceid><recordid>eNp9ksFuEzEQhlcIREvhAbggS1y4uIzX63V8QQoppZUqgSggcbIc72zislkHe5cob8EjM1FC1SLByeOZb8Yz478ongs4FQD6dRalKg0HUXEjJ5qrB8WxULLkWqnJQ7JBA1cK5FHxJOcbAFBaw-PiqKwqCULCcfHrY976ZeziInjXsU-Y45g8ZuYSsmnO0Qc3YMM2YVhStBk9XS57HxrsPbLYsllMsXdpyy7QpYGdhYwu4ymb9mzCv5GPnceuixs-rne4o4TVauzDsOVvCWzY9QabkJfs2q3WHT4tHrWuy_jscJ4UX87ffZ5d8KsP7y9n0yvua1EPvHagTQOtqPXcmNa0XrWNMWAaXXpV6spJMHPVKqNa35ZGVhqVFCgFxb1z8qTg-7p5g-txbtcprGgKG12wB9d3stCqspKV-S9_Fr5ObUwL24XRCpiouib-zZ4neIWNx35IrruXdj_Sh6VdxJ-2kkJALajAq0OBFH-MmAe7Ctlj17ke45itqKmzShkNhL78C72hX-xpfURVBmoJsiRK7CmfYs4J29tmBNidnuxeT5b0ZHd6sopyXtyd4jbjj4AIKA9roVC_wHTn6X9W_Q1NS9eU</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Lundgren, Oskar</creator><creator>Garvin, Peter</creator><creator>Jonasson, Lena</creator><creator>Andersson, Gerhard</creator><creator>Kristenson, Margareta</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>ABXSW</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>DG8</scope><scope>ZZAVC</scope></search><sort><creationdate>20150201</creationdate><title>Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease. An 8-Year Follow-up of a Community-Based Swedish Sample</title><author>Lundgren, Oskar ; Garvin, Peter ; Jonasson, Lena ; Andersson, Gerhard ; Kristenson, Margareta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c616t-6a079d0f167b99f9fc5fd9909d72c5274a309b5f595fcf29347e531e3172ccaa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Cardiovascular disease</topic><topic>Cohort Studies</topic><topic>Coronary Disease - epidemiology</topic><topic>Coronary Disease - psychology</topic><topic>Coronary heart disease</topic><topic>Depression - epidemiology</topic><topic>Family Medicine</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>General Practice</topic><topic>Health Psychology</topic><topic>Heart attacks</topic><topic>Hopelessness</topic><topic>Hostility</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Mastery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Myocardial infarction</topic><topic>Proportional Hazards Models</topic><topic>Psychology</topic><topic>Psychosocial</topic><topic>Risk Factors</topic><topic>Self Concept</topic><topic>Self esteem</topic><topic>Sense of coherence</topic><topic>Sweden - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lundgren, Oskar</creatorcontrib><creatorcontrib>Garvin, Peter</creatorcontrib><creatorcontrib>Jonasson, Lena</creatorcontrib><creatorcontrib>Andersson, Gerhard</creatorcontrib><creatorcontrib>Kristenson, Margareta</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SWEPUB Linköpings universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Linköpings universitet</collection><collection>SwePub Articles full text</collection><jtitle>International journal of behavioral medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lundgren, Oskar</au><au>Garvin, Peter</au><au>Jonasson, Lena</au><au>Andersson, Gerhard</au><au>Kristenson, Margareta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease. An 8-Year Follow-up of a Community-Based Swedish Sample</atitle><jtitle>International journal of behavioral medicine</jtitle><stitle>Int.J. Behav. Med</stitle><addtitle>Int J Behav Med</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>22</volume><issue>1</issue><spage>77</spage><epage>84</epage><pages>77-84</pages><issn>1070-5503</issn><issn>1532-7558</issn><eissn>1532-7558</eissn><abstract>Background
A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources.
Purpose
The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort.
Methods
The cohort consisted of 484 men and 497 women, aged 45–69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms.
Results
A total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery (HR 0.62 per SD,
p
= 0.003), self-esteem (HR 0.64,
p
= 0.004), and sense of coherence (HR 0.70,
p
= 0.031). An increased risk of CHD was found for vital exhaustion (HR 1.46,
p
= 0.014), hopelessness (HR 1.59,
p
= 0.003), and depressive symptoms (HR 1.45,
p
= 0.009). After further adjustment for depressive symptoms, significant associations remained for mastery (HR 0.67,
p
= 0.034), self-esteem (HR 0.69,
p
= 0.048), and hopelessness (HR 1.48,
p
= 0.023).
Conclusions
The psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>24430130</pmid><doi>10.1007/s12529-014-9387-5</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1070-5503 |
| ispartof | International journal of behavioral medicine, 2015-02, Vol.22 (1), p.77-84 |
| issn | 1070-5503 1532-7558 1532-7558 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_524349 |
| source | MEDLINE; SpringerLink Journals; SWEPUB Freely available online |
| subjects | Aged Cardiovascular disease Cohort Studies Coronary Disease - epidemiology Coronary Disease - psychology Coronary heart disease Depression - epidemiology Family Medicine Female Follow-Up Studies General Practice Health Psychology Heart attacks Hopelessness Hostility Humans Incidence Male Mastery Medicine Medicine & Public Health Middle Aged Myocardial infarction Proportional Hazards Models Psychology Psychosocial Risk Factors Self Concept Self esteem Sense of coherence Sweden - epidemiology |
| title | Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease. An 8-Year Follow-up of a Community-Based Swedish Sample |
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