title: Psycho-social risk factors for ischaemic heart disease among men in the subarctic area.
abstract: We analysed the psycho-social risk factors for acute myocardial infarction in Kiruna, a town about 150 km north of the Arctic Circle, with a high mortality in ischaemic heart disease. In a case-control study, 219 male patients aged 35 to 64 years admitted to Kiruna District Hospital, with a first acute myocardial infarction between 1973 and 1985, were compared to 438 age-matched male controls without coronary heart disease. After adjusting for main biomedical risk factors (diabetes, hypertension, number of smokers and family history) a combination of mental and physical stress at work (OR 3.5, 96% CI 1.6-7.8) and heavy physical work (OR 1.5, 95% CI 1.1-3.6) were associated with an increased risk of myocardial infarction, whereas good control over job tasks was associated with a reduced risk (OR 0.7, 95% CI 0.5-0.9). Migration into Kiruna, especially in the 15 years preceding the study compared to earlier migration, also appeared as an independent predictor of myocardial infarction. We conclude that subgroups of men in Kiruna are at particularly high risk of myocardial infarction because of adverse factors related to their work and their social life and thus enable to preventive measures.
authors.affiliation: Department of Internal Medicine, Kiruna District Hospital, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Messner
authors.forename: H
authors.initials: H
authors.lastname: Sihm
mesh_terms: D000328:Adult; D000368:Aged; D001110:Arctic Regions / Q000453:epidemiology; D016022:Case-Control Studies; D003080:Cold Temperature / Q000009:adverse effects; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012931:Social Environment; D011795:Surveys and Questionnaires; D015996:Survival Rate