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<h5 class="section-title" id="d5618507e176">Objectives:</h5>
<p id="P5">The literature has highlighted the importance of identifying symptoms predictive
of
acute myocardial infarction (AMI) in women, in addition to traditional cardiovascular
risk factors. The objective was to study subjective health problems, in relation to
later AMI, in a large sample of women, adjusted for age, educational status, smoking,
waist/hip ratio, blood pressure, total cholesterol/HDL ratio, diabetes and neighbourhood
socioeconomic status.
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<h5 class="section-title" id="d5618507e181">Study design:</h5>
<p id="P6">From December 1995 to February 2000 a cohort of 6711 women aged 50–59 years
in southern
Sweden underwent a physical examination and answered a questionnaire that had 18 items
on health problems such as stress symptoms, tiredness and pain.
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<h5 class="section-title" id="d5618507e186">Main outcome measures:</h5>
<p id="P7">Incidence of AMI during a mean follow-up of 17 years, drawn from national
registers.</p>
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<h5 class="section-title" id="d5618507e191">Results:</h5>
<p id="P8">The number of health problems showed a J-shaped relationship with AMI,
with the lowest
hazard ratio (HR) in women with a median of 4 health problems. The HR for AMI in women
with 0 health problems was 1.58 (95% CI: 0.95–2.63) and in those with 13 problems
HR 1.65 (95% CI 1.16–2.36), after adjusting for potential confounding factors.
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<h5 class="section-title" id="d5618507e196">Conclusions:</h5>
<p id="P9">The presence of several health problems, including pain and stress symptoms,
is associated
with an increased risk of later AMI in middle-aged women. Awareness among clinicians
of predictive risk factors for AMI is important for the early identification of individuals
at higher risk.
</p>
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