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• W2133217276 abstract "Although fibrinogen may be a mediator in chronic infection, inflammation, and coronary disease, as Sjogren suggests (Nov 16, p 1389),1Sjögren B Chronic bronchitis and risk of coronary heart disease.Lancet. 1996; 348: 1389Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar our data do not support his hypothesis about occupation as a determinant of coronary heart disease.From our crude figures,2Jousilahti P Vartiainen E Tuomilehto J Puska P Symptoms of chronic bronchitis and the risk of coronary disease.Lancet. 1996; 348: 567-572Summary Full Text Full Text PDF PubMed Scopus (223) Google Scholar Sjögren estimated higher coronary disease risk among farmers compared with white-collar workers, but his analysis took no account of age as an important confounding variable. In Finland, the average age of working farmers is higher (about 4 years) compared with people in other professions (about 4 years longer).In our table we present the relative risk of first coronary event and death from coronary disease among farmers, blue-collar workers, and white-collar workers. For both sexes, the crude risk of coronary disease was much higher among farmers than white-collar workers. When age was included as a covariate, this difference in relative risk disappeared among men. Among women farmers the risk ratio of coronary disease also greatly decreased after adjustment for age, but the risk of coronary death still remained higher in farmers than among the other women. Adjustment for smoking, serum total cholesterol, and systolic blood pressure showed further decrease in the risk of coronary disease in farmers, compared with other occupational groups.Fibrinogen levels were not obtained during the baseline surveys of our study cohorts in the 1970s. We have, however, done similar risk-factor surveys since then every 5 years. In the last survey (1992) plasma fibrinogen was revealed in a sub-sample of men and women aged 45–64 years.3Salomaa VV Rasi VP Vahtera EM et al.Haemostatic factors and lipoprotein(a) in three geographical areas in Finland: the Finrisk haemostasis study.J Cardiovascular Risk. 1994; 1: 241-248PubMed Google Scholar When the values of different occupational groups were compared, the age adjusted mean serum fibrinogen concentration in male farmers did not differ from the mean fibrinogen values of male white-collar and blue-collar workers (3·28 [SD 0·68], 3·32 [0·77], and 3·41 [0·73], respectively). In women, plasma fibrinogen was higher among farmers than among white collar and blue collar workers (3·57 [0·82], 3·36 [0·75], and 3·40 [0·67], respectively; farmers vs white-collar workers p=0·049). We should obviously be cautious in comparing our findings in the 1990s to the situation of the 1970s. However, during our baseline surveys women farmers may have been more exposed than women in other professions to factors leading to high serum fibrinogen, and subsequently to increased coronary disease risk. Although fibrinogen may be a mediator in chronic infection, inflammation, and coronary disease, as Sjogren suggests (Nov 16, p 1389),1Sjögren B Chronic bronchitis and risk of coronary heart disease.Lancet. 1996; 348: 1389Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar our data do not support his hypothesis about occupation as a determinant of coronary heart disease. From our crude figures,2Jousilahti P Vartiainen E Tuomilehto J Puska P Symptoms of chronic bronchitis and the risk of coronary disease.Lancet. 1996; 348: 567-572Summary Full Text Full Text PDF PubMed Scopus (223) Google Scholar Sjögren estimated higher coronary disease risk among farmers compared with white-collar workers, but his analysis took no account of age as an important confounding variable. In Finland, the average age of working farmers is higher (about 4 years) compared with people in other professions (about 4 years longer). In our table we present the relative risk of first coronary event and death from coronary disease among farmers, blue-collar workers, and white-collar workers. For both sexes, the crude risk of coronary disease was much higher among farmers than white-collar workers. When age was included as a covariate, this difference in relative risk disappeared among men. Among women farmers the risk ratio of coronary disease also greatly decreased after adjustment for age, but the risk of coronary death still remained higher in farmers than among the other women. Adjustment for smoking, serum total cholesterol, and systolic blood pressure showed further decrease in the risk of coronary disease in farmers, compared with other occupational groups. Fibrinogen levels were not obtained during the baseline surveys of our study cohorts in the 1970s. We have, however, done similar risk-factor surveys since then every 5 years. In the last survey (1992) plasma fibrinogen was revealed in a sub-sample of men and women aged 45–64 years.3Salomaa VV Rasi VP Vahtera EM et al.Haemostatic factors and lipoprotein(a) in three geographical areas in Finland: the Finrisk haemostasis study.J Cardiovascular Risk. 1994; 1: 241-248PubMed Google Scholar When the values of different occupational groups were compared, the age adjusted mean serum fibrinogen concentration in male farmers did not differ from the mean fibrinogen values of male white-collar and blue-collar workers (3·28 [SD 0·68], 3·32 [0·77], and 3·41 [0·73], respectively). In women, plasma fibrinogen was higher among farmers than among white collar and blue collar workers (3·57 [0·82], 3·36 [0·75], and 3·40 [0·67], respectively; farmers vs white-collar workers p=0·049). We should obviously be cautious in comparing our findings in the 1990s to the situation of the 1970s. However, during our baseline surveys women farmers may have been more exposed than women in other professions to factors leading to high serum fibrinogen, and subsequently to increased coronary disease risk." @default.
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• W2133217276 date "1997-02-01" @default.
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• W2133217276 title "Occupation, fibrinogen, and heart disease" @default.
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