SHEEP - Stockholm Heart Epidemiology Program

This study is part of the collection Swedish Cohort Consortium (Cohorts.se)

Creator/Principal investigator(s):

Johan Hallqvist - Uppsala University, Department of Public Health and Caring Sciences

Karin Leander - Karolinska Institute, Institute of Environmental Medicine

Description:

SHEEP (the Stockholm Heart Epidemiology Program) is a population based case-referent study of risk factors for first episode of acute myocardial infarction in women and men in the ages 45-70 years living in the Stockholm County. Exposure information was collected by a questionnaire and a health examination including blood sampling. A large number of potential risk factors were included in the questionnaire items and comprised occupational, social, as well as life style or individual factors. A total of 5452 subjects were included in SHEEP: 2246 cases and 3206 referents. The response rate was higher among men than among women. Exposure information based on both the questionnaire and biological data from the health examination was available for 78% of the male and 67% of the female non-fatal cases; the corresponding figures for their referents were 68% and 64%.

Creator/Principal investigator(s):

Johan Hallqvist - Uppsala University, Department of Public Health and Caring Sciences

Karin Leander - Karolinska Institute, Institute of Environmental Medicine

Identifiers:

SND-ID: EXT 0039

Purpose:

To simultaneously test several hypotheses concerning potential risk factors for acute myocardial infarction, first event.
To compare the effect of different risk factors/exposures between women and men.
To identify and evaluate potential effect modification between different risk factors.

Description:

SHEEP (the Stockholm Heart Epidemiology Program) is a population based case-referent study of risk factors for first episode of acute myocardial infarction in women and men in the ages 45-70 years living in the Stockholm County. Exposure information was collected by a questionnaire and a health examination including blood sampling. A large number of potential risk factors were included in the questionnaire items and comprised occupational, social, as well as life style or individual factors. A total of 5452 subjects were included in SHEEP: 2246 cases and 3206 referents. The response rate was higher among men than among women. Exposure information based on both the questionnaire and biological data from the health examination was available for 78% of the male and 67% of the female non-fatal cases; the corresponding figures for their referents were 68% and 64%.

Geographic spread:

Geographic location: Sweden

Geographic description: Stockholm County

Lowest geographic unit:

County (NUTS3)

Unit of analysis:

Population:

The Sheep study base comprised all Swedish citizens resident in the Stockholm county 1992-1994 who were 45-70 years of age and were free of previous clinically diagnosed myocardial infarction. Male cases were identified during a two-year period (1992-1993

Sampling procedure:

Exposure information was collected by a questionnaire and a health examination including blood sampling. A large number of potential risk factors were included in the questionnaire items and comprised occupational, social, as well as life style or individual factors.

Contact person for questions about the data:

Johan Hallqvist

Publications

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Möller J. Case-crossover studies of the triggering of disease. Myocardial infarction and Ménière's disease. Stockholm: Karolinska Institutet 2003 (thesis).

Bennet A. Insulin resistence, genetic variation and cytokines; associations to myocardial infarction risk. Stockholm: Karolinska Institutet 2003 (thesis).

Hallqvist J. Socioeconomic differences in myocardial infarction risk. Epidemiologic analyses of causes and mechanisms. Stockholm: Karolinska institutet 1998 (thesis).

Möller J, Theorell T, de Faire U, Ahlbom A, Hallqvist J. Work-related stressful life events and the risk of myocardial infarction. Case-referent and case-crossover analyses in the Stockholm Heart Epidemiology Program (SHEEP). J Epidemiol Community Health. 2005 January; 59(1): 23-30.

Hallqvist J, Lynch J, Bartley M, Lang T, Blane D. Accumulation of Exposure to Low Socioeconomic Positions During the Life Course and Risk of Myocardial Infarction. Can the Effect be Disentangled from Effects of Critical Periods and Social Mobility? Stockholm Heart Epidemiology Program (SHEEP). Soc Sci Med. 2004 Apr;58(8):1555-62.

Stjärne MK, Ponce de Leon A, Hallqvist J for the SHEEP Study Group. Contextual effects of social fragmentation and material deprivation on risk of myocardial infarction - Results from the Stockholm Heart Epidemiology Program (SHEEP). Int. J. Epidemiol. (2004) 33 (4): 732-741.

Fransson E, de Faire U, Ahlbom A, Reuterwall C, Hallqvist J, Alfredsson L. Interaction between leisure time, occupational and household physical activity regarding the risk of acute myocardial infarction. Results from the SHEEP study. Epidemiology Vol. 15, No. 5 (Sep., 2004), pp. 573-582.

Bennet AM, Prince JA, Fei G-Z, Lyrenäs L, Huang Y, Wiman B, Frostegård J, de Faire U. Interleukin-6 serum levels and genotypes; relations to serum-insulin, myocardial infarction and interactions with other cardiovascular risk factors. Atherosclerosis Volume 171, Issue 2, December 2003, Pages 359-367

Ahlbom A, Feychting M, Gustavsson A, Hallqvist J, Johansen C, Kheifets, Olsen J. Occupational magnetic field exposure and myocardial infarction incidence in the SHEEP study. Epidemiology. 2004 Jul;15(4):403-8.

Holmquist C, Larsson S, Wolk A, de Faire. Multivitamin supplements are inversely associated with risk of myocardial infarction in men and women - Stockholm Heart Epidemiology Program (SHEEP). J Nutr. 2003;133:2650-4.

Romelsjö A, Branting M, Hallqvist J, Alfredsson L, Hammar N, Leifman A, Ahlbom A. Abstention, alcohol use and risk of myocardial infarction in men and women taking account of social support and working conditions- the SHEEP case-control study. Addiction 2003;98:1453-62.

Leander K, Wiman B, Hallqvist J, Sten-Linder M, de Faire U. PAI-1 level and the PAI-1 4G/5G polymorphism in relation to risk of myocardial infarction. Results from the Stockholm Heart Epidemiology Program (SHEEP). Thromb Haemost 2003;89:1064-71.

Bigert C, Gustavsson P, Hallqvist J, Hogstedt C, Lewné M, Plato N, Reuterwall C, Schéele P. Myocardial infarction among professional drivers. Epidemiology 2003;14:333-9.

Hammar N, AnderssonT, Alfredsson L, Reuterwall C, Nilsson T, Hallqvist J, Knutsson A, Ahlbom A. Consumption of boiled coffee is associated with an increased incidence of first non-fatal acute myocardial infarction - The Stockholm and Västernorrland Heart Epidemiology Program. J Intern Med 2003;253:653-9.

Lundberg M, Diderichsen F, Hallqvist J for the SHEEP Study Group. Is the association between short stature and myocardial infarction explained by childhood exposures: a population-based case-referent study (SHEEP). Scand J Public Health 2002;30:249-58.

Bennet AM, Brismar K, Hallqvist J, Reuterwall C, de Faire U. The risk of myocardial infarction is enhanced by a synergistic interaction between serum insulin and smoking. Eur J Endocrinol, 2002;147: 641-647.

Leander K, Wiman B, Hallqvist J, Falk G, de Faire U. The G-455A polymorphism of the fibrinogen Bbeta-gene relates to plasma fibrinogen in male cases, but does not interact with environmental factors in causing myocardial infarction in either men or women. J Intern Med. 2002;252:332-41.

Peter R, Siegrist J, Hallqvist J, Reuterwall C, Theorell T & the SHEEP study group. Psychosocial work environment and myocardial infarction: improving the risk estimation by combining two alternative job stress models. J Epidemiol Community Health 2002; 56:294-300.

Kölegård-Stjärne M, Diderichsen F, Reuterwall C, Hallqvist J for the SHEEP study group. Socioeconomic context in area of living and its impact on risk of myocardial infarction. J Epidemiol Commun Health 2002;56:29-35.

Möller J, Ahlbom A, Hulting J, de Faire U, Diderichsen F, Reuterwall C, Hallqvist J. Sexual activity as a trigger of myocardial infarction. A case-crossover analysis in the Stockholm Heart Epidemiology Program (SHEEP). Heart 2001;86:387-90.

Rosenlund M, Berglind N, Gustavsson A, Reuterwall C, Hallqvist J, Nyberg F, Pershagen G & the SHEEP study group. Environmental tobacco smoke and myocardial infarction among non-smokers in the Stockholm Heart Epidemiology Program (SHEEP). Epidemiology 2001;12:558-64.

Rosenlund M, Berglind N, Gustavsson A, Reuterwall C, Hallqvist J, Nyberg F, Pershagen G & the SHEEP study group. Environmental tobacco smoke and myocardial infarction among non-smokers in the Stockholm Heart Epidemiology Program (SHEEP). Epidemiology 2001;12:558-64.

Leander K, Hallqvist J, Reuterwall C, Ahlbom A, de Faire U. Family history of coronary heart disease - a strong risk factor for myocardial infarction interacting with other cardiovascular risk factors. Epidemiology 2001 Mar;12:215-21.

Gustavsson P, Plato N, Lewné M, Schéele P, Hallqvist J, Hogstedt C, Reuterwall C and the SHEEP study group. Myocardial infarction and occupational exposure to combustion products - a case-referent study in Sweden. Epidemiology 2001 Mar;12:222-8.

Hammar N, Nilsson T, Knutsson A, Hallqvist J, Reuterwall C, Andersson T, Ahlbom A. Geographical differences in the incidence of acute myocardial infarction in Sweden. Analyses of possible causes using two parallel case-control studies. J Intern Med 2001 Feb;249(2):137-44.

Linnersjö A, Hammar N, Gustavsson A, Reuterwall C. Recent time trends in acute myocardial infarction in Stockholm, Sweden. International Journal of Cardiology 2000;76:17-21.

Wiman B, Reuterwall C, Hallqvist J, Andersson T, Ahlbom A, de Faire U. Increased plasma levels of tPA/PAI-1 complex, a novel risk marker for recurrent myocardial infarction in the SHEEP study. Atherosclerosis, Thrombosis and Vascular Biology 2000;20:2019-23.

Hallqvist J, Möller J, Ahlbom A, Diderichsen F, Reuterwall C, de Faire U. Does heavy physical exertion trigger myocardial infarction? A case-crossover analysis nested in a population based case-referent study (SHEEP). Am J Epidemiol 2000;151:459-67.

Möller J, Hallqvist J, Diderichsen F, Theorell T, Reuterwall C, Ahlbom A. Do episodes of anger trigger myocardial infarction? A case-crossover analysis in the Stockholm Heart Epidemiology Program (SHEEP). Psychosomatic Med 1999;61:842-9.

Reuterwall C, Hallqvist J, Ahlbom A, de Faire U, Diderichsen F, Hogstedt C, Pershagen G, Theorell T, Wiman B, Wolk A, and the SHEEP study group. Higher relative but lower absolute risks of myocardial infarction in women than in men for some major risk factors in the SHEEP study. J Intern Med 1999;246:161-74.

Tsutsumi A, Theorell T, Hallqvist J, Reuterwall C, de Faire U. The association between job characteristics and plasma fibrinogen in referents of the SHEEP study. J Epidemiol Commun Health 1999:53:348-54.

Knutsson A, Hallqvist J, Reuterwall C, Theorell T, Åkerstedt T. Shiftwork and myocardial infarction. Occ Environm Med 1999;56:46-50.

Hallqvist J, Diderichsen F, Theorell T, Reuterwall C, Ahlbom A, and the SHEEP Study Group. Is the effect of job strain on myocardial infarction risk due to interaction between high psychological demands and low decision latitude? Results from the Stockholm Heart Epidemiology Program (SHEEP). Social Sci & Med 1998;46:1405-15.

Theorell T, Tsutsumi A, Hallqvist J, Reuterwall C, Freedlund P, Emlund N, Johnson J. Decision latitude, job strain and myocardial infarction. A study of working men in Stockholm (Stockholm Heart Epidemiology Program, SHEEP). Am J Publ Health 1998;382-388.

Hallqvist J, Lundberg M, Diderichsen F, Ahlbom A. Socioeconomic differences in risk of myocardial infarction 1971-1994 among men and women in Sweden. Time trends in incidence, relative risks and population attributable risks. Int J Epidemiol 1998;27:410-5.

Hallqvist J, Lundberg M, Diderichsen F, Ahlbom A. Socioeconomic differences in risk of myocardial infarction 1971-1994 among men and women in Sweden. Time trends in incidence, relative risks and population attributable risks. Int J Epidemiol 1998;27:410-5.

Link to publication list:

If you have published anything based on these data, please notify us with a reference to your publication(s).

SHEEP - the Stockholm Heart Epidemiology Program

Data format / data structure:

Numeric

Data collection:

Mode of collection: Self-administered questionnaire: paper

Time period(s) for data collection: 1992 — 1994

Source of the data: Population group

Mode of collection: Physical measurements and tests

Time period(s) for data collection: 1992 — 1994

Source of the data: Population group

Number of individuals/objects:

5452

Response rate/participation rate:

76%