In a population study in Göteborg, Sweden, comprising women in the age strata 44, 52, 56, 60 and 66 years, serum thyrotrophin (S-TSH) was determined in 283 women representative of the general population of women of these ages. No women with previously unknown hypothyroidism were found at the clinical examination; 47 (3.7%) were on thyroxine treatment, 9 (0.7%) because of spontaneous hypothyroidism. Sixteen women (1.2%) had markedly elevated S-TSH concentration (less than 14 mU/l). They were studied further by determination of thyroid hormones and circulating antithyroid microsomal and thyroglobulin antibodies, and those with goiter were subjected to fine-needle biopsy of the thyroid gland. They were furthermore followed for four years. Four euthyroid women were given thyroxine because of goiter and abnormal laboratory test results. Of nine individuals with high S-TSH concentration as well as high titers of thyroid antibodies and/or biopsy evidence of autoimmune thyroiditis, seven became hypothyroid within the four years of follow-up. The other two women had consistently elevated basal S-TSH concentration and exaggerated S-TSH response after thyroliberin administration. We conclude that the majority of individuals without previously recognized thyroid disease who have S-TSH concentration above 14 mU/l with the assay used will require thyroxine therapy within a few years. In one woman, however, with multinodular colloid goiter and high titer of antimicrosomal antibodies, the basal S-TSH concentration decreased during follow-up to a high normal value; the S-TSH response to thyroliberin was high borderline. She remained euthyroid during follow-up. The results suggest an annual incidence of spontaneous hypothyroidism of 1-2 cases per 1000 middle-aged females in Swedish west-coast population.

A population sample of women in Göteborg, Sweden, was studied in 1968-69 and restudied in 1974-75. A number of metabolic variables could be studied cross-sectionally (in 1974-75) and longitudinally (intraindividual changes between 1968-69 and 1974-75). When studied cross-sectionally, increased serum urate concentrations were observed in women on diuretics and increased serum triglycerides in women on beta-blockers, compared to other women, while no obvious differences were found in blood glucose and serum cholesterol concentrations or in packed red cell volume (PCV). When studied longitudinally, a slight decrease in serum triglyceride concentration was found in women who started to take diuretics and an increase in women who started to beta-blockers compared to other women. Serum urate concentration tended to increase in women who started to take diuretics and PCV tended to decrease in women who started to take beta-blockers. Blood glucose was unimpaired. In conclusion, the differences observed were rather small and seemed to be rather unimportant compared to the threat presented by the arterial hypertension itself.

ABSTRACT.A population sample of women in Göteborg, Sweden, was studied in 1968–69 and re‐studied in 1974‐75. A number of metabolic variables could be studied cross‐sectionally (in 1974–75) and longitudinally (intraindividual changes between 1968–69 and 1974–75). When studied cross‐sectionally, increased serum urate concentrations were observed in women on diuretics and increased serum triglycerides in women on β‐blockers, compared to other women, while no obvious differences were found in blood glucose and serum cholesterol concentrations or in packed red cell volume (PCV). When studied longitudinally, a slight decrease in serum triglyceride concentration was found in women who started to take diuretics and an increase in women who started to take β‐blockers compared to other women. Serum urate concentration tended to increase in women who started to take diuretics and PCV tended to decrease in women who started to take β‐blockers. Blood glucose was unimpaired. In conclusion, the differences observed were rather small and seemed to be rather unimportant compared to the threat presented by the arterial hypertension itself.

A comprehensive population study of women aged 38-60 was carried out in Göteborg, Sweden in 1968-1969. A subsample comprising 194 women were submitted to a maximal work performance test using a bicycle ergometer. Exercise-induced ECG changes were common and as common in women as in men in Göteborg who had been studied in the same way. ST depressions (Minnesota Code items 4:1-2) were observed 4 min after maximal exercise in 30 women. All these women were still alive when a follow-up was made 6 years later, none had had myocardial infarction, and only 2 of them reported symptoms of angina pectoris. 1 woman later on had a fatal myocardial infarction as was found in a 12-year-follow-up study. It is concluded that exercise-induced ECG changes are of limited value for predicting myocardial infarction or death from ischaemic heart disease in women.

ABSTRACT. In a population study in Göteborg, Sweden, comprising women in the age strata 44, 52, 56, 60 and 66 years, serum thyrotrophin (S‐TSH) was determined in 1283 women representative of the general population of women of these ages. No women with previously unknown hypothyroidism were found at the clinical examination; 47 (3.7%) were on thyroxine treatment, 9 (0.7%) because of spontaneous hypothyroidism. Sixteen women (1.2%) had markedly elevated S‐TSH concentration (≥14 mU/l). They were studied further by determination of thyroid hormones and circulating antithyroid microsomal and thyroglobulin antibodies, and those with goiter were subjected to fine‐needle biopsy of the thyroid gland. They were furthermore followed for four years. Four euthyroid women were given thyroxine because of goiter and abnormal laboratory test results. Of nine individuals with high S‐TSH concentration as well as high titers of thyroid antibodies and/or biopsy evidence of autoimmune thyroiditis, seven became hypothyroid within the four years of follow‐up. The other two women had consistently elevated basal S‐TSH concentration and exaggerated S‐TSH response after thyroliberin administration. We conclude that the majority of individuals without previously recognized thyroid disease who have S‐TSH concentration above 14 mU/l with the assay used will require thyroxine therapy within a few years. In one woman, however, with multinodular colloid goiter and high titer of antimicrosomal antibodies, the basal S‐TSH concentration decreased during follow‐up to a high normal value; the S‐TSH response to thyroliberin was high borderline. She remained euthyroid during follow‐up. The results suggest an annual incidence of spontaneous hypothyroidism of 1–2 cases per 1000 middle‐aged females in a Swedish west‐coast population.

Of 1302 women aged 44–66 years in a population study in Göteborg, Sweden, in 1974–75, who were representative of women of all the ages studied in the area, 165 were taking antihypertensive drugs, mostly β-blockers and diuretics. The prevalence of sleep disturbances, nightmares, tiredness and melancholia or depression was studied in the total population sample, and a comparison was made between women who were or were not taking antihypertensive drugs. In the entire population sample no significant difference was found between the various age strata studied, although with increasing age there was a trend towards fewer complaints of nightmares, but a larger number of sleep disturbances as a whole. No difference was found between women taking or not taking various types of single-drug therapy or combinations of antihypertensive drugs.

Representative population samples of middle-aged women (1462 participants, a participation rate of 90.1%) were followed from 1968-1969 for 10 years with respect to morbidity and mortality from myocardial infarction, stroke and all causes of death. The same sample (1302 participants, 80.3%) was studied in 1974-1975. Data on the incidences of angina pectoris, intermittent claudication and hypertension in these women during the 6-year interval were analyzed. Obesity as a premorbid characteristic was estimated by weight index and sum of triceps and subscapsular skinfold thicknesses. The overall trends between weight index and the incidences of myocardial infarction and angina pectoris were weak, while there were excess frequencies in the top quintiles, indicating that only marked obesity constitutes an increased risk. The incidence of hypertension was positively correlated to both indices of obesity. The death rate irrespective of cause was negatively correlated to the sum of skinfolds but was not correlated to the weight index. The death rate from myocardial infarction seemed to be correlated to both obesity indices.

Anthropometric data and body composition, estimated from total body potassium and total body water determinations, were studied in 1968 to 1968 and 1974 to 1975 in a population sample of middle-aged women. Altogether 1302 women participated in the anthropometric studies and 79 women in the body composition studies on both occasions. Body height decreased with age both secularly and biologically. The reduction of body height was greater at higher ages. Body weight increased with age, the change being partly a cohort effect and partly an effect of age. Evidence of a reduced muscle mass in the arms with age was found. Body cell mass increased with age in some age strata. There was an increase in subcutaneous fat with age, both in the arms and in the trunk. Body fat did not change significantly with age in the age strata studied. A change in body weight was accompanied by a smiliar change in both body fat and body cell mass.

An interview concerning previous history of renal stone disease was included when a population study of 1 462 women aged 38--60 years was carried out in 1968-69. About 5% reported a history of renal stone disease. When the women were re-examined six years later, an annual incidence of 3.7 per 1 000 was found. Women with history of new attacks of renal stone disease usually had the same serum calcium and serum uric acid values as other women except for a few with markedly increased serum uric acid values.

In a population sample of 1462 middle-aged women socioeconomic data were studied in relation to obesity, assessed by a body weight index. Education, annual income, and social class were negatively correlated with weight index (WI). Husband's social class was a stronger determinant of obesity in the woman than her own class. Age of husband and number of children were significantly correlated with WI. There was also a weak correlation between being single and WI. Sick leave was not correlated to WI. Pension was correlated to WI when adjusted for age, but not when allowance was also made for social class. Age, husband's social class, education, husband's income, and number of children were independent predictors of WI among the married women. In the single women, age and own income were independent predictors of WI but not number of children, education or own social class.

A population sample totalling 1462 middle-aged women was studied in 1968-69. A re-study of the same women in 1974-75 comprised 1302 women. Body composition and adipose tissue cellularity were determined in a systematic subsample of 227 women and in a subsample of 76 obese women. There was a significant relation between body build in childhood (evaluated retrospectively as lean, normal or obese) and prevalence and degree of obesity in adulthood. There was a highly significant relation between the body weights in 1968-69 and 1974-75, while a low order negative correlation was found between body weight in 1968-69 and change in weight between 1968-69 and 1974-75. There was a significant relation between fat cell weight and weight index in the lower range and between fat cell number and weight index throughout the whole range studied. Body cell mass correlated with weight index and total fat cell number but not with fat cell weight. There was no significant correlation between body cell mass and obesity in childhood. There was a significant relation between degree of obesity and total fat cell number when age of onset was kept constant, but not between age of onset and total fat cell number when degree of obesity was kept constant. An association between childhood obesity and obesity in adulthood was shown. However, the concept of a critical period in childhood for changes in total fat cell number was not supported.

A representative population sample of middle-aged women was studied in 1968-1969 and re-studied in 1974-1975. A total of 1302 women participated in both studies (80.3% of the initial sample). A statistically significant correlation was found between weight gain and the incidences of angina pectoris and arterial hypertension. A statistically significant correlation was also found between cessation of smoking and weight gain. Regression analysis revealed statistically significant changes of systolic and diastolic blood pressures, fasting blood glucose, serum cholesterol, serum triglycerides and serum uric acid with changes in body weight.

A population sample of 1,462 middle-aged women (participation rate 90.1%) was studied in 1968–1969, 1,302 of whom (participation rate 80.3%) were reexamined in 1974–1975. Cigarette smoking was more frequent among younger women. Current smokers were leaner than nonsmokers. A U-shaped relationship was found between obesity index and cigarette consumption. This relationship was not explained by differences in energy intake, physical activity, or social class. Cessation of smoking was correlated with weight gain, and commencement of smoking with weight loss. Of those who quit 13% gained weight ⪖10.0 kg and 22% gained between 5.0 and 9.9 kg compared with 4 and 14%, respectively, among those who did not change smoking habits. The average weight change was +3.5 and −0.7 kg among those who quit smoking and started smoking, respectively, compared with +1.4 kg among those who did not change smoking habits. A greater weight gain with the amount smoked was found both in those who stopped smoking and in those who continued smoking. Increased physical activity and reduced energy intake need consideration at cessation of smoking, especially among heavy smokers. The quantitative aspects of the relationship between smoking and obesity, and between cessation of smoking and weight gain, are considered to be of special interest for health personnel engaged in antismoking campaigns.

A variety of anthropometric measurements was made in a randomized population sample of middle-aged women in five age strata in whom body composition was estimated from total body potassium and total body water determined by whole body counting and isotope dilution technique, respectively. No significant differences with age were found for total body potassium or total body water. A significant age difference was found for body fat mass. Simple linear correlations between anthropometric variables and body fat mass estimates were found to be 0.90, 0.86, 0.77 for body weight, buttock circumference, and sum of triceps and subscapular skinfold thicknesses, respectively. Multiple regression analysis showed that these three variables accounted for 80 to 91% of the variation in body fat in the different age strata studied. Multiple regression equations for prediction of body fat from anthropometric variables are given. In about two-thirds of the subjects, the difference between predicted body fat mass and estimated body fat mass was found to be less than ±2.5 kg.

A representative population sample of middle-aged women was studied in 1974-75. In a subsample, body composition and adipose tissue cellularity variables were determined and individuals with a particular clinical disorder were compared with the total subsample. Women with diabetes mellitus had more body fat and higher fat cell weights and larger fat cell members, whereas these variables did not differ in women with IHD or hypertension compared with the total subsample. Total body fat correlated with arterial BPs, fasting blood glucose, serum lipids and serum uric acid. The correlations were stronger than those reported previously by us between weight index and these variables. In univariate analyses, fat cell weight correlated with systolic BP, serum triglycerides and serum uric acid, and fat cell number with diastolic BP, fasting blood glucose and serum uric acid. In multivariate analyses, when due allowance was made for total body fat, the correlations between these variables and fat cell weight or fat cell number did not reach statistical significance.

Body weight, body height, skinfolds, circumferences and weight indices in a population sample of 1462 women in ages between 38 and 60 years are presented. Significant age differences were noted. High correlations (r) were found between body weight and triceps and subscapular skinfolds (0.62 and 0.72 respectively) and between body weight and arm, waist and buttock circumferences (0.75-0.88). Age differences were mostly noted between 46 and 50 years of age. After that age there was a comparatively greater increase of the waist circumference than of the buttock circumference, while triceps skinfold seemed to decrease after the age of 50 indicating an altered adipose tissue distribution from the extremities to the trunk with increasing age. When taking data from a previous study of body weight in the same population of women into consideration it seems that the age differences in body weight found in cross-sectional study like the present one may to a large extent depend on differences between different cohorts studied.

ABSTRACT A comprehensive population study of women aged 38–60 was carried out in Göteborg, Sweden in 1968‐69. The same women were re‐studied six years later, in 1974‐75. Erythrocyte sedimentation rate (ESR) was studied on both occasions. A statistically significant rise in ESR with age was noted both cross‐sectionally and longitudinally, which means that the increase was related to age and was not a cohort effect. The mean annual increase in ESR was about 0.6 mm/h, but there was a significant difference between the ages studied, the increment being larger in the upper age groups. Women with high ESR (here defined as ESR ≥30 mm/h) had lower Hb and Hct values than other women. Leucocyte counts were higher in women with ESR ≥30 mm/h than in the others, but differences were statistically significant only in the upper age groups. Serum iron levels were lower in women with high ESR, while TIBC values were similar to those in the other women. Significant differences were found for transferrin saturation (lower in women with high ESR). Cholesterol levels were similar, while triglyceride levels either tended to be or were significantly higher in women with high ESR. About half of the women with ESR ≥30 mm/h had a possible explanation for their increased ESR. In no case did an increased ESR give rise to a new diagnosis of clinical significance, either in 1968‐69 or in 1974‐75. Nor had any diagnoses been missed in women with a high ESR in 1968‐69, according to the re‐examination six years later. All except one woman, in whom the diagnosis of neoplastic disease was made in the interval between the two examinations, had ESR ≥30 mm/h in 1968‐69, and women in whom a neoplastic disease was found later had on average no higher ESR in 1968‐69 than the others. It is concluded that for screening purposes, ESR is of very limited value.