Generalised anxiety disorder and hospital admissions: findings from a large, population cohort study.

Objective: Generalised anxiety disorder (GAD) is the most common anxiety disorder in the general population and has been associated with high economic and human burden. However, it has been neglected in the health services literature. The objective of this study is to assess whether GAD leads to hospital admissions using data from the European Prospective Investigation of Cancer-Norfolk.

A strong sense of coherence associated with reduced risk of anxiety disorder among women in disadvantaged circumstances: British population study.

Objective: Many patients receiving medical treatment for anxiety relapse or do not improve. Research has therefore been turning to coping mechanisms as a way to decrease anxiety rates. Previously, we showed that living in a deprived area significantly increases the risk of anxiety in women, but not in men.

Cumulative social risk exposure in childhood and smoking and excessive alcohol use in adulthood.

Background: Social inequalities in adult smoking and excessive alcohol intake may be associated with exposure to multiple childhood social risk factors across different domains of risk within the household.

Methods: We used data from a cross-sectional cohort study of adults (40-75 years) in 1993-97 living in England (N = 19466) to examine the association between clusters of childhood social risks across different domains with adult smoking and excessive alcohol use. Participants reported exposure to six childhood social risk factors, current smoking behaviour and alcohol intake.

Discovery and refinement of loci associated with lipid levels.

Levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and total cholesterol are heritable, modifiable risk factors for coronary artery disease. To identify new loci and refine known loci influencing these lipids, we examined 188,577 individuals using genome-wide and custom genotyping arrays. We identify and annotate 157 loci associated with lipid levels at P < 5 × 10(-8), including 62 loci not previously associated with lipid levels in humans.

Common variants associated with plasma triglycerides and risk for coronary artery disease.

Triglycerides are transported in plasma by specific triglyceride-rich lipoproteins; in epidemiological studies, increased triglyceride levels correlate with higher risk for coronary artery disease (CAD). However, it is unclear whether this association reflects causal processes. We used 185 common variants recently mapped for plasma lipids (P < 5 × 10(-8) for each) to examine the role of triglycerides in risk for CAD.

Social adversity experience and blood pressure control following antihypertensive medication use in a community sample of older adults.

Background: Psychosocial stress is a risk factor for hypertension and has been shown to affect response to treatment for psychiatric illnesses.

Purpose: We investigate the relationship between a history of social adversity experience and blood pressure control following antihypertensive medication use.

Methods: A total of 1,186 participants selected from the European Prospective Investigation into Cancer-Norfolk study (531 men and 655 women, aged 42 to 80 years) had attended two health checks at which blood pressure measurements were taken; were taking antihypertensive medication at the second, but not the first health check; and had completed a questionnaire assessment of their social and psychological circumstances which included details of traumatic experiences in childhood and of adverse life events, long-term difficulties, and perceived stress in adulthood.

Lipoprotein(a) and risk of coronary, cerebrovascular, and peripheral artery disease: the EPIC-Norfolk prospective population study.

Objective: Although the association between circulating levels of lipoprotein(a) [Lp(a)] and risk of coronary artery disease (CAD) and stroke is well established, its role in risk of peripheral arterial disease (PAD) remains unclear. Here, we examine the association between Lp(a) levels and PAD in a large prospective cohort. To contextualize these findings, we also examined the association between Lp(a) levels and risk of stroke and CAD and studied the role of low-density lipoprotein as an effect modifier of Lp(a)-associated cardiovascular risk.

Genetic determinants of lipid homeostasis.

Circulating levels of blood lipids are heritable risk factors for atherosclerosis and heart disease, and are the target of therapeutic intervention. Studies of monogenic disorders and - more recently - genome-wide association studies have identified several important genetic determinants of blood lipid levels. These have the potential to provide new drug targets to alter blood lipid levels and may improve prediction of cardiovascular disease.

Educational attainment and mean leukocyte telomere length in women in the European Prospective Investigation into Cancer (EPIC)-Norfolk population study.

Background: Telomere length has been postulated as a marker of biological aging. Recent evidence has suggested that educational attainment but not social class is associated with telemore length.

Methods: We investigated the associations between educational attainment, social class and relative mean telomere length in an ethnically homogeneous population of 4441 women, aged 41-80 years.

A genome-wide screen for interactions reveals a new locus on 4p15 modifying the effect of waist-to-hip ratio on total cholesterol.

Recent genome-wide association (GWA) studies described 95 loci controlling serum lipid levels. These common variants explain ∼25% of the heritability of the phenotypes. To date, no unbiased screen for gene-environment interactions for circulating lipids has been reported.

Life stress, emotional health, and mean telomere length in the European Prospective Investigation into Cancer (EPIC)-Norfolk population study.

We investigated the association between psychological stress, emotional health, and relative mean telomere length in an ethnically homogeneous population of 4,441 women, aged 41-80 years. Mean telomere length was measured using high-throughput quantitative real-time polymerase chain reaction. Social adversity exposure and emotional health were assessed through questionnaire and covariates through direct measurement and questionnaire.

Lifestyle behaviours and quality-adjusted life years in middle and older age.

Objective: to examine the relationship between combined lifestyle behaviours and quality-adjusted life years (QALYs) in a general population.

Methods: a population-based study was conducted in 13,358 men and women who participated in the European Prospective Investigation into Cancer (EPIC)-Norfolk (baseline 1993-97). A score of 1 was given to each of non-smoking, physically not inactive, moderate alcohol consumption (1-14 units) and consumption of at least five portions of fruit and vegetables (vitamin C level ≥50 µmol/l).

Mastery is associated with cardiovascular disease mortality in men and women at apparently low risk.

Objective: We examine the prospective relationship between mastery, where limited mastery is defined as the inability to control negative emotions (and perceiving stressful experiences as beyond personal control), and cardiovascular disease (CVD) mortality particularly among individuals at apparently low CVD risk.

Design: Prospective population-based study of 19,067 men and women, aged 41-80 years with no previous heart disease or stroke at baseline assessment.

Main Outcome Measures: Primary outcome measure CVD mortality.

Physical functional health predicts the incidence of coronary heart disease in the European Prospective Investigation into Cancer-Norfolk prospective population-based study.

Background: Little is known about the relationship between physical functional health and long-term risk of coronary heart disease (CHD) independently of known risk factors in a general population.

Methods: Men and women aged 40-79 years at baseline who completed a health and lifestyle questionnaire and attended a health examination during 1993-97 participating in the European Prospective Investigation into Cancer-Norfolk who were free of myocardial infarction (MI), stroke and cancer were included. Eighteen months later, physical functional health was assessed using physical component summary (PCS) scores of Short-Form 36-item questionnaire (SF-36).

The Short-Form Six-Dimension utility index predicted mortality in the European Prospective Investigation into Cancer-Norfolk prospective population-based study.

Objective: To examine the relationship between the Short-Form Six-Dimension (SF-6D) and mortality.

Study Design And Setting: Participants were 17,736 men and women aged 40-79 years at baseline who lived in Norfolk, UK, and had no known cardiovascular disease or cancer, and completed the anglicized Short-Form 36 (SF-36)-item during 1996-2000 in the European Prospective Investigation into Cancer-Norfolk prospective population study. The SF-36 data were converted to SF-6D.

No evidence that social stress is associated with breast cancer incidence.

Women commonly attribute the experience of stress as a contributory cause of breast cancer. The purpose of this study is to investigate the associations between a history of social stress and breast cancer risk. A total of 11,467 women with no prior history of breast cancer, participants in the European Prospective Investigation into Cancer (EPIC)-Norfolk population-based prospective cohort study, completed a comprehensive assessment of lifetime social adversity exposure.

Effect of age and sex on the relationship between different socioeconomic indices and self-reported functional health in the EPIC-Norfolk population-based study.

Background: The relationship between different social-economic indices and physical and mental functional health of older people compared with younger people is unclear.

Objective: To examine the effect of age and sex on the relationship between various social-economic indices and self-reported functional health.

Methods: A population-based cross-sectional study was conducted in 19,088 participants of European Prospective Investigation into Cancer (EPIC)-Norfolk, UK, ages 40-79 years at baseline.

No association between APOE and major depressive disorder in a community sample of 17,507 adults.

Mood-related phenotypes are commonly comorbid with, and have been implicated in the development of, neurological disorders. APOE is a major susceptibility gene for neurodegeneration. Recent evidence from case-control studies has suggested that the apoE 2 allele is associated with major depressive disorder (MDD).

Major depression, C-reactive protein, and incident ischemic heart disease in healthy men and women.

Objective: To investigate how C-reactive protein (CRP) and major depressive disorder (MDD) relate to each other and to incident ischemic heart disease (IHD). Studies have shown that both depression and raised CRP concentration predict IHD and that elevated CRP is linked with increased risk of depression.

Methods: A prospective case-control study of healthy men and women, aged 45 to 79 years, was undertaken within the United Kingdom European Prospective Investigation into Cancer (EPIC)-Norfolk study.

Depression and ischemic heart disease mortality: evidence from the EPIC-Norfolk United Kingdom prospective cohort study.

Objective: The authors investigated the association between major depressive disorder, including its clinical course, and mortality from ischemic heart disease.

Method: This was a prospective cohort study of 8,261 men and 11,388 women 41-80 years of age who were free of clinical manifestations of heart disease and participated in the Norfolk, U.K.

Healthy lifestyle choices: could sense of coherence aid health promotion?

Background: A research framework based on the personal characteristic defined by a sense of coherence (SOC) focuses on the effective use of resources to maintain good health.

Objectives: To test the hypothesis that individual differences in SOC are associated with healthier lifestyle choices independently of social class and education.

Design And Setting: Cross sectional.

Self-reported mental health-related quality of life and mortality in men and women in the European Prospective Investigation into Cancer (EPIC-Norfolk): a prospective population study.

Objective: To explore the relationship between self-reported mental functional health and mortality.

Methods: Participants included 17,777 men and women aged 40 to 79 years at baseline who lived in Norfolk, UK, and had no known cardiovascular disease or cancer, and completed the anglicized Short Form 36-item questionnaire (UK SF-36) during 1996 to 2000 in the European Prospective Investigation into Cancer-Norfolk prospective population study. We examined the relationship between mental functional health derived from the mental component summary scores of the SF-36 and mortality from all causes, cardiovascular disease, cancer, and other causes during an average 6.

Adaptation to social adversity is associated with stroke incidence: evidence from the EPIC-Norfolk prospective cohort study.

Background And Purpose: Laboratory-based studies have suggested that individual differences in cardiovascular reactivity and stress adaptive capacity are associated with stroke incidence. We test the hypothesis that sense of coherence (SOC), a marker of social stress adaptive capacity, is associated with incident stroke in a population-based prospective cohort study.

Methods: A total of 20,629 participants, aged 41 to 80 years, in the UK European Prospective Investigation into Cancer (EPIC)-Norfolk study, who had not previously experienced a stroke, completed assessments that included SOC and details of their experience of life events during adulthood.

Psychosocial factors and asthma in a community sample of older adults.

Objective: The objective of this study was to investigate the associations between psychosocial factors and asthma in a population-based cohort study of older adults.

Methods: A total of 20,888 participants in the Norfolk cohort of the European Prospective Investigation into Cancer study completed assessments that included details of lifetime self-reported doctor-diagnosed asthma, mood disorder history, social adversity experience, and social support.

Results: Doctor-diagnosed asthma was reported by 1699 (8.