Understanding men's priorities: a first step towards improving men's health

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SMH Congress 2011 Abstracts

oi:10.1016/j.jomh.2011.08.097

Abstract ID: #0131ERUM CORTISOL AND CARDIOVASCULAR MORTALITY IN MENITH CHRONIC KIDNEY DISEASE

. Tomaschitz1,∗, S. Pilz2, E. Ritz3, T. Grammer4, K. Kienreich2,. Winkelmann5, B. Boehm6, W. März7

Medical University of Graz, Graz, Austria, 2 Deparment of Endocrinology andetabolism, Medical University of Graz, Graz, Austria, 3 Department of Nephrology,niversity of Heidelberg, Heidelberg, Germany, 4 Mannheim Institute of Pub-ic Health, Rupertus Carola University, Medical Faculty Mannheim, Mannheim,ermany, 5 Cardiology Group Sachsenhausen, Frankfurt am Main, Germany,Division of Endocrinology, Diabetes and Metabolism, Graduate School of Moleculariabetology and Endocrinology, Ulm University, Ulm, Germany, 7 Clinical Institutef Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz,ustria

ackground: An appropriate response of theypothalamic–pituitary–adrenal axis to critical illness and traumas a crucial factor for survival. Elevated cortisol levels in the long-term,eflecting the chronic stress response, are, however, an emergingardiovascular risk factor in patients with reduced kidney function.e therefore aimed to evaluate the association between serum cortisol

oncentration (SCC) and risk of cardiovascular death in a cohort oflderly male patients with an estimated glomerular filtration rate (eGFR)f <60ml/min/1.73m2.aterials & Methods: We examined 229 male patients with an eGFR60ml/min/1.73m2 from the Ludwigshafen Risk and Cardiovascularealth (LURIC) Study. This prospective cohort study included Caucasianatients without primary kidney disease who were routinely referred fororonary angiography at baseline (1997–2000). Information on vital statusas continuously obtained from local person registries.esults: At baseline, 229 men (mean age = 68.0± 9.4 years) with mean SCCf 21.4± 1.5mg/l and mean eGFR of 46.8± 11.9ml/min/1.73m2, wereeferred for coronary angiography. Of these, 100 (43.7%) participantsad an acute coronary syndrome (ACS). Mean SCC (20.4 vs. 22.2�g/dl;= 0.086; [reference range: 5.0–25.0�g/dl]) did not differ significantlyetween patients with and without ACS, respectively.uring a median follow-up of almost 10 years, 64 (27.9%) male patientsied due to cardiovascular causes. Multivariate adjusted Cox proportionalazard analysis showed that higher SCC values at baseline were stronglyelated to increased cardiovascular mortality (hazard ratio for the thirdnd highest vs. lowest quartile of SCC were 2.13, 95% CI = 1.02–4.44nd 2.33, 95% CI = 1.12–4.85, respectively). In addition, adjusted analyseshowed that for each increase of 5 mg/l in SCC there was a 26% (P= 0.009)ncrease in the risk of cardiovascular mortality.

onclusion: Higher serum cortisol levels are associated with increased car-iovascular mortality in male patients with chronic kidney disease. Thesendings support the suggestion that elevated cortisol levels reflectinghronic stress play amajor role in the pathogenesis of fatal cardiovascularvents in men with reduced kidney function.

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40 jmh Vol. 8, No. 3, pp. 208–245, 2011

oi:10.1016/j.jomh.2011.08.098

Abstract ID: #0122

opic: Non-Urology/Psychosocial Behavior

NDERSTANDING MEN’S PRIORITIES: A FIRST STEP TOWARDSMPROVING MEN’S HEALTH

.J. Ng1,∗, E.M. Khoo1, W.Y. Low1, L.P. Wong1, H.M. Tan2

University of Malaya, Kuala Lumpur, Malaysia, 2 Sime Darby Medical Centre,uala Lumpur, Malaysia

ackground: This study aimed to compare the priorities of life in men fromenerations X and Y.aterials & Methods: This study used a qualitative methodology to explorehe priorities of men in terms of health, family, relationships, career, sexnd spiritual needs. It was conducted in an urban area of Malaysia in009/2010. Men were sampled purposively based on their age, ethnicitynd education level. Generation X was defined as those aged 30–44 yearshile generation Y comprised men aged 19–29 years.rained facilitators conducted 10 focus group interviews with men fromeneration X (n= 54) and 12 with men from generation Y (n= 69) usingsemi-structured interview guide. The interviews were audio-recorded,

ranscribed verbatim and checked for accuracy. Two researchers analysedhe transcripts independently by extracting and agreeing on the emerg-ng themes before converting them into nodes for coding across the 22ranscripts. NVivo 9 was used to manage the data.esults: There was a substantial difference in life priorities between menrom generations X and Y but this was less obvious among men from dif-erent ethnicities and educational backgrounds. Men from generation Xonsidered family as their main priority. Health and money were consid-red as a means to achieving quality in life and happiness. Those withower education did not place as much emphasis on health compared tohose with higher education. However, financial gain was the top prioritymong men from generation Y. Money was considered essential in sup-orting their education, social activities, enjoyment in life and for startingfamily. Some participants viewed family as a priority as it was theirmainource of emotional and financial support. Health was considered bymosts a pre-requisite for achieving their goals in life. Relationships and sexere not the main priority among the participants in this study.onclusion: In this study, health was not a priority among men from gen-rations X and Y. Family and financial gain were the priorities for men

rom generation X and Y, respectively. When planning for strategies tomprove men’s health, it is important to consider these priorities, whichould be used as a source of motivation for behavioural change.

oi:10.1016/j.jomh.2011.08.099

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