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Dog Ownership and Cardiovascular Disease
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. (Tove Fall)ORCID iD: 0000-0002-6877-4307
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

The relationship between pet ownership and human health has been studied extensively; however, the effect of dog ownership on human health has had conflicting results. The overall aim of this research project was to investigate the impact of dog ownership, and the death of the dog, on human cardiovascular health and all-cause mortality.

Study I was a population-based study investigating the association between dog ownership with the risk of cardiovascular disease (CVD) and death. Of 3,432,153 individuals included, dog ownership (13.1%) was associated with a lower risk of CVD- and all-cause death by 23% and 20%, respectively. In single-person households, there was an inverse association between dog ownership and incident CVD, as well as a stronger inverse association with CVD-death and all-cause death.

Study II was a population-based study investigating the association between dog ownership and initiation of treatment for cardiovascular risk factors in 2,026,865 adults. Dog ownership (14.6%) was associated with a slightly elevated risk of initiating treatment (2%) for hypertension and dyslipidaemia, but not for diabetes mellitus. However, some evidence for residual confounding was found.

Study III investigated the risk of death after hospitalization for a first-ever acute myocardial infarction (n=181,696) or first-ever ischemic stroke (n=157,617) in two population-based cohorts. Dog ownership was associated with a 20% to 24% lower risk of all-cause mortality and CVD-death, respectively.

In Study I-III, ownership of hunting breed dogs was associated with the lowest risk of the outcomes, while owning dogs of mixed pedigree was associated with worse cardiovascular health.

Study IV found evidence of an increased risk of CVD after the loss of a life-insured pet (dog or cat; n=147,251) during the first week, 3-6 months after and 6-12 months after pet-loss.

This thesis has used the Swedish population and health registers to investigate the relationship between various aspects of dog ownership and cardiovascular risk. By using defined, quantifiable end-points and robust statistical methods, this project has made an important contribution to the body of research underlying the positive relationship between dog ownership and cardiovascular health, paving the way for further research into causal mechanisms.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. , p. 70
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1490
Keywords [en]
dog ownership, cardiovascular risk, cardiovascular disease, pet ownership
National Category
Medical and Health Sciences
Research subject
Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-357629ISBN: 978-91-513-0418-2 (print)OAI: oai:DiVA.org:uu-357629DiVA, id: diva2:1240590
Public defence
2018-10-09, Humanistiska Teatern, Engelska parken, Thunbergsvägen 3, Uppsala, 09:00 (English)
Opponent
Supervisors
Available from: 2018-09-18 Created: 2018-08-21 Last updated: 2018-09-18
List of papers
1. Dog ownership and the risk of cardiovascular disease and death: a nationwide cohort study
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2017 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, no 1, article id 15821Article in journal (Refereed) Published
Abstract [en]

Dogs may be beneficial in reducing cardiovascular risk in their owners by providing social support and motivation for physical activity. We aimed to investigate the association of dog ownership with incident cardiovascular disease (CVD) and death in a register-based prospective nation-wide cohort (n = 3,432,153) with up to 12 years of follow-up. Self-reported health and lifestyle habits were available for 34,202 participants in the Swedish Twin Register. Time-to-event analyses with time-updated covariates were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). In single- and multiple-person households, dog ownership (13.1%) was associated with lower risk of death, HR 0.67 (95% CI, 0.65-0.69) and 0.89 (0.87-0.91), respectively; and CVD death, HR 0.64 (0.59-0.70), and 0.85 (0.81-0.90), respectively. In single-person households, dog ownership was inversely associated with cardiovascular outcomes (HR composite CVD 0.92, 95% CI, 0.89-0.94). Ownership of hunting breed dogs was associated with lowest risk of CVD. Further analysis in the Twin Register could not replicate the reduced risk of CVD or death but also gave no indication of confounding by disability, comorbidities or lifestyle factors. In conclusion, dog ownership appears to be associated with lower risk of CVD in single-person households and lower mortality in the general population.

National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-334415 (URN)10.1038/s41598-017-16118-6 (DOI)000415658600066 ()29150678 (PubMedID)
Funder
Swedish Research Council Formas, 2013-1673
Available from: 2017-11-23 Created: 2017-11-23 Last updated: 2018-08-24Bibliographically approved
2. Dog ownership and Cardiovascular Risk Factors: a nationwide prospective register-based cohort study
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, article id e023447Article in journal (Refereed) Submitted
Abstract [en]

Objective To study the association between dog ownership and cardiovascular risk factors.

Design A nationwide register–based cohort study and a cross-sectional study in a subset.

Setting A cohort of 2 026 865 participants was identified from the Register of the Total Population and linked to national registers for information on dog ownership, prescribed medication, hospital admissions, education level, income and country of birth. Participants were followed from 1 October, 2006, to the end of the study on 31 December, 2012, assessing medication for a cardiovascular risk factor, emigration and death. Cross-sectional associations were further assessed in 10 110 individuals from the TwinGene study with additional adjustment for professional level, employment status, Charlson comorbidity index, disability and tobacco use.

Participants All Swedish residents aged 45–80 years on 1 October, 2006.

Main outcome measures Initiation of medication for hypertension, dyslipidaemia and diabetes mellitus.

Results After adjustment for confounders, the results indicated slightly higher likelihood of initiating antihypertensive (HR, 1.02; 95% CI, 1.01 to 1.03) and lipid-lowering treatment (HR, 1.02; 95% CI, 1.01 to 1.04) in dog owners than in non-owners, particularly among those aged 45–60 years and in those owning mixed breed or companion/toy breed dogs. No association of dog ownership with initiation of treatment for diabetes was found in the overall analysis (HR, 0.98; 95% CI, 0.95 to 1.01). Sensitivity analyses in the TwinGene cohort indicated confounding of the association between dog ownership and prevalent treatment for hypertension, dyslipidaemia and diabetes mellitus, respectively, from factors not available in the national cohort, such as employment status and non cardiovascularchronic disease status.

Conclusions In this large cohort study, dog ownership was associated with a minimally higher risk of initiation of treatment for hypertension and dyslipidaemia implying that the previously reported lower risk of cardiovascular mortality among dog owners in this cohort is not explained by reduced hypertension and dyslipidaemia. These observations may suffer from residual confounding despite access to multiple important covariates, and future studies may add valuable information.

Keywords
cardiovascular risk, hypertension, dog ownership, diabetes, registers
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-357625 (URN)10.1136/bmjopen-2018-023447 (DOI)000471144900063 ()30850401 (PubMedID)
Funder
Swedish Research Council, 2017-00641Swedish Research Council Formas, 2013-1673Göran Gustafsson Foundation for Research in Natural Sciences and Medicine
Available from: 2018-08-19 Created: 2018-08-19 Last updated: 2019-07-22Bibliographically approved
3. Dog ownership and mortality after a major cardiovascular event – a register-based prospective study
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(English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685Article in journal (Refereed) Submitted
Keywords
mortality, dog ownership, major cardiovascular event
National Category
Medical and Health Sciences
Research subject
Epidemiology
Identifiers
urn:nbn:se:uu:diva-357626 (URN)
Available from: 2018-08-19 Created: 2018-08-19 Last updated: 2018-08-21
4. The impact of death of a pet on major acute cardiovascular risk in the owner: a register-based cohort study
Open this publication in new window or tab >>The impact of death of a pet on major acute cardiovascular risk in the owner: a register-based cohort study
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(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-357627 (URN)
Available from: 2018-08-19 Created: 2018-08-19 Last updated: 2018-08-21

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