Secular changes in cardiovascular risk factors and attack rate of myocardial infarction among men aged 50 in Gothenburg, Sweden. Accurate prediction using risk models

J Intern Med. 2008 Jun;263(6):636-43. doi: 10.1111/j.1365-2796.2008.01931.x. Epub 2008 Feb 20.

Abstract

Aims: Coronary risk factor changes were related to attack rate of acute myocardial infarction (AMI).

Methods and results: Cross-sectional population samples of 50-year-old men were examined every 10th year from 1963 to 2003. Attack rates of AMI were recorded from 1975 to 2004. Prevalence of smoking decreased from 56% in 1963 to 22% in 2003. Leisure time physical activity decreased (n.s.), while psychological stress remained the same. Diabetes prevalence increased from 3.6% to 6.6%. Body mass index (BMI) increased from 24.8 to 26.4 kg m(-2). Blood pressures decreased from 138.2/90.6 to 134.7/84.9 mmHg (P = 0.00001). Serum total cholesterol decreased from 6.42 to 5.50 mmol L(-1) (P = 0.0001), but serum triglycerides increased from 1.26 to 1.71 mmol L(-1) (P = 0.0001). The multivariable risk according to total cholesterol, blood pressure and smoking for AMI decreased from the set value 1.0 in 1963 to 0.418. From 1975-1979 to 2000-2004 attack rates for AMI for the age groups 35-44, 45-54 and 55-64 declined to 45%, 46% and 45%, respectively. The 28-day case fatality declined from 30%, 38% and 46% to 12%, 16% and 20%.

Conclusion: The more than 50% decline in attack rate of AMI during 30 years was comparable with the decline in risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anthropometry
  • Blood Pressure
  • Cardiovascular Diseases / etiology
  • Diabetes Mellitus / epidemiology
  • Epidemiologic Methods
  • Health Behavior
  • Humans
  • Lipids / blood
  • Male
  • Middle Aged
  • Motor Activity
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / etiology
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking / trends
  • Stress, Psychological / complications
  • Stress, Psychological / epidemiology
  • Sweden / epidemiology

Substances

  • Lipids