Temporal Shifts in Cardiovascular Risk Factor Distribution

Abstract

BackgroundComplementary strategies to shift risk factor population distributions and target high-risk individuals are required to reduce the burden of type 2 diabetes and cardiovascular disease (CVD).PurposeTo examine secular changes in glucose and CVD risk factors over 20 years during an individual and population-based CVD prevention program in Västerbotten County, Sweden.MethodsPopulation-based health promotion intervention was conducted and annual invitation for individuals turning 40, 50, and 60 years to attend a health assessment, including an oral glucose tolerance test, biochemical measures, and a questionnaire. Data were collected between 1991 and 2010, analyzed in 2012 and available for 120,929 individuals. Linear regression modeling examined age-adjusted differences in CVD risk factor means over time. Data were direct-age-standardized to compare disease prevalence.ResultsBetween 1991–1995 and 2006–2010, mean age-adjusted cholesterol (men=−0.53, 95% CI=−0.55, −0.50 mmol/L; women=−0.48, 95% CI=−0.50, −0.45 mmol/L) and systolic blood pressure declined (men=−3.06, 95% CI=−3.43, −2.70 mm Hg; women=−5.27, 95% CI=−5.64, −4.90 mm Hg), with corresponding decreases in the age-standardized prevalence of hypertension and hyperlipidemia. Mean age-adjusted 2-hour plasma glucose (men=0.19, 95% CI=0.15, 0.23 mmol/L; women=0.08, 95% CI=0.04, 0.11 mmol/L) and BMI increased (men=1.12, 95% CI=1.04, 1.21; women=0.65, 95% CI=0.55, 0.75), with increases in the age-standardized prevalence of diabetes and obesity.ConclusionsThese data demonstrate the potential of combined individual- and population-based approaches to CVD risk factor control and highlight the need for additional strategies addressing hyperglycemia and obesity.

Living in an urban environment and non-communicable disease risk in Thailand: Does timing matter?

“…Those who spent their early childhoods in an urban area and more than 75% of their life in an urban residence had a much higher LDL cholesterol level than those who also spent their childhoods in urban areas but have spent less than 25% of their lives in an urban residence, an effect size of similar magnitude to the effect of statins in lowering LDL cholesterol (Law et al, 2003). Incorporating individual and population level interventions focusing on population shifts in distributions of risk factors (Rose, 2001), such as the one conducted in Sweden that focused on adults from age 30 (Weinehall et al, 1999, Long et al, 2014, could be a cost-effective public health policy to prevent NCDs in developing countries such as Thailand. 12.9 62.0 14.3 *16 additional participants are in the study population but were no longer in the hospital database by July 2014 when demographic characteristics of the source population were obtain from official hospital personnel records.…”

Healthy behaviours and 10-year incidence of diabetes: A population cohort study

“…In one large population-based UK cohort, meeting five behavioural goals was inversely associated with the risk of developing diabetes over four years (Simmons et al, 2006). In the face of a growing burden of disease associated with rising glycaemia levels (Long et al, 2014), an improved understanding of the population impact meeting health behaviour goals might have on diabetes risk could help optimise and refine populationlevel health interventions.…”

Cardiovascular risk factors in elderly : With special emphasis on atrial fibrillation, hypertension and diabetes

“…Physically active persons have less atherosclerotic and metabolic risk factors for CVDs and live longer than physically inactive individuals [23]. There is a need for population based as well as individual prevention programs in PHC [23,24]. Several risk calculation instruments are available to assess the overall CVD risk, for example The Framingham Risk Score, UKPDS Risk Engine and SCORE, where the latter is customised for Swedish conditions [25].…”