Temporal Shifts in Cardiovascular Risk Factor Distribution

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• 作者：Gr谩inne H. Long ; Rebecca K. Simmons ; Margareta Norberg ; Patrik Wennberg ; Bernt Lindahl ; Olov Rol ; sson ; Simon J. Griffin ; Lars Weinehall
• 刊名：American Journal of Preventive Medicine
• 出版年：February, 2014
• 年：2014
• 卷：46
• 期：2
• 页码：112-121
• 全文大小：684 K

文摘

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lass="h4">Background

Complementary 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).

lass="h4">Purpose

To examine secular changes in glucose and CVD risk factors over 20 years during an individual and population-based CVD prevention program in V盲sterbotten County, Sweden.

lass="h4">Methods

Population-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.

lass="h4">Results

Between 1991-1995 and 2006-2010, mean age-adjusted cholesterol (men=鈭?.53, 95% CI=鈭?.55, 鈭?.50 mmol/L; women=鈭?.48, 95% CI=鈭?.50, 鈭?.45 mmol/L) and systolic blood pressure declined (men=鈭?.06, 95% CI=鈭?.43, 鈭?.70 mm Hg; women=鈭?.27, 95% CI=鈭?.64, 鈭?.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.

lass="h4">Conclusions

These 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.