title: Predictiveness of body mass index for fatal coronary heart disease in men according to length of follow-up: a 21-year prospective cohort study.
abstract: OBJECTIVE
  To test the association between body mass index (BMI) and other coronary risk factors and the risk of a fatal coronary heart disease (CHD) event in different time periods during follow-up.
  
  
  METHODS
  Prospective cohort study with a 21 year follow-up period. A screened sample of 14,403 men aged 40-49 years initially free of CHD. Risk of fatal CHD was calculated for 21 years' cumulative follow-up and for four consecutive 5-year periods.
  
  
  RESULTS
  After adjustment for age and the other risk factors, total cholesterol and systolic blood pressure retained their predictive strength for CHD mortality throughout follow-up. Though cigarette smoking remained a significant predictor, the relative risk decreased with time (test of trend: p=0.01). Intermediate to vigorous physical activity at leisure was protective for 10 years of follow-up and a question on mental stress for 5 years. The test of trend indicated that the risk associated with BMI increased with the duration of follow-up (p=0.002).
  
  
  CONCLUSIONS
  Our data show that coronary risk factors predicted CHD mortality differently according to the length of follow-up, and suggest that the harm associated with obesity may take more than a decade to become evident, in contrast to the classical CHD risk factors.
authors: Norwegian Health Service Research Centre, Department of Preventive Cardiology, Preventive Medicine Clinic, Ullevål University Hospital, Oslo, Norway. lise.lund.haheim@nhsrc.no
authors: Lise Lund
authors: LL
authors: Håheim
authors: Serena
authors: S
authors: Tonstad
authors: Ingvar
authors: I
authors: Hjermann
authors: Paul
authors: P
authors: Leren
authors: Ingar
authors: I
authors: Holme
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003327:Coronary Disease / Q000401:mortality* / Q000523:psychology; D015444:Exercise; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013315:Stress, Psychological / Q000150:complications
chemical_list: D008055:Lipids