title: Secular changes in cardiovascular risk factors and attack rate of myocardial infarction among men aged 50 in Gothenburg, Sweden. Accurate prediction using risk models.
abstract: OBJECTIVE
  Coronary risk factor changes were related to attack rate of acute myocardial infarction (AMI).
  
  
  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%.
  
  
  CONCLUSIONS
  The more than 50% decline in attack rate of AMI during 30 years was comparable with the decline in risk factors.
authors.affiliation: Section of Preventive Cardiology, Göteborg University, Göteborg, Sweden. lars.wilhelmsen@gu.se
authors.forename: L
authors.initials: L
authors.lastname: Wilhelmsen
authors.forename: L
authors.initials: L
authors.lastname: Welin
authors.forename: K
authors.initials: K
authors.lastname: Svärdsudd
authors.forename: H
authors.initials: H
authors.lastname: Wedel
authors.forename: H
authors.initials: H
authors.lastname: Eriksson
authors.forename: P-O
authors.initials: PO
authors.lastname: Hansson
authors.forename: A
authors.initials: A
authors.lastname: Rosengren
mesh_terms: D000886:Anthropometry; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004812:Epidemiologic Methods; D015438:Health Behavior; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000639:trends; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
chemical_list: D008055:Lipids