title: Obesity, smoking and secular trends in cardiovascular risk factors in middle-aged women: data from population studies in Göteborg from 1980 to 2003.
abstract: BACKGROUND
  To study the trends in cardiovascular risk factors in middle-aged city-dwelling Swedish women from 1980 to 2003.
  
  
  METHODS
  Using cross-sectional population-based surveys, five random population samples of a total of 1915 women aged between 45 and 54 years, participating in the BEDA study in 1980, WHO MONICA studies in 1985, 1990 and 1995, and a study of 50-year-old women in 2003 were measured for the following parameters: anthropometry, serum cholesterol and triglyceride levels, smoking habits, blood pressure, physical activity and stress.
  
  
  RESULTS
  Over almost 25 years, middle-aged women gained on average 4.4 kg in weight, with a net increase in body mass index (BMI) from 24.7 to 25.6 kg m⁻². The proportion of participants classified as obese (≥30 kg m⁻²) increased by 50% from 10.4% to 15.1%. Women who were smokers in 2003 did not have lower BMI values than nonsmokers. Mean serum cholesterol concentrations decreased markedly, whereas smoking habits did not significantly change. The prevalence of hypertension decreased by 8%, whereas that of diabetes remained stable at around 2%. Optimal risk factor status - no smoking, normotension and serum cholesterol <5 mmol l⁻¹ - was present in less than one in six women in 2003, and similar across BMI categories.
  
  
  CONCLUSIONS
  The favourable decline in cholesterol levels and hypertension and the increase in leisure time physical activity were offset by an increase in obesity, triglyceride levels and experience of stress, with only a minority of participants (less than one in six) having an optimal level of risk factors with respect to smoking, serum cholesterol and hypertension in 2003. This applied also to overweight and obese women. In earlier cohorts, subjects with low BMI values were more often smokers, whereas the opposite is observed in recent cohorts. Thus, women who smoke no longer have the advantage of lower weight.
authors.affiliation: Department of Emergency and Cardiovascular Medicine, Sahlgrenska University Hospital/Östra, Göteborg, Sweden. saga.johansson@astrazeneca.com
authors.forename: S
authors.initials: S
authors.lastname: Johansson
authors.forename: L
authors.initials: L
authors.lastname: Wilhelmsen
authors.forename: C
authors.initials: C
authors.lastname: Welin
authors.forename: H
authors.initials: H
authors.lastname: Eriksson
authors.forename: L
authors.initials: L
authors.lastname: Welin
authors.forename: A
authors.initials: A
authors.lastname: Rosengren
mesh_terms: D000886:Anthropometry / Q000379:methods; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000639:trends; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
chemical_list: D008055:Lipids