title: Why have sustained increases in obesity and type 2 diabetes not offset declines in cardiovascular mortality over recent decades in Western countries?
abstract: The majority of Western countries have reported large falls in cardiovascular diseases (CVD) mortality rates since the 1970s. Yet since the 1980s, they have also experienced two-fold or three-fold increases in the prevalence of obesity and type 2 diabetes--both considered substantial risk factors for CVD. So why have these increasing risks apparently not impacted on CVD mortality falls? This viewpoint outlines the main factors involved; examines recent trends and apparent contradictions; offers some explanations for the trends; discusses how more usefully complex epidemiological models might lead to clearer evidence; offers some explanations for the trends; and explores the implications for CVD prevention.
authors.affiliation: Department of Public Health & Policy, University of Liverpool, Liverpool L69 3BX, UK. capewell@liverpool.ac.uk
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
authors.forename: Iain
authors.initials: I
authors.lastname: Buchan
mesh_terms: D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors