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Rea F. Progress in cardiovascular mortality: Latest data on mortality from ischemic heart disease. Int J Cardiol 2024; 409:132192. [PMID: 38795970 DOI: 10.1016/j.ijcard.2024.132192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Affiliation(s)
- Federico Rea
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
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2
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Sun S, Zhang T, Yu H, Xia T, Yao Y, Sun M, Liang H, Huang Q, Wang W, Yang H, Hong X. Time trends in Alzheimer's disease mortality attributable to metabolic risks and smoking in China from 1990 to 2019: an age-period-cohort analysis. Front Aging Neurosci 2024; 16:1425577. [PMID: 39026988 PMCID: PMC11256009 DOI: 10.3389/fnagi.2024.1425577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Background With the increase in the aging population worldwide, Alzheimer's disease has become a rapidly increasing public health concern. In the Global Burden of Disease Study 2019, there are three risk factors judged to have evidence for a causal link to Alzheimer's disease and other dementias: smoking, high body-mass index (HBMI), and high fasting plasma glucose (HFPG). Objective This study aimed to analyze trends in AD mortality and the relevant burden across China from 1990 to 2019, as well as their correlation with age, period, and birth cohort. Methods The data were extracted from the GBD 2019. Trends in AD mortality attributable to metabolic risks (HFPG and HBMI) and smoking were analyzed using Joinpoint regression. The age-period-cohort (APC) model was used to evaluate cohort and period effects. Results From 1990 to 2019, the overall age-standardized mortality rate of AD increased, especially in women. There was an increase in AD mortality due to smoking in the net drift, and it was more significant in women (0.46, 95%CI = [0.09, 0.82]) than men (-0.03, 95%CI = [-0.11, 0.05]). For the cause of HFPG, the net drift values for men and women were 0.82% and 0.43%. For HBMI, the values were 3.14% and 2.76%, respectively, reflecting substantial increases in AD mortality. Conclusion Time trends in AD mortality caused by metabolic risks and smoking in China from 1990 to 2019 have consistently increased. Therefore, it is necessary to prevent excessive weight gain and obesity during the later stages of life, especially for females.
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Affiliation(s)
- Simeng Sun
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ting Zhang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Hao Yu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Ting Xia
- Monash Addiction Research Centre, Monash University, Clayton, VIC, Australia
| | - Yunan Yao
- Nantong Center for Disease Control and Prevention, Nantong, Jiangsu, China
| | - Mengting Sun
- Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China
| | - Hongmei Liang
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiaoyu Huang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Weiwei Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Huafeng Yang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xin Hong
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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Wolf S, Schievano E, Amidei CB, Kucher N, Valerio L, Barco S, Fedeli U. Mortality trend of ischemic heart disease (2008-2022): A retrospective analysis of epidemiological data. Int J Cardiol 2024; 406:132042. [PMID: 38614362 DOI: 10.1016/j.ijcard.2024.132042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/21/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Age-sex specific trend analyses of ischemic heart disease (IHD)-related mortality and prevalent risk factors can improve our understanding and approach to the disease. METHODS We performed a 15-year retrospective epidemiological analysis of acute and chronic IHD-related mortality and prevalent cardiovascular risk factors using administrative data from Veneto, a socio-economically homogeneous Italian region. Standard mortality statistics using the underlying cause of death (UCOD) and deaths with any mention of IHD in death certificates (MCOD) from ICD-10 codes I20-I25 was performed between 2008 and 2022. RESULTS A total of 134,327 death certificates reported IHD-related deaths, representing 18.6% of all deaths. Proportional mortality decreased from 14.6% in 2008 to 7.8% in 2022 for deaths with IHD as the UCOD and from 23.5% to 14.6% for deaths with IHD among the MCOD. A more pronounced decline of proportionate and case-specific mortality rate was seen in women. The decline in mortality over the whole study period was larger for acute (vs. chronic) IHD. The COVID-19 pandemic led to a marked increase in mortality in 2020 (+12.2%) with a subsequent further decline. IHD-related deaths displayed a typical seasonal pattern with more deaths during winter. The prevalence of cardiovascular risk factors was higher in IHD (vs. no IHD) deaths: this association appeared more pronounced in younger adults. CONCLUSIONS We provided an analysis of epidemiological trends in IHD-related mortality and prevalence of risk factors. Our findings indicate a change in the pattern of cardiovascular deaths and may suggest a switch in death from acute to chronic conditions.
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Affiliation(s)
- Simon Wolf
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland.
| | - Elena Schievano
- Epidemiological Department, Azienda Zero, Veneto Region, Padua, Italy
| | | | - Nils Kucher
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| | - Luca Valerio
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefano Barco
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland; Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ugo Fedeli
- Epidemiological Department, Azienda Zero, Veneto Region, Padua, Italy
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Moreno A, Pulido J, Cea-Soriano L, Mateo A, Pezzotti P, Regidor E. Differences urban versus non-urban trends in mortality from ischemic heart disease and diabetes in Italy and Spain, 2003-2019. Eur J Prev Cardiol 2024:zwae197. [PMID: 38857174 DOI: 10.1093/eurjpc/zwae197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/23/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND AND AIMS In recent years, mortality from ischemic heart disease and diabetes has decreased. There is an inequality in mortality reduction between urban and non-urban areas. This study aims to estimate the trend in mortality from ischemic heart disease and diabetes mellitus in urban and non-urban areas in Italy and Spain, throughout the first two decades of the 21st century. METHODS Deaths and population data by age and sex, according to the area de residence, were obtained from the National Institutes of Statistics. Annual age-standardized mortality rates from ischemic heart disease and diabetes mellitus were calculated from 2003 to 2019, in each of the two areas of residence in both countries. The average annual percentage change (APC) in the mortality rate in each area was estimated using linear regression models and taking age-standardized mortality rates as dependent variable. RESULTS Mortality rates from both causes of death decreased between the beginning and the end of the period analysed. In Italy, the APC in was -4.0% and -3.6% in mortality rate from ischemic heart disease and -1.5% and -1.3% in mortality rate from diabetes mellitus, in urban and non-urban areas, respectively. In Spain, the APC in was -4.4% and -3.7% in mortality rate from ischemic heart disease and -3.3% and -2.0% in mortality rate from diabetes mellitus, in urban and non-urban areas, respectively. CONCLUSION Mortality from ischemic heart disease and mortality from diabetes have shown a greater reduction in urban than in non-urban areas since the first years of the 21st century in Spain and Italy.
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Affiliation(s)
- Almudena Moreno
- Department of Sociology, Universidad Pública de Navarra
- I-COMMUNITAS - Institute for Advanced Social Research, Universidad Pública de Navarra, Pamplona, Spain
| | - José Pulido
- Department of Public Health and Maternal & Child Health, Faculty of Medecine, Universidad Complutense de Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lucía Cea-Soriano
- Department of Public Health and Maternal & Child Health, Faculty of Medecine, Universidad Complutense de Madrid, Spain
| | - Alberto Mateo
- Infectious Diseases Department, Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Infectious Diseases Department, Istituto Superiore di Sanità, Rome, Italy
| | - Enrique Regidor
- Department of Public Health and Maternal & Child Health, Faculty of Medecine, Universidad Complutense de Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Yuan R, Tong Z, Chen JX, Wang Y, Zhou YF. Global Burden of Ischemic Heart Disease in Adolescents and Young Adults, 1990-2019. Am J Prev Med 2024; 66:751-759. [PMID: 38104848 DOI: 10.1016/j.amepre.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Few studies have evaluated the global burden of ischemic heart disease (IHD) in adolescents and young adults (AYAs). METHODS Age-standardized rates (ASRs) of incidence (ASIR), mortality (ASMR) and Disability-Adjusted Life Years (DALYs) (ASDR) were used to describe the burden of IHD in AYAs. Estimated Annual Percentage Changes (EAPCs) of ASRs were used to describe the trend from 1990 to 2019. Risk factors were calculated by population attributable fractions (PAFs). Analyses were conducted in 2023. RESULTS In 2019, the ASIR, ASMR, and ASDR of IHD in AYAs were 26.81 (95% uncertainty interval [UI]: 20.36-34.54) per 100,000, 7.15 (95% UI: 6.56-7.87) per 100,000 and 409.51 (95% UI: 376.57-449.59) per 100,000. The ASIR and ASMR were higher among men than among women. From 1990 to 2019, the ASIR increased (EAPC=0.18%, 95% CI 0.14%-0.22%), while the ASMR (EAPC=-0.39%, -0.50% to -0.27%) and ASDR (EAPC=-0.40%, -0.52% to -0.29%) decreased. The largest increase in ASIR was observed in countries with a middle sociodemographic index (SDI) (EAPC=0.56%, 0.51%-0.60%). Globally, the proportional contribution of risk factors for DALY varied across regions, with the highest proportions of high low-density lipoprotein cholesterol in high SDI regions (PAF=74.26%) and high-middle (PAF=71.30%) and the highest proportions of air pollution in low (PAF=41.79%) and low-middle SDI regions (PAF=40.90%). CONCLUSIONS The burden of IHD in AYAs remains high globally, and varies by age, sex, (male/female), region, and country. Targeted measures are needed to address the rising burden of IHD in AYAs, focusing on prevention, early diagnosis, and reduction in disparities.
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Affiliation(s)
- Ruixia Yuan
- Clinical Big Data Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhuang Tong
- Clinical Big Data Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jun-Xiang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yi Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Yan-Feng Zhou
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China.
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Hou L, Liu W, Sun W, Cao J, Shan S, Feng Y, Zhou Y, Yuan C, Li X, Song P. Lifetime cumulative effect of reproductive factors on ischaemic heart disease in a prospective cohort. Heart 2024; 110:170-177. [PMID: 37852733 PMCID: PMC10850633 DOI: 10.1136/heartjnl-2023-322442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/20/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVE This study aimed to examine the association between lifetime oestrogen exposure and ischaemic heart disease (IHD), based on the hypothesis that higher lifetime oestrogen exposure is linked to lower cardiovascular risk. METHODS In 2004-2008, lifetime cumulative exposure to reproductive factors was assessed among postmenopausal females from the China Kadoorie Biobank using reproductive lifespan (RLS), endogenous oestrogen exposure (EEE) and total oestrogen exposure (TEE). EEE was calculated by subtracting pregnancy-related and contraceptive use duration from RLS, while TEE by adding up the same components except for lactation. Incident IHD during follow-up (2004-2015) was identified. Stratified Cox proportional hazards models estimated the HRs and 95% CIs of IHD for RLS, EEE and TEE. RESULTS Among 118 855 postmenopausal females, 13 162 (11.1%) developed IHD during a median follow-up of 8.9 years. The IHD incidence rates were 13.0, 12.1, 12.5, 13.8 per 1000 person-years for RLS Q1-Q4, 15.8, 12.6, 11.3, 12.1 per 1000 person-years for EEE Q1-Q4 and 13.7, 12.3, 12.2, 13.4 per 1000 person-years for TEE Q1-Q4. The highest quartile (Q4) of RLS and TEE were associated with lower risks of IHD (adjusted HR (aHR) 0.95, 95% CI 0.91 to 1.00 and 0.92, 95% CI 0.88 to 0.97, respectively) compared with the lowest quartile (Q1). Longer EEE showed progressively lower risks of incident IHD (aHR 0.93, 95% CI 0.88 to 0.97; 0.88, 95% CI 0.84 to 0.93; 0.87, 95% CI 0.83 to 0.92 for Q2-Q4 vs Q1). CONCLUSIONS Longer RLS, TEE and EEE were associated with lower risks of IHD among Chinese postmenopausal females.
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Affiliation(s)
- Leying Hou
- Department of Social Medicine, School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wen Liu
- Department of Social Medicine, School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Weidi Sun
- Department of Social Medicine, School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jin Cao
- Department of Social Medicine, School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shiyi Shan
- Department of Social Medicine, School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yan Feng
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yimin Zhou
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Changzheng Yuan
- Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xue Li
- Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Peige Song
- Department of Social Medicine, School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Puddu PE, Piras P, Kafatos A, Adachi H, Tolonen H, Menotti A. Competing Risks of Coronary Heart Disease Mortality versus Other Causes of Death in 10 Cohorts of Middle-Aged Men of the Seven Countries Study Followed for 60 Years to Extinction. J Cardiovasc Dev Dis 2023; 10:482. [PMID: 38132650 PMCID: PMC10743998 DOI: 10.3390/jcdd10120482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES To assess whether competing risks help explain why regions with initially high serum cholesterol have higher mortality from coronary heart disease (CHD) and lower mortality from stroke and other major heart diseases, while the reverse is found for those with initially lower serum cholesterol. MATERIAL AND METHODS Ten cohorts of men (N = 9063) initially aged 40-59 in six countries were examined and followed for fatal outcomes for 60 years. Major cardiovascular disease (CVD) groups were CHD, stroke, and other Heart Diseases of Uncertain Etiology (HDUE), or the combination of stroke and HDUE (STHD), along with all other causes of death. Fine-Gray competing risk analysis was applied with CHD versus all other causes of death or STHD (direct mode) and all other causes of death or STHD versus CHD (inverse mode), and the effects of 19 covariates (of which 3 references) on the cause-specific hazard of the outcomes were assessed, thus investigating potential etiologic roles. A systematic comparison with results obtained by running the Cox model in direct and inverse modes with the same end-point results was also performed and illustrated graphically. RESULTS CHD mortality is bound to different risk factor relationships when compared with all other causes of death and with STHD. The role of serum cholesterol is crucial since, in both comparisons, by Fine-Gray, its coefficients are positive and significant for CHD and negative and significant for all other causes of death and STHD. Risk factor capabilities in specific outcome types of the CVD domain (CHD versus STHD) are different depending on the outcome types considered. Risk factor coefficients are smaller in Fine-Gray modelling and larger in the Cox model. Fine-Gray detects different risk factors whose coefficients may have opposite algebraic signs. CONCLUSIONS This is the first report whereby a large group of risk factors are investigated in connection with life-long CVD outcomes by Fine-Gray competing risk analysis, and a systematic comparison is performed with results obtained by Cox models in both direct and inverse modes. Subtypes of CVD mortality should be summed with full awareness that some risk factors vary by pathology, and they should at least be disentangled into CHD and STHD.
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Affiliation(s)
- Paolo Emilio Puddu
- Association for Cardiac Research, 00182 Rome, Italy;
- EA 4650, Signalisation, Électrophysiologie et Imagerie des Lésions d’Ischémie Reperfusion Myocardique, Université de Normandie, 14032 Caen, France
| | - Paolo Piras
- Department of Structural Engineering, Sapienza University of Rome, 00185 Rome, Italy;
| | - Anthony Kafatos
- Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, 70013 Heraklion, Greece;
| | - Hisashi Adachi
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan;
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, FI-00271 Helsinki, Finland;
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Rehm M, Jaensch A, Schöttker B, Mons U, Hahmann H, Koenig W, Brenner H, Rothenbacher D. Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart. BMC Cardiovasc Disord 2023; 23:428. [PMID: 37644408 PMCID: PMC10466796 DOI: 10.1186/s12872-023-03469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND This study aimed to describe the characteristics and mortality of two cohorts of patients with chronic coronary syndrome (CCS) recruited with identical study designs in the same rehabilitation clinics but approximately 10 years apart. METHODS The KAROLA cohorts included patients with CCS participating in an inpatient cardiac rehabilitation programme in Germany (KAROLA-I: years 1999/2000, KAROLA-II: 2009-2011). Blood samples and information on sociodemographic factors, lifestyle, and medical treatment were collected at baseline, at the end of rehabilitation, and after one year of follow-up. A biomarker-based risk model (ABC-CHD model) and Cox regression analysis were used to evaluate cardiovascular (CV) and non-CV mortality risk. RESULTS We included 1130 patients from KAROLA-I (mean age 58.7 years, 84.4% men) and 860 from KAROLA-II (mean age 60.4 years, 83.4% men). Patients in the KAROLA-I cohort had significantly higher concentrations of CV biomarkers and fewer patients were taking CV medications, except for statins. The biomarker-based ABC-CHD model provided a higher estimate of CV death risk for patients in the KAROLA-I cohort (median 3-year risk, 3.8%) than for patients in the KAROLA-II cohort (median 3-year risk, 2.7%, p-value for difference < 0.001). After 10 years of follow-up, 91 (8.1%) patients in KAROLA-I and 45 (5.2%) in KAROLA-II had died from a CV event. CONCLUSIONS Advances in disease management over the past 20 years may have led to modest improvements in pharmacological treatment during cardiac rehabilitation and long-term outpatient care for patients with CCS. However, modifiable risk factors such as obesity have increased in the more recent cohort and should be targeted to further improve the prognosis of these patients.
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Affiliation(s)
- Martin Rehm
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ute Mons
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Harry Hahmann
- Klinik Schwabenland, Isny-Neutrauchburg, Isny, Germany
| | - Wolfgang Koenig
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumour Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dietrich Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Södergren A, Solbritt Rantapää-Dahlqvist, Ljung L. Time Trends of Cardiovascular Disease in the General Population and Inflammatory Arthritis. Rheum Dis Clin North Am 2023; 49:1-17. [PMID: 36424020 DOI: 10.1016/j.rdc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cardiovascular diseases (CVDs) are the leading causes of death in the world, but declining trends for cardiovascular (CV) mortality and morbidity have been observed during the last decades. Reports on secular trends regarding the excess CV mortality and morbidity in rheumatoid arthritis show diverging results. Data support that also patients with inflammatory arthritis have benefited from improved treatment and prevention for CVD, which can be observed, for example, in decreased case fatality after CV event. However, several recent studies indicate a remaining excess CV risk in patients with inflammatory arthritis.
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Affiliation(s)
- Anna Södergren
- Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, 901 87 Umeå, Sweden; Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden.
| | | | - Lotta Ljung
- Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, 901 87 Umeå, Sweden; Center for Rheumatology, Academic Specialist Center, Stockholm Health Services, Box 6357, Stockholm 102 35, Sweden. https://twitter.com/lotta_ljung
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10
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Wang W, Zhou N, Yu H, Yang H, Zhou J, Hong X. Time Trends in Ischemic Heart Disease Mortality Attributable to PM 2.5 Exposure in Southeastern China from 1990 to 2019: An Age-Period-Cohort Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:973. [PMID: 36673728 PMCID: PMC9859070 DOI: 10.3390/ijerph20020973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
PM2.5 exposure is a major environmental risk factor for the mortality of ischemic heart disease (IHD). This study aimed to analyze trends in IHD mortality attributable to PM2.5 exposure in Jiangsu Province, China, from 1990 to 2019, and their correlation with age, period, and birth cohort. METHODS Data were extracted from the Global Burden of Disease study 2019 (GBD2019). The magnitude and direction of the trends in IHD mortality attributable to PM2.5 exposure were analyzed by Joinpoint regression. The age-period-cohort (APC) model was used to evaluate the cohort and period effect. RESULTS Age-standardized mortality rate (ASMR) of IHD attributable to PM2.5 exposure decreased from 1990 to 2019, with an average annual percentage change (AAPC) of -1.71% (95%CI: -2.02~-1.40), which, due to ambient PM2.5 (APM) exposure and household PM2.5 (HPM) exposure increased with AAPCs of 1.45% (95%CI: 1.18~1.72) and -8.27% (95%CI: -8.84~-7.69), respectively. APC analysis revealed an exponential distribution in age effects on IHD mortality attributable to APM exposure, which rapidly increased in the elderly. The risk for IHD mortality due to HPM exposure showed a decline in the period and cohort effects, which, due to APM, increased in the period and cohort effects. However, favorable period effects were found in the recent decade. The overall net drift values for APM were above zero, and were below zero for HPM. The values for local drift with age both for APM and HPM exposures were initially reduced and then enhanced. CONCLUSION The main environmental risk factor for IHD mortality changed from HPM to APM exposure in Jiangsu Province, China. Corresponding health strategies and prevention management should be adopted to reduce ambient air pollution and decrease the effects of APM exposure on IHD mortality.
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Affiliation(s)
- Weiwei Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, 3 Zizhulin Road, Gulou District, Nanjing 210003, China
| | - Nan Zhou
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, 3 Zizhulin Road, Gulou District, Nanjing 210003, China
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
| | - Hao Yu
- Department of Non-Communicable Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Gulou District, Nanjing 210009, China
| | - Huafeng Yang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, 3 Zizhulin Road, Gulou District, Nanjing 210003, China
| | - Jinyi Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
- Department of Non-Communicable Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Gulou District, Nanjing 210009, China
| | - Xin Hong
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, 3 Zizhulin Road, Gulou District, Nanjing 210003, China
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China
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11
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James E, Goodall S, Nichols S, Walker K, Carroll S, O'Doherty AF, Ingle L. Serum transthyretin and aminotransferases are associated with lean mass in people with coronary heart disease: Further insights from the CARE-CR study. Front Med (Lausanne) 2023; 10:1094733. [PMID: 36891188 PMCID: PMC9986330 DOI: 10.3389/fmed.2023.1094733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/01/2023] [Indexed: 02/22/2023] Open
Abstract
Background Low muscle mass disproportionately affects people with coronary heart disease compared to healthy controls but is under-researched and insufficiently treated. Inflammation, poor nutrition, and neural decline might contribute to low muscle mass. This study aimed to assess circulatory biomarkers related to these mechanisms [albumin, transthyretin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and C-terminal agrin fragment] and their relationship with muscle mass in people with coronary heart disease. Our findings could be beneficial to indicate mechanisms of sarcopenia, detect sarcopenia, and evaluate treatment. Methods Serum blood samples from people with coronary heart disease were analysed for biomarker concentrations using enzyme-linked immunosorbent assays. Skeletal muscle mass was estimated using dual X-ray absorptiometry derived appendicular lean mass and reported as skeletal muscle index (SMI; kg m-2), and as a proportion of total body mass [appendicular skeletal mass (ASM%)]. Low muscle mass was defined as a SMI <7.0 and <6.0 kg m-2, or ASM% <25.72 and <19.43% for men and women, respectively. Associations between biomarkers and lean mass were adjusted for age and inflammation. Results Sixty-four people were assessed; 14 (21.9%) had low muscle mass. People with low muscle mass had lower transthyretin (effect size 0.34, p = 0.007), ALT (effect size 0.34, p = 0.008), and AST (effect size 0.26, p = 0.037) concentrations, compared to those with normal muscle mass. SMI was associated with inflammation-corrected ALT (r = 0.261, p = 0.039) and with inflammation- and age-adjusted AST/ALT ratio (r = -0.257, p = 0.044). Albumin and C-terminal agrin fragment were not associated with muscle mass indices. Conclusion Circulatory transthyretin, ALT and AST were associated with low muscle mass in people with coronary heart disease. Low concentrations of these biomarkers might indicate that low muscle mass is partially explained by poor nutrition and high inflammation in this cohort. Targeted treatments to address these factors could be considered for people with coronary heart disease.
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Affiliation(s)
- Emily James
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom.,Diabetes Research Centre, University of Leicester, Leicester, United Kingdom.,NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom
| | - Stuart Goodall
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Simon Nichols
- Sport and Physical Activity Research Group, Sheffield Hallam University, Sheffield, United Kingdom.,Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Karen Walker
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Sean Carroll
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, United Kingdom
| | - Alasdair F O'Doherty
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Lee Ingle
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, United Kingdom
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12
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Wagener M, Boeddinghaus J, Gaemperli O, Räber L, Nietlispach F, Meier P, Muller O, Weilenmann D, Jeger R. Trends in Coronary and Structural Heart Interventions in Switzerland over the Last 16 Years and Impact of COVID-19: Insights from the National Swiss PCI Survey. J Clin Med 2022; 11:7459. [PMID: 36556075 PMCID: PMC9783484 DOI: 10.3390/jcm11247459] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/04/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Considering the global burden of cardiovascular disease, we analysed trends in interventional coronary and structural procedures over the past 16 years (2005-2021), using continuous data from the Swiss national registry. METHODS Based on a standardised questionnaire, data on coronary and structural interventions in Switzerland were assessed by the Working Group Interventional Cardiology of the Swiss Society of Cardiology (SSC). Here, we analysed the trend of annually performed interventions from 2005 to 2021 in Switzerland and the impact of the COVID-19 pandemic. RESULTS We observed a constant increase in the total number of cases (including coronary angiographies (CA) and percutaneous coronary interventions (PCI)) from 36,436 cases in 2005 to 56,555 cases in 2021 (+55%). With 18 cases in 2007, TAVI procedures have increased to 2004 cases in 2021. During the early phase of the COVID-19 pandemic in 2020, a slight decrease in CAs and PCIs of 9.15% was observed. In contrast, we did not observe an impact of the COVID-19 pandemic on the number of no TAVI procedures. Most importantly, all cause in-hospital mortality for coronary interventions before and during the peak of the COVID-19 pandemic was comparable (1.4% vs. 1.3%). CONCLUSION Over a 16-year period, we observed an upward trend in diagnostic and therapeutic procedures for coronary as well as structural heart disease, with only a small short-term impact of the COVID-19 pandemic on interventions and a similar procedure-related in-hospital-mortality in Switzerland.
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Affiliation(s)
- Max Wagener
- Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, 4031 Basel, Switzerland
- Department of Cardiology, University Hospital Galway, H91 YR71 Galway, Ireland
| | - Jasper Boeddinghaus
- Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, 4031 Basel, Switzerland
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Oliver Gaemperli
- Department of Cardiology, Heart Clinic Hirslanden, 8032 Zurich, Switzerland
| | - Lorenz Räber
- Department of Cardiology, Bern University Hospital, 3010 Bern, Switzerland
| | - Fabian Nietlispach
- Heart Centre Im Park, Hirslanden Clinic Im Park, 8027 Zurich, Switzerland
| | - Pascal Meier
- Cantonal Hospital Freiburg, 1752 Villars-sur-Glâne, Switzerland
| | - Olivier Muller
- Department of Cardiology, University Hospital Vaud, 1011 Lausanne, Switzerland
| | | | - Raban Jeger
- Department of Cardiology, Triemli Hospital Zurich, 8063 Zurich, Switzerland
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
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13
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Christensen DM, Schjerning AM, Smedegaard L, Charlot MG, Ravn PB, Ruwald AC, Fosbøl E, Køber L, Torp-Pedersen C, Schou M, Gerds T, Gislason G, Sehested TSG. Long-term mortality, cardiovascular events, and bleeding in stable patients 1 year after myocardial infarction: a Danish nationwide study. Eur Heart J 2022; 44:488-498. [PMID: 36433809 PMCID: PMC9902154 DOI: 10.1093/eurheartj/ehac667] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/25/2022] [Accepted: 11/03/2022] [Indexed: 11/27/2022] Open
Abstract
AIMS Outcomes after myocardial infarction (MI) improved during recent decades alongside better risk factor management and implementation of guideline-recommended treatments. However, it is unknown whether this applies to stable patients who are event-free 1 year after MI. METHODS AND RESULTS Using nationwide Danish registries, we included all patients with first-time MI during 2000-17 who survived 1 year free from bleeding and cardiovascular events (n = 82 108, median age 64 years, 68.2% male). Follow-up started 1 year after MI and continued through January 2022. Crude risks of mortality, cardiovascular events, and bleeding were estimated in consecutive 3-year periods. Standardized risks were calculated with respect to the distribution of age, sex, comorbidities, and treatments in the latter period. Guideline-recommended treatment use increased during the study period: e.g. statins (68.6-92.5%) and percutaneous coronary intervention (23.9-68.2%). The crude 5-year risks of outcomes decreased (all P-trend <0.001): Mortality, 18.6% (95% confidence interval [CI]: 17.9-19.2) to 12.5% (CI: 11.9-13.1); Recurrent MI, 7.5% (CI: 7.1-8.0) to 5.5% (CI: 5.1-6.0); Bleeding, 3.9% (CI: 3.6-4.3) to 2.7% (CI: 2.4-3.0). Crude 5-year risk of mortality in 2015-17 was as low as 2.6% for patients aged <60 years. Use of guideline-recommended treatments was associated with improved outcomes: After standardization for changes in treatments, 5-year risk of mortality in 2000-02 was 15.5% (CI: 14.9-16.2). CONCLUSIONS For patients who were event-free 1 year after MI, the long-term risks of mortality, cardiovascular events, and bleeding decreased significantly, along with an improved use of guideline-recommended treatments between 2000 and 2017. In the most recent period, 1 year after MI, the risk of additional events was lower than previously reported.
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Affiliation(s)
| | - Anne-Marie Schjerning
- Danish Heart Foundation, Copenhagen, Denmark,Department of Cardiology, Zealand University Hospital Roskilde, Roskilde, Denmark
| | - Lærke Smedegaard
- Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
| | - Mette Gitz Charlot
- Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
| | - Pauline B Ravn
- Department of Cardiology, Zealand University Hospital Roskilde, Roskilde, Denmark,Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
| | - Anne Christine Ruwald
- Department of Cardiology, Zealand University Hospital Roskilde, Roskilde, Denmark,Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
| | - Emil Fosbøl
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Nordsjællands University Hospital, Hillerød, Denmark,Department of Public Health, University of Copenhagen, Denmark
| | - Morten Schou
- Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Gerds
- Danish Heart Foundation, Copenhagen, Denmark,Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Gunnar Gislason
- Danish Heart Foundation, Copenhagen, Denmark,Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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14
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Okoth K, Crowe F, Marshall T, Thomas GN, Nirantharakumar K, Adderley NJ. Sex-specific temporal trends in the incidence and prevalence of cardiovascular disease in young adults: a population-based study using UK primary care data. Eur J Prev Cardiol 2022; 29:1387-1395. [PMID: 35139185 DOI: 10.1093/eurjpc/zwac024] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/15/2022] [Accepted: 02/02/2022] [Indexed: 11/13/2022]
Abstract
AIMS There is concern that cardiovascular disease (CVD) in young adults is rising. However, current trends in the UK are unknown. We investigated sex-specific trends in the incidence and prevalence of CVD in young UK adults. METHODS AND RESULTS A series of annual (1998-2017) cohort and cross-sectional studies were conducted to estimate incidence rates and prevalence in men and women aged 16-50. Joinpoint regression models were fitted to evaluate changes in trends. From 1998 to 2017, incidence and prevalence had an overall downward trend for ischaemic heart disease (IHD) and angina, while coronary revascularization, stroke/transient ischaemic attack (TIA), and heart failure (HF) had an upward trend in both sexes. Myocardial infarction (MI) trends were stable in men and increased in women. For incidence, the average annual percentage change (AAPC) for men vs. women, respectively, was IHD -2.6% vs. -3.4%; angina -7.0% vs. -7.3%; MI 0.01% vs. 2.3%; revascularization 1.1% vs. 3.9%; stroke/TIA 1.9% vs. 0.6%; HF 5.6% vs. 5.0% (P for trend <0.05 for all except MI and revascularization in men and stroke/TIA in women). For prevalence, AAPCs for men vs. women, respectively, were IHD -2.8% vs. -4.9%; angina -7.2% vs. -7.8%; MI -0.2% vs. 2.0; revascularization 3.2% vs. 4.1%; stroke/TIA 3.1% vs. 3.6%; HF 5.0% vs. 3.0% (P for trend <0.05 for all except MI in men). In recent years, IHD and revascularization trends levelled off, while stroke/TIA and HF trends increased in both sexes. CONCLUSION Overall trends in incidence and prevalence of CVD are worsening in young adults. Factors behind unfavourable trends warrant investigation and public health intervention.
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Affiliation(s)
- Kelvin Okoth
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Francesca Crowe
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Institute of Metabolism and Systems Research, Edgbaston, Birmingham B15 2TT, UK
| | - Nicola J Adderley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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15
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Doblhammer G, Fritze T, Reinke C, Fink A. Can dementia become the most prevalent disease at the time of death in Germany? Projections up to the year 2060 for the five most important diseases at the time of death. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09365-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractData on the burden of disease in the last years of life are an important basis for health policy decisions and the allocation of health care resources. Since dementia is one of the most expensive diseases, we ask the question whether dementia will ever be the most common disease at the time of death in older people? While international cause-of-death statistics report the underlying cause of death, dementia patients generally die from complications or sequelae. Instead of using causes of death, we identified the five most prevalent disease categories at age 70 and older at the time of death using German health claims data from 2004 to 2007 and 2014–2017, and combined their prevalence rates with the estimated number of deaths at age 70 and older up to the year 2060. We developed two scenarios, first, to represent the impact of population aging and increasing life expectancy. Second, to additionally examine the impact of morbidity trends among those who died. We found that dementia was already the most prevalent disease at the time of death among German women aged 70 years and older in 2014–2017, while it was still in fifth place among German men. Population aging and increasing life expectancy will result in dementia ranking first among women and second among men if the morbidity profile at the time of death remains constant. Extrapolating the observed time trends into the projections, cancer will be the most prevalent disease at the time of death for both sexes. Dementia will be second for women, and third for men after IHD. In addition to projections of causes of death, we also need projections of diseases at the time of death to better prepare for the needs of people in their final stages of life.
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16
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Arnesen EK, Retterstøl K. Secular trends in serum lipid profiles in young adults in Norway, 2001-19. ATHEROSCLEROSIS PLUS 2022; 48:60-67. [PMID: 36644560 PMCID: PMC9833235 DOI: 10.1016/j.athplu.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/09/2022] [Accepted: 03/21/2022] [Indexed: 01/18/2023]
Abstract
Background Lower prevalence of major cardiovascular disease (CVD) risk factors, such as dyslipidemia, hypertension and smoking, can explain a substantial part of the decline in CVD mortality and incidence for the past decades in Western countries. However, some studies have indicated less favorable trends in risk factors in recent years. We have assessed time trends in lipid profiles among young adults in Norway measured between 2001 and 2019. Methods Samples of serum lipids analyzed at one large medical laboratory in Oslo, Norway, mainly requisitioned by primary care physicians, were analyzed cross-sectionally to estimate year-to-year trends among men and women aged 18-49 years. We also assessed the lipid distributions and proportions with adverse lipid levels. Results In total, more than 2,6 million blood samples, comprising more than 1 million individuals (mean age 37.7 years) from all regions of Norway were included. All measures improved among all age groups in both women and men, especially in total and non-HDL cholesterol (-0.22 and -0.25 mmol/l per decade, respectively). There were downward shifts in the population distribution of total, non-HDL-C and LDL-C. The overall prevalences of total cholesterol ≥5.0 mmol/l and non-HDL-C ≥3.9 mmol/l similarly decreased, from ∼63 to 46% and from ∼52 to 34%, respectively. More than 1/3 had elevated levels of total and/or non-HDL-C in 2019. Conclusion In a large proportion of the Norwegian population aged 18-49 years old, the lipid profiles improved during the last two decades. As the use of lipid-lowering medications is low in this age group, this likely reflects favorable secular trends.
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Affiliation(s)
- Erik Kristoffer Arnesen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O.Box 1046 Blindern, 0317, Oslo, Norway,Corresponding author.
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O.Box 1046 Blindern, 0317, Oslo, Norway,The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Aker, PO Box 4959, Nydalen, 0424, Oslo, Norway
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