Changes in cholesterol, blood pressure, and smoking predicted a 44% and 49% decline in ischaemic heart disease mortality in men and women, explaining most of the observed 55% and 68% declines.
Observational (n=29,043)
Yes
Do changes in main coronary risk factors (serum cholesterol, blood pressure, and smoking) explain the decline in mortality from ischaemic heart disease?
Most of the decline in mortality from ischaemic heart disease in Finland between 1972 and 1992 can be explained by population-level reductions in serum cholesterol, blood pressure, and smoking.
Abstract Objectives : To estimate the extent to which changes in the main coronary risk factors (serum cholesterol concentration, blood pressure, and smoking) explain the decline in mortality from ischaemic heart disease and to evaluate the relative importance of change in each of these risk factors. Design : Predicted changes in ischaemic heart disease mortality were calculated by a ligistic regression model using the risk factor levels assessed by cross sectional population surveys, in 1972, 1977, 1982, 1987, and 1992. These predicted changes were compared with observed changes in mortality statistics. Setting : North Karelia and Kuopio provinces, Finland. Subjects : 14 257 men and 14 786 women aged 30–59 randomly selected from the national population register. Main outcome measures : Levels of the risk factors and predicted and observed changes in mortality from ischaemic heart disease. Results — The observed changes in the risk factors in the population from 1972 to 1992 predicted a decline in mortality from ischaemic heart disease of 44% (95% confidence interval 37% to 50%) in men and 49% (37% to 59%) in women. The observed decline was 55% (51% to 58%) and 68% (61 to 74) respectively. Conclusion : An assessment of the data on the risk factors for ischaemic heart disease and mortality suggests that most of the decline in mortality from ischaemic heart disease can be explained by changes in the three main coronary risk factors.
Vartiainen et al. (1994) conducted an observational in Ischaemic heart disease (n=29,043). Changes in coronary risk factors (serum cholesterol, blood pressure, smoking) was evaluated on Predicted decline in mortality from ischaemic heart disease in men (95% CI 37-50). Changes in cholesterol, blood pressure, and smoking predicted a 44% and 49% decline in ischaemic heart disease mortality in men and women, explaining most of the observed 55% and 68% declines.