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Background: Although the mortality of coronary heart disease (CHD) has declined in Western countries during the last decades, studies have suggested that the prevention and treatment of CHD may not have been as effective in women as in men. We examined gender- and age-specific trends in incidence, case fatality and the severity of first myocardial infarction (MI) in a large Norwegian population-based study., Design: Prospective population-based cohort study., Methods: A total of 31,323 participants enrolled between 1974 and 2001 were followed throughout 2004 for a total of 400,572 person-years. Suspected coronary events were adjudicated by a review of hospital records and death certificates. A total of 1669 events fulfilled standardized criteria of first-ever fatal or non-fatal MI., Results: In the age group 35-79 years, the age-adjusted incidence of MI declined significantly in men, whereas an increase was observed in women. For men and women ≥ 80 years the incidence rates remained unchanged. The severity of MI and the 28-day and 1-year case fatality rates declined significantly and similarly in men and women., Conclusion: Trends in MI incidence differed by sex and age; in the age group 35-79 years a marked decrease was observed among men but an increase was observed among women, while no change was observed among older patients. MI severity and case fatality were clearly reduced for both sexes. These data suggest that the burden of CHD is shifting from middle-aged men toward middle-aged women and elderly patients.

The role of dairy fat in the aetiology of myocardial infarction (MI) is controversial. The aim of this study was to evaluate the association between intake of dairy fat and dairy products, and risk of a first acute MI. A total of 111 MI patients with a first acute MI and 107 population controls (men and women, age 45 75 years) were studied. Diet was assessed using a 180-item food frequency questionnaire. The MI cases had higher intake of total fat, but lower intake of saturated fat and dairy fat than the control persons. No effect of dairy fat or saturated fat on the odds ratio for MI was observed, however. A significant inverse trend in odds of MI for intake of cheese was observed, but the trend was no longer significant after adjustment for smoking. The results suggest that intake of fat from dairy products may not be associated with increased risk of having a first MI. The healthy control persons had a diet that differed from the diet of the MI patients in many aspects, and dairy products were a part of this diet. This may have protected them from having a first MI.

Certain dietary patterns may be related to the risk of CVD. We hypothesised that a plant-centred dietary pattern would be associated with a reduced risk of first myocardial infarction (MI). A case-control study of Norwegian men and postmenopausal women (age 45-75 years) was performed. A FFQ was administered, generally within 3 d after incident MI (n 106 cases). Controls (n 105) were frequency matched on sex, age and geographic location. On the FFQ, 190 items were categorised into thirty-five food groups and an a priori healthy diet pattern score was created. We estimated OR using logistic regression with adjustment for energy intake, family history of heart disease, marital status, current smoking, education and age. Among food groups, the risk of MI was significantly higher per SD of butter and margarine (OR 1.66 (95 % CI 1.12, 2.46)), and lower per SD of tomatoes (OR 0.53 (95 % CI 0.35, 0.79)), high-fat fish (OR 0.57 (95 % CI 0.38, 0.86)), wine (OR 0.58 (95 % CI 0.41, 0.83)), salad (OR 0.59 (95 % CI 0.40, 0.87)), whole grain breakfast cereals (OR 0.64 (95 % CI 0.45, 0.90)), cruciferous vegetables (OR 0.66 (95 % CI 0.47, 0.93)) and non-hydrogenated vegetable oil (OR 0.68 (95 % CI 0.49, 0.95)). An abundance of cases were found to have a low a priori healthy diet pattern score. A dietary pattern emphasising nutrient-rich plant foods and high-fat fish and low in trans fatty acids was associated with decreased risk of MI among Norwegians.

Certain dietary patterns may be related to the risk of CVD. We hypothesised that a plant-centred dietary pattern would be associated with a reduced risk of first myocardial infarction (MI). A case???control study of Norwegian men and postmenopausal women (age 45???75 years) was performed. A FFQ was administered, generally within 3??d after incident MI (n 106 cases). Controls (n 105) were frequency matched on sex, age and geographic location. On the FFQ, 190 items were categorised into thirty-five food groups and an a priori healthy diet pattern score was created. We estimated OR using logistic regression with adjustment for energy intake, family history of heart disease, marital status, current smoking, education and age. Among food groups, the risk of MI was significantly higher per sd of butter and margarine (OR 1??66 (95??% CI 1??12, 2??46)), and lower per sd of tomatoes (OR 0??53 (95??% CI 0??35, 0??79)), high-fat fish (OR 0??57 (95??% CI 0??38, 0??86)), wine (OR 0??58 (95??% CI 0??41, 0??83)), salad (OR 0??59 (95??% CI 0??40, 0??87)), wholegrain breakfast cereals (OR 0??64 (95??% CI 0??45, 0??90)), cruciferous vegetables (OR 0??66 (95??% CI 0??47, 0??93)) and non-hydrogenated vegetable oil (OR 0??68 (95??% CI 0??49, 0??95)). An abundance of cases were found to have a low a priori healthy diet pattern score. A dietary pattern emphasising nutrient-rich plant foods and high-fat fish and low in trans fatty acids was associated with decreased risk of MI among Norwegians. [ABSTRACT FROM PUBLISHER]

Background: Few studies have used individual person data to study whether contemporary trends in the incidence of coronary heart disease are associated with changes in modifiable coronary risk factors.Methods and Results: We identified 29 582 healthy men and women ≥25 years of age who participated in 3 population surveys conducted between 1994 and 2008 in Tromsø, Norway. Age- and sex-adjusted incidence rates were calculated for coronary heart disease overall, out-of-hospital sudden death, and hospitalized ST-segment-elevation and non-ST-segment-elevation myocardial infarction. We measured coronary risk factors at each survey and estimated the relationship between changes in risk factors and changes in incidence trends. A total of 1845 participants had an incident acute coronary heart disease event during 375 064 person-years of follow-up from 1994 to 2010. The age- and sex-adjusted incidence of total coronary heart disease decreased by 3% (95% confidence interval, 2.0-4.0; P<0.001) each year. This decline was driven by decreases in out-of-hospital sudden death and hospitalized ST-segment-elevation myocardial infarction. Changes in coronary risk factors accounted for 66% (95% confidence interval, 48-97; P<0.001) of the decline in total coronary heart disease. Favorable changes in cholesterol contributed 32% to the decline, whereas blood pressure, smoking, and physical activity each contributed 14%, 13%, and 9%, respectively.Conclusions: We observed a substantial decline in the incidence of coronary heart disease that was driven by reductions in out-of-hospital sudden death and hospitalized ST-segment-elevation myocardial infarction. Changes in modifiable coronary risk factors accounted for 66% of the decline in coronary heart disease events. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes is associated with increased risk of coronary heart disease (CHD). The relative risk has been found to be higher in women than men, and the more pronounced adverse effect has even been claimed to eliminate the female advantage in risk. However, few previous studies have quantified the difference in risk between men and women among individuals with diabetes. Aims: To evaluate interaction between gender and diabetes in relation to the risk of incident myocardial infarction (MI). Methods: Population-based prospective study of 33,859 individuals (51% women) in Tromsø, Norway. Median follow-up time at ages 35-94 years was 17.6 years; 2,746 individuals (854 women) were diagnosed with MI during follow-up. At their last visit, a total of 1063 individuals (3.1%) reported they had diabetes (530 men, 533 women); 170 (74 women) were later diagnosed with MI. Incidence rate ratios (IRR) were calculated as estimates of relative risk in Poisson regression analysis of person-years at risk. Interaction terms were included in the model to evaluate heterogeneity in risk estimates across subgroups. Results: Adjusted for age, gender and established CHD risk factors, diabetes was associated with a doubling in risk of MI (IRR=2.18, 95% CI=1.86-2.55). The adverse effect was slightly more pronounced for women than men (IRR of 2.55 vs. 1.96, p=0.11, test for interaction). Accordingly, the gender contrast in risk was less pronounced among individuals with diabetes (IRR of 1.63 vs 2.11), but the elevated risk in men remained significant. Considering combined categories of interacting factors, women with diabetes had a risk level close to men without diabetes, but men with diabetes had a risk about four times as high as women without diabetes. Some heterogeneity across age groups was seen, but risk estimates were imprecise. These results are preliminary. Gender heterogeneity in associations with adjustment factors may influence risk estimates. Analyses based on data with 5 year extended follow-up are planned. Conclusions: In terms of relative risk, the association between diabetes and risk of MI was more pronounced for women than men, but the female advantage in risk of MI was not erased in persons with diabetes. [ABSTRACT FROM AUTHOR]