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Trends in Modifiable Risk Factors Are Associated With Declining Incidence of Hospitalized and Nonhospitalized Acute Coronary Heart Disease in a Population.
- Source :
-
Circulation . 1/5/2016, Vol. 133 Issue 1, p74-81. 8p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>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.<bold>Methods and Results: </bold>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.<bold>Conclusions: </bold>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]
- Subjects :
- *CORONARY disease
*MYOCARDIAL infarction risk factors
*MEDICAL care of cardiac patients
*MOLECULAR epidemiology
*SUDDEN death
*DIAGNOSIS
*TREATMENT of acute coronary syndrome
*HOSPITAL care
*LONGITUDINAL method
*MORTALITY
*PUBLIC health surveillance
*DISEASE incidence
*ACUTE coronary syndrome
Subjects
Details
- Language :
- English
- ISSN :
- 00097322
- Volume :
- 133
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 112069529
- Full Text :
- https://doi.org/10.1161/CIRCULATIONAHA.115.016960