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. 2014 Jun;43(3):866-77.
doi: 10.1093/ije/dyt279. Epub 2014 Jan 24.

Effect of secular trends on age-related trajectories of cardiovascular risk factors: the Whitehall II longitudinal study 1985-2009

Adam Hulmán  1 , Adam G Tabák  2 , Tibor A Nyári  3 , Dorte Vistisen  3 , Mika Kivimäki  3 , Eric J Brunner  3 , Daniel R Witte  3
Affiliations

Effect of secular trends on age-related trajectories of cardiovascular risk factors: the Whitehall II longitudinal study 1985-2009

Adam Hulmán et al. Int J Epidemiol. 2014 Jun.

Abstract

Background: Secular trends in cardiovascular risk factors have been described, but few studies have examined simultaneously the effects of both ageing and secular trends within the same cohort.

Methods: Development of cardiovascular risk factors over the past three decades was analysed using serial measurements from 10 308 participants aged from 35 to 80 years over 25 years of follow-up from five clinical examination phases of the Whitehall II study. Changes of body mass index, waist circumference, blood pressure and total and high-density lipoprotein cholesterol distribution characteristics were analysed with quantile regression models in the 57-61 age group. Age-related trajectories of risk factors were assessed by fitting mixed-effects models with adjustment for year of birth to reveal secular trends.

Results: Average body mass index and waist circumference increased faster with age in women than in men, but the unfavourable secular trend was more marked in men. Distributions showed a fattening of the right tail in each consecutive phase, meaning a stronger increase in higher percentiles. Despite the higher obesity levels in younger birth cohorts, total cholesterol decreased markedly in the 57-61 age group along the entire distribution rather than in higher extremes only.

Conclusion: The past three decades brought strong and heterogeneous changes in cardiovascular risk factor distributions. Secular trends appear to modify age-related trajectories of cardiovascular risk factors, which may be a source of bias in longitudinal analyses.

Keywords: Obesity; ageing; blood pressure; cholesterol; quantile regression; secular trend.

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Figures

Figure 1 A,B.
Figure 1 A,B.
Sequential cross-sectional analysis (age group: 57–61 years). Smooth kernel distributions of cardiovascular risk factors (probability density functions are displayed) in men (A) and women (B) (dotted line: phase 3, dashed line: phase 5, solid line: phase 7, thick line: phase 9).
Figure 1 A,B.
Figure 1 A,B.
Sequential cross-sectional analysis (age group: 57–61 years). Smooth kernel distributions of cardiovascular risk factors (probability density functions are displayed) in men (A) and women (B) (dotted line: phase 3, dashed line: phase 5, solid line: phase 7, thick line: phase 9).
Figure 2A, B.
Figure 2A, B.
Longitudinal trajectory analysis. Age-related trajectories (in years) of cardiovascular risk factors in men (A) and women (B) with adjustment for four different birth cohorts: 1933 (▪), 1938 (♦), 1943 (▴), 1948 (•) and unadjusted (– – –).
Figure 2A, B.
Figure 2A, B.
Longitudinal trajectory analysis. Age-related trajectories (in years) of cardiovascular risk factors in men (A) and women (B) with adjustment for four different birth cohorts: 1933 (▪), 1938 (♦), 1943 (▴), 1948 (•) and unadjusted (– – –).
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References

    1. Townsend N, Wickramasinghe N, Bhatnagar P, et al. Coronary Heart Disease Statistics. London: British Heart Foundation; 2012
    1. Mathers CD, Boerma T, Ma Fat D. Global and regional causes of death. Br Med Bull 2009;92:7–32 - PubMed
    1. Danaei G, Finucane MM, Lin JK, et al. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5·4 million participants. Lancet 2011;377:568–77 - PubMed
    1. Arnett DK, Jacobs DR, Luepker RV, Blackburn H, Armstrong C, Claas SA. Twenty-year trends in serum cholesterol, hypercholesterolemia, and cholesterol medication use: the Minnesota Heart Survey, 1980-1982 to 2000-2002. Circulation 2005;112:3884–91 - PubMed
    1. Carroll MD, Lacher DA, Sorlie PD, et al. Trends in serum lipids and lipoproteins of adults, 1960-2002. JAMA 2005;294:1773–81 - PubMed

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