Secular changes in cardiovascular risk factors in Swedish 50-year-old men over a 50-year period: The study of men born in 1913, 1923, 1933, 1943, 1953 and 1963

Abstract

Background During the past decades, declining trends in mean cholesterol levels and smoking have been observed in Western Europe, whereas obesity and a sedentary lifestyle have increased. Simultaneously, there has been a marked decrease in mortality from cardiovascular (CV) diseases. Methods The aim of the study was to determine whether these trends in CV risk factors continued over a period of 50 years. Six systematic or random population samples of 50-year-old men ( n = 3563) living in Gothenburg, Sweden, were investigated between 1963 and 2013. Results During the 50 years, mean body mass index (BMI) at 50 years of age increased by 2 kg/m², from 24.8 kg/m² in 1963 to 26.8 kg/m² in 2013 ( p < 0.001). A decrease in systolic blood pressure of nearly 10 mmHg was observed from 1963 to 1993, but was not sustained through the past two decades. Mean serum cholesterol fell from 6.42 (SD 1.12) mmol/L to 5.34 (SD 0.97) mmol/L. The prevalence of smoking at 50 years of age decreased markedly from 56.1% in 1963 to 11.9% in 2013. The number of participants with a sedentary lifestyle during leisure time decreased until 1993, but has remained unchanged since. In 2013, 50-year-old men had a 6.9-times higher likelihood of lacking CV risk factors than 50-year-old men in 1963 (95% confidence interval (CI): 3.5-13.3, p < 0.001). The odds ratio for having four or more risk factors was only 0.13 (95% CI: 0.062-0.29, p < 0.001). Conclusion Despite increasing body weight, the total CV risk factor burden has decreased in 50-year-old men over the past 50 years.

Keywords: Secular trends; cardiovascular risk factors; lifestyle; obesity.