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Long-term temporal trends in cardiovascular and metabolic risk factors

Langfristige Trends bei kardiovaskulären und metabolischen Risikofaktoren

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Zusammenfassung

ZIELE: Kardiovaskuläre Risikofaktoren wie Adipositas, Bluthochdruck, erhöhte Blutfette und Blutzucker wurden in den letzten Jahren zunehmend mit dem Auftreten von Krebserkrankungen in Verbindung gebracht. Das MeCan (Metabolic Syndrome and Cancer) Projekt untersucht diese Zusammenhänge unter Verwendung österreichischer und skandinavischer Kohortendaten. Diese Daten wurden nun in der vorliegenden Studie genutzt, um langfristige Trends in den genannten Risikofaktoren zu untersuchen. METHODEN: Daten aus Gesundenuntersuchungen mit Nüchternblutabnahme im Zeitraum 1975 bis 2004 von insgesamt 239.602 Personen (Alter 25–64 Jahre) wurden für die Schätzung der Prävalenzveränderungen verwendet. ERGEBNISSE: Die Prävalenz der Adipositas und der Hyperglykämie zeigte einen deutlichen Anstieg im Untersuchungszeitraum. Die Adipositas stieg dabei um einen Faktor von 1,54 (95% KI: 1,42–1,66) pro Jahrzent bei Männer und um einen Faktor von 1,48 (95% KI: 1,41–1,56) bei Frauen. Noch deutlicher war der Anstieg bei der Hyperglykämie mit einem Anstieg um das 1,62-fache (95% KI: 1,49–1,76) bei Männern und um das 1,66-fache (95% KI: 1,57–1,75) bei Frauen. Bluthochdruck sank um den Faktor 0,71 (95% KI: 0,68–0,74) bei Männern und 0,83 (95% KI: 0,79–0,86) bei Frauen. Die Prävalenz der Hyperlipidämie (gemessen durch Gesamtcholesterin und Triglyceride) stieg bis Ende der achtziger Jahre und ging anschließend zurück. Als Proxy für das Metabolische Syndrom wurde eine Kombination aus drei oder mehr dieser Risikofaktoren untersucht, diese verzeichnete einen moderaten Anstieg um das 1,15-fache (95% KI: 1,08–1,22) bei Männern und um das 1,20–fache (95% KI: 1,15–1,27) pro Dekade bei Frauen. SCHLUSSFOLGERUNGEN: Über die letzten drei Jahrzehnte zeigten sich sowohl in Österreich als auch in Schweden deutliche Umschichtungen in den untersuchten Risikofaktoren. Im Hinblick auf die Prävention von Herzkreislauferkrankungen aber auch Krebserkrankungen verdienen vor allem die besorgniserregenden Entwicklungen bei Übergewicht und Diabetes besondere Aufmerksamkeit.

Summary

OBJECTIVES: Metabolic factors such as obesity, hypertension, dyslipidemia and hyperglycemia have consistently been associated with increased risk of cardiovascular disease. There is also growing evidence that these factors are linked to cancer incidence and mortality. The aim of this study was to investigate long-term trends in major metabolic risk factors in three large cohorts. MATERIALS AND METHODS: Data from 239,602 individuals aged 25–64 years participating in health examinations between 1976 and 2005 were used to estimate prevalence and trends in five risk factors. RESULTS: Irrespective of geographic location, individual metabolic risk factors showed divergent trends across the observation period. Whereas obesity and hyperglycemia in men increased by a per decade ratio of 1.54 (95% CI: 1.42–1.66) and 1.62 (95% CI: 1.49–1.76), respectively, and in women by 1.48 (95% CI: 1.41–1.56) and 1.66 (95% CI: 1.57–1.75), hypertension decreased by 0.71 (95% CI: 0.68–0.74) in men and 0.83 (95% CI: 0.79–0.86) in women. Dyslipidemia increased from the 1970s to the 1980s but declined in the succeeding decade. A combination of three or more of these risk factors increased significantly in men by a ratio of 1.15 (95% CI: 1.08-1.22) per decade and in women by 1.20 (95% CI: 1.15–1.27). CONCLUSION: The study shows that individual metabolic risk factors followed divergent trends over the period of three decades even though the combination of three or more risk factors used as a proxy for the metabolic syndrome appeared to be stable over the last two of the decades. The two key components of the syndrome, namely BMI and glucose levels, increased significantly and deserve professional attention.

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Correspondence to Hanno Ulmer.

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Borena, W., Stocks, T., Strohmaier, S. et al. Long-term temporal trends in cardiovascular and metabolic risk factors. Wien Klin Wochenschr 121, 623–630 (2009). https://doi.org/10.1007/s00508-009-1238-z

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  • DOI: https://doi.org/10.1007/s00508-009-1238-z

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