Secular trends in cardiovascular risk factors with a 36-year perspective: Observations from 38- and 50-year-olds in the Population Study of Women in Gothenburg

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Abstract
Objectives. To study secular trends in cardiovascular risk factors in four different cohorts of women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005. Design. Comparison of four representative cohorts of 38- and 50-year-old women over a period of 36 years. Setting. Gothenburg, Sweden with similar to 450 000 inhabitants. Subjects. Four representative samples of 38- and 50-year-old women were invited to free health examinations (participation rate 59-90%, n =1901). Main outcome measures. Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), leisure time exercise, use of antihypertensive medication, smoking, levels of haemoglobin, b-glucose, s-cholesterol, s-triglycerides and HDL-cholesterol. Results. There was no significant difference in mean BMI from 1968-1969 versus 2004-2005. Mean leisure time exercise was significantly higher in later born cohorts; in 1968, around 15% were physically active compared with 40% in 2004. SBP and DBP, mean s-cholesterol and s-triglyceride levels were significantly lower in both 38- and 50-year-old cohorts in 2004-2005 versus 1968-1969. HDL-cholesterol (not measured until 1992-1993), showed a significantly higher mean level in 2004-2005. Reduction of risk factors was apparent in women with a high as well as low level of physical activity. Smoking declined most in women with high levels of physical activity. Conclusions. Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.