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Population-attributable risk of coronary heart disease risk factors during long-term follow-up: the Malmö Preventive Project.

Nilsson, P M ; Nilsson, Jan-Åke LU and Berglund, Göran LU (2006) In Journal of Internal Medicine 260(2). p.134-141
Abstract
Aims To calculate the population-attributable risk (PAR) of coronary events (CE) from 10 risk factors, during long-term follow-up. Methods We used both case-cohort and case-control analyses for calculation of PAR in relation to 10 baseline risk factors. First CE (fatal or nonfatal, n = 3072) in 22 444 males and 10 902 females was recorded during a mean follow-up of 20 years by use of national registers. Results Using a Cox regression analysis in a case-cohort design, smoking (prevalence in men 49%, women 37%) was the strongest risk factor, RR 2.29 (95% CI 2.09-2.52; PAR 39%), followed by hypercholesterolaemia, RR 1.70 (95% CI 1.56-1.86; PAR 18%), and diabetes, RR 1.67 (95% CI 1.41-1.99; PAR 3%). For women the strongest risk factors were... (More)
Aims To calculate the population-attributable risk (PAR) of coronary events (CE) from 10 risk factors, during long-term follow-up. Methods We used both case-cohort and case-control analyses for calculation of PAR in relation to 10 baseline risk factors. First CE (fatal or nonfatal, n = 3072) in 22 444 males and 10 902 females was recorded during a mean follow-up of 20 years by use of national registers. Results Using a Cox regression analysis in a case-cohort design, smoking (prevalence in men 49%, women 37%) was the strongest risk factor, RR 2.29 (95% CI 2.09-2.52; PAR 39%), followed by hypercholesterolaemia, RR 1.70 (95% CI 1.56-1.86; PAR 18%), and diabetes, RR 1.67 (95% CI 1.41-1.99; PAR 3%). For women the strongest risk factors were smoking, RR 3.16 (95% CI 2.50-3.98; PAR 44%), diabetes, RR 2.59 (95% CI 1.78-3.76; PAR 6%), and hypertension, RR 2.47 (95% CI 1.94-3.14; PAR 23%). In men, smoking was the strongest predictor both after 10 years [RR 2.69 (95% CI 2.23-3.24)] and 20 years [RR 2.45 (95% CI 2.15-2.79)], followed by hypercholesterolaemia (RR 2.16-1.63), hypertension (RR 2.04-1.51), and diabetes (RR 1.85 -1.47). The case-control design gave very similar results. Total PAR varied from 74% (fully adjusted Cox regression, case-control, in men) to 116% in women (case-cohort). Conclusion Smoking is the most important long-term risk factor for CE in both genders, based on data from a population with a high proportion of smokers. Ten measured variables explained almost all variation in risk and could be used as a basis for intervention programmes. (Less)
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keywords
Sweden: epidemiology, Smoking: adverse effects, Non-U.S. Gov't, Health Surveys, Female, Epidemiologic Methods, Coronary Disease: prevention & control, Coronary Disease: epidemiology, Time Factors, Adult, Humans, Male, Middle Aged, Registries, Research Support
in
Journal of Internal Medicine
volume
260
issue
2
pages
134 - 141
publisher
Wiley-Blackwell
external identifiers
  • wos:000239006800004
  • pmid:16882277
  • scopus:33745953940
ISSN
1365-2796
DOI
10.1111/j.1365-2796.2006.01671.x
language
English
LU publication?
yes
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b6044dfe-e8ee-4a24-b628-2324c3809362 (old id 160310)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16882277&dopt=Abstract
date added to LUP
2016-04-01 16:29:33
date last changed
2021-06-02 01:42:59
@article{b6044dfe-e8ee-4a24-b628-2324c3809362,
  abstract     = {Aims To calculate the population-attributable risk (PAR) of coronary events (CE) from 10 risk factors, during long-term follow-up. Methods We used both case-cohort and case-control analyses for calculation of PAR in relation to 10 baseline risk factors. First CE (fatal or nonfatal, n = 3072) in 22 444 males and 10 902 females was recorded during a mean follow-up of 20 years by use of national registers. Results Using a Cox regression analysis in a case-cohort design, smoking (prevalence in men 49%, women 37%) was the strongest risk factor, RR 2.29 (95% CI 2.09-2.52; PAR 39%), followed by hypercholesterolaemia, RR 1.70 (95% CI 1.56-1.86; PAR 18%), and diabetes, RR 1.67 (95% CI 1.41-1.99; PAR 3%). For women the strongest risk factors were smoking, RR 3.16 (95% CI 2.50-3.98; PAR 44%), diabetes, RR 2.59 (95% CI 1.78-3.76; PAR 6%), and hypertension, RR 2.47 (95% CI 1.94-3.14; PAR 23%). In men, smoking was the strongest predictor both after 10 years [RR 2.69 (95% CI 2.23-3.24)] and 20 years [RR 2.45 (95% CI 2.15-2.79)], followed by hypercholesterolaemia (RR 2.16-1.63), hypertension (RR 2.04-1.51), and diabetes (RR 1.85 -1.47). The case-control design gave very similar results. Total PAR varied from 74% (fully adjusted Cox regression, case-control, in men) to 116% in women (case-cohort). Conclusion Smoking is the most important long-term risk factor for CE in both genders, based on data from a population with a high proportion of smokers. Ten measured variables explained almost all variation in risk and could be used as a basis for intervention programmes.},
  author       = {Nilsson, P M and Nilsson, Jan-Åke and Berglund, Göran},
  issn         = {1365-2796},
  language     = {eng},
  number       = {2},
  pages        = {134--141},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Internal Medicine},
  title        = {Population-attributable risk of coronary heart disease risk factors during long-term follow-up: the Malmö Preventive Project.},
  url          = {http://dx.doi.org/10.1111/j.1365-2796.2006.01671.x},
  doi          = {10.1111/j.1365-2796.2006.01671.x},
  volume       = {260},
  year         = {2006},
}