TRENDS IN CORONARY HEART-DISEASE RISK-FACTORS IN AUCKLAND 1982-94

Aims. This paper describes trends in major coronary heart disease risk factors over the period 1982 to 1994 in the city of Auckland, New Zea land. Methods. Coronary heart disease risk factor levels were measured in three cross-sectional surveys in Auckland in 1982, 1986-8 and 1993 -4, following a standardised protocol. Random samples of nonMaori, non Pacific Island adults aged 35-64 years were selected from the Auckland general electoral rolls using similar methods in all three surveys. P articipants attended a study centre for interview and risk factor meas urement. Results. The analyses presented are based on samples of 1029 men and 569 women in 1982, 541 men and 365 women in 1986-8, and 712 me n and 685 women in 1993-4. The data are directly age-standardised to t he 1986 New Zealand population. Over the 12 year period the prevalence of self-reported cigarette consumption declined significantly from 28 .6% to 16.9% in men and from 24.5% to 14.8% in women. Mean serum total cholesterol showed little change between 1982 and 1986-8 but declined significantly between 1986-8 and 1993-4 by approximately 6% from 6.12 mmol/L to 5.73 mmol/L in men and by 9% from 6.17 mmol/L to 5.60 mmol/ L in women. Mean serum high density lipoprotein (HDL) cholesterol show ed a modest increase between 1982 and 1986-8 but declined significantl y between 1986-8 and 1993-4 by 12% from 1.25 mmol/L to 1.10 mmol/L in men and by 9% from 1.55 mmol/L in women to 1.40 mmol/L in women. The t otal cholesterol to HDL cholesterol ratio increased significantly betw een 1986-8 and 1993-4 by 6% in men but showed little change in women. Mean blood pressure levels fell by 4-6 mmHg systolic and 6-7 mmHg dias tolic over the 12 year period in men and women. Mean body mass index i ncreased significantly from 25.6 to 26.4 in men and from 24.5 to 25.1 in women during this period. Conclusions. Over the 12 year period, 198 2-94 there have been substantial reductions in the prevalence of self reported cigarette smoking, mean serum total cholesterol levels and me an blood pressure levels in middle aged Aucklanders. Of concern, the p revalence of obesity has increased and mean serum HDL cholesterol leve ls have fallen over the period. Coronary heart disease-prevention and central programmes appear to have been successful in reducing the prev alence of most major coronary heart disease risk factors however some reorientation will be required to redress the adverse trends in HDL ch olesterol levels and obesity.