Secular changes in cardiovascular risk factors over 30 years in Swedish men aged 50: the study of men born in 1913, 1923, 1933 and 1943

Objectives, To study secular trends in cardiovascular risk factors in men a ged 50 over a period of 30 years. Design, Cross-sectional studies of successive cohorts of men from 1963 to 1 993, Setting, City of Goteborg, Sweden, Subjects. Four random population samples of men born in 1913, 1923, 1933 an d 1943, aged 50 when they were examined in 1963, 1973, 1983, and 1993 (n = 855, 226, 776, and 798, respectively), Main outcome measures. Anthropometric measurements, blood pressure, serum c holesterol and triglycerides and smoking habits over three decades. Results, Over 30 years, men increased in weight from a mean (SD) of 75.9 (1 1.0) rig to 82.8 (12.1) kg and gained 3.4 cm in height, with a net increase in body mass index from 24.8 (3.2) to 26.0 (3.4) kg m(-2) (P < 0.0001), an d a concomitant increase in waist circumference. The proportion of men who were overweight but not obese (BMI = 25-30 kg m(-2)) increased from 38 to 4 7%, whereas the prevalence of frank obesity (more than 30 kg m(-2)) increas ed from 6% in 1963 to 11% in 1993. Despite the increase in weight, mean sys tolic blood pressure fell by almost 10 mmHg (P < 0.0001). Mean serum choles terol concentration decreased from 6.42 (1.12) to 5.88 (1.04) (P < 0.0001). Serum triglycerides increased from 1.26 (0.77) to 1.69 (1.04) mmol L-1 (P = 0.001). The proportion of men who smoked decreased from 56% in 1963 to 30 % in 1993 (P < 0.0001). This was due more to an increase in smoking cessati on rates than to an increase in the proportion of men who had never smoked, In particular, smelters and former smokers are now more obese than the cor responding categories 30 years ago and smokers are no longer leaner than me n who have never smoked. Conclusions, Over a period of 30 years, serum cholesterol as well as systol ic blood pressure and the prevalence of smoking decreased. This favourable decline in coronary risk factors was offset by an appreciable increase in b ody mass index and waist circumference.