Optimal risk factors in the population: Prognosis, prevalence, and seculartrends - Data from Goteborg population studies

Aims To assess the prognosis and prevalence of optimal risk factors in the population. Methods and Results Data from several Goteborg population studies were used . Optimal risk factors were defined as serum cholesterol <5 mmol. l(-1), bl ood pressure < 140/90 without treatment and being a non-smoker. In a 20-yea r follow-up of 7130 men aged 47 to 55 at baseline a group of 117 men who we re optimal with respect to cholesterol, blood pressure and smoking were ide ntified. In this group there was only one death from coronary disease, corr esponding to 0.4 deaths per 1000 years, whereas the overall risk of coronar y death in the study was 4.8 per 1000 years. Among men and women aged 25 to 34 in the Goteborg MONICA study 1995, less than half were optimal on all t hree scores, and in men and women aged 55 to 64, only 7% and 6%, respective ly, were optimal. If body mass index below 25 was included only 34% and 37% , respectively, of men and women aged 25 to 34 were optimal, and 11% and 22 % among men and women aged 35 to 44. In an analysis of secular trends over 30 years in four successive cohorts of men aged 50 the prevalence of optima l risk factors with respect to cholesterol, blood pressure and smoking incr eased from 1963 to 1993 but was still only 11% in 1993. Conclusions As expected, optimal risk factors with respect to serum cholest erol, blood pressure and smoking confers a very low risk of coronary death. However, the prevalence of optimal risk factor status in the Swedish popul ation is still low. (C) 2001 The European Society of Cardiology.