Background: The long-term collection of population-based data should improve our knowledge of the contribution of trend in cardiovascular risk factors to the steady fall in mortality associated with coronary heart disease in high-income countries.
Aims: To assess long-term time trends in the prevalence of cardiovascular risk factors, estimated coronary heart disease risk and mortality between 1986 and 2013 in the Lille urban area (northern France).
Methods: We studied representative samples of inhabitants of the Lille urban area (aged 40-64 years) in 1986-1988 (n=860), 1995-1996 (n=1021), 2005-2007 (n=1021) and 2011-2013 (n=1636), together with data from the Lille MONICA registry.
Results: In men, the age-standardized prevalence fell between 1986 and 2013 from 70.5% to 42.5% for hypertension, from 71.1% to 58.3% for dyslipidaemia and from 44.1% to 24.7% for smoking (all P<0.001). The prevalence of being overweight increased from 59.6% to 65.1% (P<0.05). In women, the prevalences decreased from 56.6% to 34.3% for hypertension and from 60.9% to 42.2% for dyslipidaemia (both P<0.001). The prevalences of smoking (17%) and being overweight (50%) were stable. The mean 10-year (95% confidence interval) predicted risk of fatal coronary heart disease (estimated with the Systematic Coronary Risk Evaluation equation) decreased by 2.02% (1.78-2.25%) per year for men and by 1.55% (1.32-1.78%) for women. The observed coronary mortality rate fell by 2.6% (2.2-3.0%) in men and 2.8% (1.9-3.6%) in women.
Conclusions: Prevalences of main risk factors and estimated coronary mortality risk decreased concomitantly with the observed coronary mortality - indicating that primary prevention made a major contribution to the decrease in mortality.
Keywords: Coronary disease; Dyslipidaemia; Dyslipidémie; Enquête de santé; Epidemiology; Facteur de risque; Health surveys; Hypertension; Maladies coronariennes; Risk factor; Épidémiologie.
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