Trends in the incidence of coronary heart disease and changes in diet and lifestyle in women

Hu, Frank, Stampfer, Meir J. , Manson, JoAnn E. , Grodstein, Francine, Colditz, Graham A. , Speizer, Frank E. and Willett, Walter C. (2000) Trends in the incidence of coronary heart disease and changes in diet and lifestyle in women. New England Journal of Medicine, 343 8: 530-537. doi:10.1056/NEJM200008243430802

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Author Hu, Frank
Stampfer, Meir J.
Manson, JoAnn E.
Grodstein, Francine
Colditz, Graham A.
Speizer, Frank E.
Willett, Walter C.
Title Trends in the incidence of coronary heart disease and changes in diet and lifestyle in women
Journal name New England Journal of Medicine   Check publisher's open access policy
ISSN 0028-4793
1533-4406
Publication date 2000-08-04
Sub-type Article (original research)
DOI 10.1056/NEJM200008243430802
Open Access Status File (Publisher version)
Volume 343
Issue 8
Start page 530
End page 537
Total pages 8
Place of publication Waltham, MA, United States
Publisher Massachusetts Medical Society
Language eng
Formatted abstract
Background: Previous studies have found concurrent declines in blood pressure, serum cholesterol levels, and the incidence of and mortality from coronary disease. However, the effects of changes in diet and lifestyle on trends in coronary disease are largely unknown.

Methods: We followed 85,941 women who were 34 to 59 years old and had no previously diagnosed cardiovascular disease or cancer from 1980 to 1994 in the Nurses' Health Study. Diet and lifestyle variables were assessed at base line and updated during follow-up.

Results: After adjustment for the effect of age, the incidence of coronary disease declined by 31 percent from the two-year period 1980–1982 to the two-year period 1992–1994. From 1980 to 1992, the proportion of participants currently smoking declined by 41 percent, the proportion of postmenopausal women using hormone therapy increased by 175 percent, and the prevalence of overweight, defined as a body-mass index (the weight in kilograms divided by the square of the height in meters) of 25 or more, increased by 38 percent. During the study period, diet improved substantially. Statistically, changes in these variables — when considered simultaneously — explained a 21 percent decline in the incidence of coronary disease, representing 68 percent of the overall decline from 1980–1982 to 1992–1994. Taken individually, the reduction in smoking explained a 13 percent decline in the incidence of coronary disease; improvement in diet explained a 16 percent decline; and increase in postmenopausal hormone use explained a 9 percent decline. On the other hand, the increase in body-mass index explained an 8 percent increase in the incidence of coronary disease.

Conclusions: Reduction in smoking, improvement in diet, and an increase in postmenopausal hormone use accounted for much of the decline in the incidence of coronary disease in this group of women. An increasing prevalence of obesity, however, appears to have slowed the decline in the incidence of coronary disease.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 10 Jun 2008, 21:14:38 EST