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Why should population attributable fractions be periodically recalculated? An example from cardiovascular risk estimation in southern Europe.

Abstract：

OBJECTIVE:To determine the effect of age and study period on coronary heart disease (CHD) risk attributable to cardiovascular risk factors. METHODS:A cohort of cardiovascular disease (CVD)-free randomly participants from Girona (Spain) aged 35-74 years recruited in 1995 and 2000 and followed for an average of 6.9 years. A survey conducted in the same area in 2005 was also used for the analysis. Smoking, hypertension, diabetes, sedentary lifestyle, obesity, total cholesterol > or = 240 mg/dl, low-density lipoprotein (LDL) cholesterol > or = 160 mg/dl, and high-density lipoprotein cholesterol <40 mg/dl were the risk factors considered. The composite end-point included myocardial infarction, angina pectoris, and CHD death. RESULTS:LDL cholesterol had the highest potential for CHD prevention between 35 and 74 years [42% (95% Confidence Interval: 23,58)]. The age-stratified analysis showed that the population attributable risk (PAF) for smoking was 64% (30,80) in subjects < 55 years; for those > or = 55 years, the PAF for hypertension was 34% (1,61). The decrease observed between 1995 and 2005 in the population's mean LDL cholesterol level reduced that PAF in all age groups. CONCLUSION:Overall, LDL cholesterol levels had the highest potential for CHD prevention. Periodic PAF recalculation in different age groups may be required to adequately monitor population trends.

journal_name

Prev Med

journal_title

Preventive medicine

authors

Grau M,Subirana I,Elosua R,Fitó M,Covas MI,Sala J,Masiá R,Ramos R,Solanas P,Cordon F,Nieto FJ,Marrugat J,REGICOR Investigators.

doi

10.1016/j.ypmed.2010.03.012

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

78-84

issue

1

eissn

0091-7435

issn

1096-0260

pii

S0091-7435(10)00108-8

journal_volume

51

pub_type

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