Journal
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Volume 43, Issue 3, Pages 866-877Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyt279
Keywords
Obesity; blood pressure; cholesterol; secular trend; ageing; quantile regression
Categories
Funding
- Medical Research Council [K013351]
- British Heart Foundation [RG/13/2/30098]
- National Heart Lung and Blood Institute [RO1 HL036310]
- National Institute of Aging [RO1AG13196, RO1AG034454]
- National Excellence Program - European Union [TAMOP 4.2.4.A/1-11-1-2012-0001]
- European Social Fund
- [TAMOP 4.2.2.A-11/1/KONV-2012-0052]
- British Heart Foundation [RG/13/2/30098] Funding Source: researchfish
- Economic and Social Research Council [ES/J023299/1] Funding Source: researchfish
- Medical Research Council [MR/K013351/1] Funding Source: researchfish
- ESRC [ES/J023299/1] Funding Source: UKRI
- MRC [MR/K013351/1] Funding Source: UKRI
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Background: Secular trends in cardiovascular risk factors have been described, but few studies have examined simultaneously the effects of both ageing and secular trends within the same cohort. Methods: Development of cardiovascular risk factors over the past three decades was analysed using serial measurements from 10 308 participants aged from 35 to 80 years over 25 years of follow-up from five clinical examination phases of the Whitehall II study. Changes of body mass index, waist circumference, blood pressure and total and high-density lipoprotein cholesterol distribution characteristics were analysed with quantile regression models in the 57-61 age group. Age-related trajectories of risk factors were assessed by fitting mixed-effects models with adjustment for year of birth to reveal secular trends. Results: Average body mass index and waist circumference increased faster with age in women than in men, but the unfavourable secular trend was more marked in men. Distributions showed a fattening of the right tail in each consecutive phase, meaning a stronger increase in higher percentiles. Despite the higher obesity levels in younger birth cohorts, total cholesterol decreased markedly in the 57-61 age group along the entire distribution rather than in higher extremes only. Conclusion: The past three decades brought strong and heterogeneous changes in cardiovascular risk factor distributions. Secular trends appear to modify age-related trajectories of cardiovascular risk factors, which may be a source of bias in longitudinal analyses.
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