Development of cardiovascular disease risk in middle-aged men. The Cardiovascular Risk Factor Study in Southern Sweden, CRISS

Abstract: The Cardiovascular Risk Factor Study in Southern Sweden, CRISS, was initiated to explore if men at increased risk at developing CVD risk factors can be identified already before age 40. Starting in 1990 two birth cohorts of men residing in Helsingborg, Sweden, were surveyed at age 37 (n=991, participation rate 68%), at age 40 (n=770) and age 43 (n=702), respectively. A study questionnaire, a physical examination, and blood samples were required for participation. · An annual increase by 0.04 mmol/L in S-Cholesterol was accounted for by a rise in Non-HDL-Cholesterol. · Body height was independently and inversely associated with high (baseline) and increasing S-Cholesterol and Non-HDL-Cholesterol. · Associations between unemployment and CVD risk factors were lost when general unemployment rates increased, whereas associations with length of education remained consistent over the study period. · Overweight, high alcohol consumption and being born abroad, were strong determinants for increasing blood pressure. · At baseline 35% of the men were hypertensive (³140/90 mm Hg), a proportion that increased to 49% over six years. Men with high normal blood pressure (130-139/85-89 mm Hg) at baseline had a higher risk to develop hypertension (OR 2.4, CI: 1.59; 3.80) than men with normal blood pressure (<130/85 mm Hg). This study shows that men at increased risk of developing important CVD risk factors accessible to life style modifications can be identified already before 40 years of age. This has important implications both for clinical practise, and from a public health perspective. The main conclusion of CRISS is to change the aims of primary prevention from the prevention of CVD to of increased CVD risk