Neuropsychiatric Epidemiology Unit, Neuropsykiatri SU/Mölndal, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, Mölndal, 431 41 Gothenburg, Sweden.
Aging Clin Exp Res. 2013 Aug;25(4):377-83. doi: 10.1007/s40520-013-0058-1. Epub 2013 Jun 4.
The number of older people are increasing worldwide, and cardiovascular diseases are the major causes of death in western societies. This study examines birth cohort differences in cardiovascular disorders and risk factors in Swedish elderly.
Representative samples of 75-year-olds living in Gothenburg, Sweden, examined in 1976-1977 and in 2005-2006. Blood pressure, s-cholesterol, s-triglycerides, height, body weight, body mass index, history of myocardial infarction, angina pectoris and stroke/TIA, and diabetes mellitus were measured.
The prevalence of total cardiovascular disorders, hypertension and hypercholesterolemia decreased, and the prevalence of stroke increased in both genders. The prevalence of cardiovascular disorders was higher in women than in men in 1976-1977, and higher in men than in women in 2005-2006. The decrease in blood pressure occurred independently of antihypertensive treatment. The prevalence of current smokers decreased in men and increased in women. The prevalence of life-time smokers and diabetes mellitus increased only in women. The proportion on antihypertensive treatment and overweight and obesity increased only in men. Hypertension, overweight and obesity were more common in women in 1976-1977. These sex differences were not observed in 2005-2006.
The overall prevalence of cardiovascular disorders decreased, and sex differences reversed between the 1970s and 2000s among Swedish septuagenarians. Our findings emphasize the importance of environmental factors, not only for the prevalence of cardiovascular disorders, but also as explanations for sex differences. Reasons for changes could be increased survival in those with disorders and risk factors, changes in lifestyle and diet, and better preventive strategies, such as treatment of hypercholesterolemia and hypertension.
全球老年人口数量不断增加，心血管疾病是西方社会人群主要的死亡原因。本研究旨在探讨瑞典老年人中心血管疾病及其危险因素的出生队列差异。
选取瑞典哥德堡的 75 岁老年人作为研究对象，分别于 1976-1977 年和 2005-2006 年进行调查。测量指标包括血压、血清胆固醇、血清三酰甘油、身高、体重、体重指数、心肌梗死史、心绞痛和卒中/TIA 病史以及糖尿病。
在两个性别中，心血管疾病、高血压和高胆固醇血症的总患病率均有所下降，而卒中的患病率则有所上升。1976-1977 年时，女性的心血管疾病患病率高于男性，而 2005-2006 年时则相反。血压的下降与降压治疗无关。男性的吸烟率下降，而女性的吸烟率上升。终生吸烟者和糖尿病的患病率仅在女性中有所增加。降压治疗、超重和肥胖的比例仅在男性中有所增加。1976-1977 年时，高血压、超重和肥胖在女性中更为常见。而这些性别差异在 2005-2006 年并未出现。
在瑞典 70 多岁的老年人中，心血管疾病的总体患病率下降，且性别差异在 20 世纪 70 年代和 2000 年代之间发生了逆转。本研究结果强调了环境因素的重要性，这些因素不仅影响心血管疾病的患病率，还可能是导致性别差异的原因。导致变化的原因可能是与心血管疾病和危险因素相关的患者生存率的提高、生活方式和饮食的改变，以及更有效的预防策略，如高胆固醇血症和高血压的治疗。
