scholarly journals Impact of prior cerebrovascular disease and glucose status on incident cerebrovascular disease in Japanese

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Momoko Oe ◽  
Kazuya Fujihara ◽  
Mayuko Harada-Yamada ◽  
Taeko Osawa ◽  
Masaru Kitazawa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glucose Tolerance ◽  
Cerebrovascular Disease ◽  
Systolic Blood Pressure ◽  
Cox Regression ◽  
Drug Prescription ◽  
Cvd Risk ◽  
Cox Regression Analysis ◽  
The Impact ◽  
Glucose Status

Abstract Background Although both a history of cerebrovascular disease (CVD) and glucose abnormality are risk factors for CVD, few large studies have examined their association with subsequent CVD in the same cohort. Thus, we compared the impact of prior CVD, glucose status, and their combinations on subsequent CVD using real-world data. Methods This is a retrospective cohort study including 363,627 men aged 18–72 years followed for ≥ 3 years between 2008 and 2016. Participants were classified as normoglycemia, borderline glycemia, or diabetes defined by fasting plasma glucose, HbA1c, and antidiabetic drug prescription. Prior and subsequent CVD (i.e. ischemic stroke, transient ischemic attack, and non-traumatic intracerebral hemorrhage) were identified according to claims using ICD-10 codes, medical procedures, and questionnaires. Results Participants’ mean age was 46.1 ± 9.3, and median follow up was 5.2 (4.2, 6.7) years. Cox regression analysis showed that prior CVD + conferred excess risk for CVD regardless of glucose status (normoglycemia: hazard ratio (HR), 8.77; 95% CI 6.96–11.05; borderline glycemia: HR, 7.40, 95% CI 5.97–9.17; diabetes: HR, 5.73, 95% CI 4.52–7.25). Compared with normoglycemia, borderline glycemia did not influence risk of CVD, whereas diabetes affected subsequent CVD in those with CVD- (HR, 1.50, 95% CI 1.34–1.68). In CVD-/diabetes, age, current smoking, systolic blood pressure, high-density lipoprotein cholesterol, and HbA1c were associated with risk of CVD, but only systolic blood pressure was related to CVD risk in CVD + /diabetes. Conclusions Prior CVD had a greater impact on the risk of CVD than glucose tolerance and glycemic control. In participants with diabetes and prior CVD, systolic blood pressure was a stronger risk factor than HbA1c. Individualized treatment strategies should consider glucose tolerance status and prior CVD.

scholarly journals Impact of Prior Cerebrovascular Disease and Glucose Status on Incident Cerebrovascular Disease in Japanese

2021 ◽  
Author(s):  
Momoko Oe ◽  
Kazuya Fujihara ◽  
Mayuko Harada Yamada ◽  
Taeko Osawa ◽  
Masaru Kitazawa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glucose Tolerance ◽  
Cerebrovascular Disease ◽  
Systolic Blood Pressure ◽  
Cox Regression ◽  
Drug Prescription ◽  
Cvd Risk ◽  
Cox Regression Analysis ◽  
The Impact ◽  
Glucose Status

Abstract Background: Although both a history of cerebrovascular disease (CVD) and glucose abnormality are risk factors for CVD, few large studies have examined their association with subsequent CVD in the same cohort. Thus, we compared the impact of prior CVD, glucose status, and their combinations on subsequent CVD using real-world data. Methods: This is a retrospective cohort study including 363,627 men aged 18-72 years followed for ≥3 years between 2008 and 2016. Participants were classified as normoglycemia, borderline glycemia, or diabetes defined by fasting plasma glucose, HbA1c, and antidiabetic drug prescription. Prior and subsequent CVD (i.e. ischemic stroke, transient ischemic attack, and non-traumatic intracerebral hemorrhage) were identified according to claims using ICD-10 codes, medical procedures, and questionnaires. Results: The subjects’ mean age was 46.1 ± 9.3, and median follow up was 5.2 (4.2, 6.7) years. Cox regression analysis showed that prior CVD+ conferred excess risk for CVD regardless of glucose status (normoglycemia: hazard ratio (HR) , 8.77; 95% CI, 6.96-11.05; borderline glycemia: HR, 7.40, 95% CI, 5.97-9.17; diabetes: HR, 5.73, 95% CI, 4.52-7.25). Compared with the normoglycemia, borderline glycemia did not influence risk of CVD, whereas diabetes affected subsequent CVD in those with CVD- (HR, 1.50, 95% CI, 1.34-1.68). In CVD-/diabetes, age, current smoking, systolic blood pressure, HDL cholesterol, and HbA1c were associated with risk of CVD, but only systolic blood pressure was related to CVD risk in CVD+/diabetes.Conclusions: Prior CVD had a greater impact on risk of CVD than glucose tolerance and glycemic control. In diabetes with prior CVD, systolic blood pressure was a stronger risk factor than HbA1c. Individualized treatment strategy should consider glucose tolerance status and prior CVD.

P4663Hyperinsulinemia, hypertension and two clusters of biomarkers predict aortic stenosis in 10,144 Finnish men

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Ojanen ◽  
R Jauhiainen ◽  
J Vangipurapu ◽  
T Kuulasmaa ◽  
J Kuusisto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Regression Analysis ◽  
Glucose Tolerance ◽  
Systolic Blood Pressure ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Plasma Insulin ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Fasting Plasma

Abstract BACKROUND Recent studies show that hypertension predicts aortic stenosis (AS). Other predictors of AS are not established. Purpose To investigate a large panel of biomarkers as predictors of AS in the population-based METSIM cohort. Methods Anthropometric, metabolic and inflammatory biomarkers were measured at baseline in the cohort of 10,197 Finnish men. Subjects with AS at baseline (n=53) were excluded from the analyses. Cases of AS were identified from the medical records. Cox regression analysis was used to identify variables predicting AS. Principal components analysis was applied to investigate clustering of variables predicting AS. Uni- and multivariate logistic regression analysis were used to investigate the clusters of biomarkers as predictors of AS. Results Over a mean follow-up time of 10.8 years, incident AS was diagnosed in 116 (1.1%) men. In Cox regression analysis, fasting plasma insulin (9.8±12.8 in men without AS vs. 14.5±18.2 mU/l in men with incident AS; P=6.13 x 10–6) and systolic blood pressure (138.2±16.7 vs. 146.3±19.4 mmHg; P=3.8 x 10–7) were associated with higher risk of AS (HR 1.44 (95% CI 1.23–1.68); P=4.04 x 10–5 and HR 1.54 (1.30–1.83); P=3.01 x 10–7, respectively). Other biomarkers, which significantly predicted AS were age, body mass index, waist, waist/hip ratio, body fat mass percentage, urine albumin, CRP, blood GHbA1C, fasting plasma glucose and proinsulin, oral glucose tolerance test (OGTT) 30 min plasma insulin and proinsulin, OGTT 120 min plasma insulin and proinsulin, and serum C-peptide. Glucose tolerance (ADA 2003), and insulin resistance and insulin secretion indices based on HOMA were significant predictors of AS. After adjusting for age, the same biomarkers except for OGTT 120 min plasma proinsulin, blood GHbA1C and fasting plasma glucose significantly predicted AS. After exclusion of diabetic subjects, all biomarkers mentioned above except for GHbA1C, fasting plasma glucose and glucose tolerance predicted AS in unadjusted Cox models. Two clusters of risk factors were found in principal components analysis, one consisting of fasting plasma insulin, HOMA insulin resistance index, waist/hip ratio, GHbA1c and CRP, and another consisting of age, systolic blood pressure and urine albumin, explaining 38.33 and 15.37% of the total variance, respectively. In univariate logistic regression analysis both clusters predicted AS (HR 1.35 (1.15–1.59); P=2.47 x 10–4 and HR 1.73 (1.46–2.04); P=1.53 x 10–10, respectively), and were statistically significant when entered in the multivariate model (HR 1.30 (1.11–1.52); P=1.01 x 10–3 and HR 1.69 (1.43–1.99); P=5.84 x 10–10, respectively). Conclusion In the present large-scale population-based study, several biomarkers, particularly hyperinsulinemia and systolic blood pressure, predicted AS. In addition, two clusters of biomarkers, one with high loading on insulin and another on systolic blood pressure, independently predicted AS. Acknowledgement/Funding Kuopio University Hospital ja Academy of Finland

scholarly journals Level of systolic blood pressure within the normal range and risk of cardiovascular events in the absence of risk factors in Chinese

2021 ◽  
Author(s):  
Chunpeng Ji ◽  
Na Wang ◽  
Jihong Shi ◽  
Zhe Huang ◽  
Shuohua Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Cox Regression ◽  
Healthy Population ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cox Regression Analysis ◽  
Study Participants

AbstractThe risk of cardiovascular disease (CVD) at currently defined normal systolic blood pressure (SBP) levels in individuals without CVD risk factors is not well examined. We evaluated whether higher systolic blood pressure within the range considered normal is associated with a higher CVD risk in Chinese without traditional CVD risk factors. The community-based study included 25,529 individuals (mean age:47.3 ± 12.3 years;range:18–95 years) with a baseline SBP of 90–129 mmHg, who were free of CVD and traditional CVD risk factors, and who were re-examined in biennial intervals. During a mean follow-up of 10.6 ± 1.49 years (maximum. 11.5 years), 847 CVD events occurred. CVD incidence per 1000 person-years increased with higher baseline SBP levels (SBP,90–99 mmHg:1.45;100–109 mmHg:2.15;110–119 mmHg:3.06; and 120–129 mmHg:3.80). After adjusting for CVD risk factors, the categorical Cox regression suggested that the CVD risk was not statistically significant for study participants with a baseline SBP level of 100–109 mmHg, 110–119 mmHg, and 120–129 mmHg compared with those with a baseline SBP level of 90–99 mmHg. If CVD risk factors including blood pressure categories which developed during follow-up were included in a time-dependent Cox regression analysis, the normal baseline SBP was still not associated with incident CVDs. A SBP between 90 and 129 mmHg was not associated with an increased CVD risk in a healthy population.

Abstract TP431: Association of Systolic Blood Pressure and Cardiovascularrisk According to Hemoglobin Concentration

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jun Young Chang ◽  
Se Young Jang ◽  
Sun-uck Kwon
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cox Regression ◽  
Hemoglobin Concentration ◽  
Cardiovascular Death ◽  
Normal Range ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Hb Concentration

Introduction: We evaluated whether the optimal cutoff of blood pressure to reduce cardiovascular risk is different according to hemoglobin (Hb) concentration and its changing pattern using the National Health Insurance Service-Health Screening Cohort. Methods: The study population consisted of individuals who underwent both 2002-2003 and 2004-2005 health examinations. Individuals who were diagnosed with cardiovascular disease or who died before index date of 1 January 2006 were excluded. The primary outcome of the study was the association between systolic blood pressure (SBP) and MACE (composite of myocardial infarction, stroke, and cardiovascular death) according to Hb concentration. Hazard ratios (HR) were calculated using Cox regression analysis adjusted for age and sex. Results: A total of 290573 were included in the analysis. During the follow up period from 1 January 2006 to 31 December 2013, a total of 18292 experienced MACE. There was a significant interaction between SBP and Hb concentration with regard to cardiovascular diseases (p for interaction= 0.07). Among the subjects with Hb <10, a significant increment of MACE was observed when SBP ≥140 mmHg. HR for MACE increased when SBP ≥130mmHg among the subjects with 10≤ Hb <11 and 11≤ Hb <12. HR for MACE increased when SBP ≥ 120 mmHg among the subjects with 12≤ Hb <13, 13≤ Hb <15, and 15≤ Hb. Cardiovascular risk was the lowest in SBP below 120mmHg and cut off value for increasing cardiovascular risk was 120 mmHg or above in subjects who maintain normal range of hemoglobin level and whose hemoglobin concentration changed from anemia to normal range. However, individuals who maintain anemic state and whose hemoglobin concentration changed from normal range to anemia, SBP threshold for increasing cardiovascular risk was equal or above 130 mmHg . Conclusion: The threshold of SBP which increases cardiovascular risk may be different according to the hemoglobin concentration and change pattern of hemoglobin.

scholarly journals Associations of Systolic Blood Pressure and Diastolic Blood Pressure With the Incidence of Coronary Artery Disease or Cerebrovascular Disease According to Glucose Status

2021 ◽  
Author(s):  
Mayuko Harada Yamada ◽  
Kazuya Fujihara ◽  
Satoru Kodama ◽  
Takaaki Sato ◽  
Taeko Osawa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cerebrovascular Disease ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Artery Disease ◽  
Glucose Status

<b>Aims: </b>To determine associations of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with new-onset coronary artery disease (CAD) or cerebrovascular disease (CVD) according to glucose status. <p><b>Research Design and Methods: </b>Examined was a nationwide claims database from 2008 – 2016<b> </b>on 593,196 individuals. Cox proportional hazards model identified risks of CAD and CVD events among 5 levels of SBP and DBP. </p> <p><b>Results:</b> During the study period 2,240 CAD and 3,207 CVD events occurred. Compared with SBP ≤119 mmHg, which was the lowest quintile of SBP, hazard ratios (HRs) (95% confidence interval) for CAD/CVD in the 4 higher quintiles (120-129, 130-139, 140-149, ≥150 mmHg) gradually increased from 2.10 (1.73 to 2.56)/ 1.46 (1.27 to 1.68) in quintile 2 to 3.21 (2.37 to 4.34)/4.76 (3.94 to 5.75) in quintile 5 for normoglycemia; from 1.39 (1.14 to 1.69)/1.70 (1.44 to 2.10) in quintile 2 to 2.52 (1.95 to 3.26)/4.12 (3.38 to 5.02) in quintile 5 for borderline glycemia; and from 1.50 (1.19 to 1.90)/1.72 (1.31 to 2.26) in quintile 2 to 2.52 (1.95 to 3.26)/3.54 (2.66 to 4.70) in quintile 5 for diabetes. A similar trend was observed for DBP across 4 quintiles (75-79, 80-84, 85-89, ≥90 mmHg) compared with ≤74 mmHg, which was the lowest quintile. </p> <p><b>Conclusions: </b>Results indicated that cardiovascular risks gradually increased with increases in SBP and DBP regardless of the presence of and degree of a glucose abnormality. Further interventional trials are required to apply findings from this cohort study to clinical practice. </p>

scholarly journals Exploiting dietary supplementation trials to assess the impact of the prenatal environment on CVD risk

2008 ◽  
Vol 68 (1) ◽  
pp. 78-88 ◽  
Author(s):  
Sophie Hawkesworth
Keyword(s):  
Blood Pressure ◽  
Body Composition ◽  
Systolic Blood Pressure ◽  
Fasting Glucose ◽  
Disease Risk ◽  
Maternal Diet ◽  
Current Evidence ◽  
Cvd Risk ◽  
Protein Energy ◽  
The Impact

Animal studies have demonstrated that altering the maternal diet during pregnancy affects offspring disease risk. Data from human subjects on the early-life determinants of disease have been derived primarily from birth-weight associations; studies of the impact of the maternal diet are scarce and inconsistent. Investigating CVD risk factors in the offspring of women who have participated in maternal supplementation trials provides a useful resource in this research field, by virtue of employing an experimental design (as compared with observational studies). To date, follow-up studies have been published only for a small number of trials; these trials include the impact of maternal protein–energy, multiple-micronutrient and Ca supplementation on offspring disease risk. In Nepal maternal micronutrient supplementation has been shown to be associated with lower offspring systolic blood pressure at 2 years of age. Data from Guatemala on a pre- and postnatal protein–energy community intervention have suggested long-term improvements in fasting glucose and body composition but not in blood pressure. In The Gambia no association has been found between prenatal protein–energy supplementation and markers of CVD risk including body composition, blood pressure and fasting glucose and insulin in childhood and adolescence. Little evidence of an effect of maternal Ca supplementation on offspring blood pressure has been demonstrated in four trials, although the risk of high systolic blood pressure was found to be reduced in one trial. The present paper reviews the current evidence relating maternal nutritional supplementation during pregnancy to offspring CVD risk and explores the potential explanations for the lack of association.

scholarly journals Immunofluorescence deposits in the mesangial area and glomerular capillary loops did not affect the prognosis of immunoglobulin a nephropathy except C1q:a single-center retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lingzhi Wu ◽  
Di Liu ◽  
Ming Xia ◽  
Guochun Chen ◽  
Yu Liu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Cox Regression ◽  
Immunoglobulin A ◽  
Study Endpoint ◽  
Immunoglobulin A Nephropathy ◽  
Renal Outcomes ◽  
Kaplan Meier ◽  
Renal Prognosis ◽  
The Impact

Abstract Background Immunoglobulin A nephropathy (IgAN) is identified as mesangial IgA deposition and is usually accompanied by other immunofluorescence deposits. The impact of immunofluorescent features in IgAN patients, however, remains unclear. Methods Baseline clinicopathologic parameters and renal outcomes of 337 patients diagnosed with IgAN between January 2009 and December 2015 were analyzed. We then categorized these patients into four groups: without immunofluorescence deposits, mesangial-only, mesangial and glomerular capillary loops (GCLs), and GCLs-only. The study endpoint was end-stage kidney disease (ESKD) or a ≥ 50% decline in the estimated glomerular filtration rate (eGFR). Kaplan–Meier and Cox regression analyses were performed to calculate renal survival. Results Of the 337 IgAN patients, women comprised 57.0%. Compared to patients with IgA deposition in the mesangial-only group, patients with IgA deposition in the mesangial +GCLs group were much heavier, and exhibited higher systolic blood pressure, lower serum IgG levels, and heavier proteinuria (all P < 0.05). Patients with IgG deposition in the mesangial +GCLs group presented with higher levels of cholesterol, heavier proteinuria than IgG deposition in the mesangial-only group (both P < 0.05). Compared with the mesangial-only group exhibiting C3 deposits, patients in the mesangial +GCLs group with C3 deposition had a higher systolic blood pressure (P = 0.028). A total of 38 patients (11.3%) continued to the study endpoint after a median follow-up time of 63.5 months (range,49.8–81.4). Kaplan–Meier analysis and Cox regression analysis showed that C1q deposition in the mesangial +GCLs group predicted a poor renal prognosis. Conclusions IgA and IgG deposits in the mesangial region and GCLs were associated with more unfavorable clinical and histopathologic findings in IgAN patients. C1q deposition in the mesangial region and GCLs predicted a poor renal prognosis. However, the impact of the pattern of immunofluorescence deposits on renal outcomes remains to be proven by further investigation.

scholarly journals Pulmonary hypertension: state of problem and analysis of referential center work (results of first Ukrainian Register)

2019 ◽  
Vol 26 (4) ◽  
pp. 56-72
Author(s):  
G. D. Radchenko ◽  
I. O. Zhyvylo ◽  
Yu. M. Sirenko
Keyword(s):  
Blood Pressure ◽  
Pulmonary Hypertension ◽  
Regression Analysis ◽  
Survival Rate ◽  
Connective Tissue ◽  
Systolic Blood Pressure ◽  
Right Ventricular ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
The Right

The aim – to analyze the structure of patients who were treated in specialized referential center; to evaluate Ukrainian reality of survival of patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) who were treated at the referential center and to determine the predictors of death. Materials and methods. Data of 359 patients with pulmonary hypertension were included in the study. To assess survival, 281 patients (52 (18.5 %) with CTEPH and 229 (81.5 %)) with PAH were examined who were treated at the center of pulmonary hypertension of M.D. Strazhesko Institute of Cardiology of NAMS of Ukraine. The diagnosis of pulmonary hypertension was based on the data of the catheterization of the right heart. Survival was determined by the method of constructing the Kaplan – Meier curves. The observation period was 51 months. Predictors were determined using binary logistic regression and Cox regression analysis. Results and discussion. The survival rate of the overall patient cohort was 93.3 %, 86.8 % and 81.5 % at stages one, two, and three, respectively. The best survival rate was in patients with PAH associated with congenital heart diseases – CHD (92.7 %) compared to patients with idiopathic PAH (67.5 %, long rank р=0.002), PAH associated with connective tissue diseases (49.7 %, long rank р=0.001) and CTEPH (83.2 %, long rank р=0.04). According to the univariate Cox analysis, the predictors of death were: functional class IV according to the WHO (OR=4.94, 95 % CI 2.12–11.48), presence of ascites (OR=4.52, 95 % CI 2.21–9.24), PAH associated with connective tissue disease (OR=3.07, 95 % CI 1.07–8.87), PAH associated with CHD (OR=0.28, 95 % CI 0.11–0.68), heart rate at the background of treatment > 105 beats per minute (OR=7.85, 95 % CI 1.83–33.69), office systolic blood pressure < 100 mm Hg (OR=2.78, 95 % CI 1.26–6.1), the distance of the 6-minute test at the background of treatment < 340 m (OR=3.47, 95 % CI 1.01–12.35), NT-proBNP level > 300 pg/ml (OR=4.98, 95 % CI 1.49–16.6), right atrial area > 22 cm2 (OR=14.2, 95 % CI 1.92–104.89), right ventricular area in diastole (OR=1.08, 95 % CI 1.03–1.14), right ventricular area in systole (OR=1.08, 95 % CI 1.02–1.11), 1 mm Hg increase of mean pressure in the right atrium (OR=1.02, 95 % CI 1.02–1.19). In multivariate Cox regression analysis, independent predictors of death were ascites, office systolic blood pressure < 100 mm Hg, and NT-proBNP level > 300 pg/ml. PAH associated with CHD reduced the likelihood of death. Conclusions. These are the first results of the study that was conducted at the only Ukrainian center for the diagnosis and treatment of pulmonary hypertension. They show that the structure of patients with PAH in Ukraine is significantly different from that in centers of other countries, though the survival rates are comparable. Quite simple indicators are found which can be evaluated in routine practice and which are independent predictors of death.

Abstract P206: The Risk for Cardiovascular Disease Attributable to Traditional Risk Factors Increases

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Susanne Rospleszcz ◽  
Barbara Thorand ◽  
Tonia de las Heras Gala ◽  
Christa Meisinger ◽  
Rolf Holle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Systolic Blood Pressure ◽  
Population Attributable Risk ◽  
Temporal Trends ◽  
Cvd Risk ◽  
Traditional Risk Factors ◽  
The Impact

Background: Cardiovascular disease (CVD) is a major cause of mortality and morbidity. Traditional risk factors include systolic blood pressure, diabetes, adiposity, cholesterol and smoking. The prevalence and distribution of these risk factors in the population have changed within the last decades and CVD mortality rates have been declining. However, the impact of these changes on the contribution of the single risk factors to overall CVD risk remains to be investigated. Hypothesis: We assessed the hypothesis that the population attributable risk (PAR) of traditional risk factors changes from 1985 to 2000. Methods: The sample comprises N = 11 760 participants aged 30 - 65 years from four prospective population-based cohort studies enrolled in Southern Germany in 1985, 1990, 1995, and 2000. Participants were followed up for incident CVD events for ten years. We analyzed the traditional risk factors hypertension, defined as systolic blood pressure ≥ 140 mmHg or treatment with antihypertensive medication; diabetes mellitus; obesity, defined as a Body Mass Index ≥ 30 kg/m 2 ; hypercholesterolemia, defined as total cholesterol levels ≥ 200 mg/dL; and smoking. We calculated the PAR first according to Levin’s formula using both crude relative risks as well as adjusted hazard ratios and second as an average of all single sequential PARs according to the formulae by Ferguson. Results: Temporal trends in prevalence varied for the respective risk factors. The prevalence of hypertension decreased slightly for women (from 25.0% in 1985 to 23.0% in 2000) and increased slightly for men (32.3% to 33.3%), whereas the prevalence of diabetes and obesity increased for both women and men. Prevalence of hypercholesterolemia decreased slightly for women (from 73.4% to 71.4%) and more pronounced for men (80.5% to 74.5%). Prevalence of smoking increased for women (20% to 23.6%), but decreased for men (36.4% to 32.4%). CVD events occurred in 2.4% of women in 1985 and 2.3% in 2000; for men, event rates were and 6.2% and 6.3%, respectively. For both women and men the risk factor with the highest PAR in 1985 was hypertension (64.0% and 43.3%, respectively according to Levin’s formula). However, in 2000 the risk factor with the highest PAR was hypercholesterolemia (78.2% and 57.0%, respectively). The PAR for diabetes declined for women and increased for men. The PAR for smoking varied substantially between the studies without a discernible trend. According to Ferguson’s formulae, the PAR of all risk factors taken together increased from 74.3% to 84.2% in women and from 70.8% to 81.8% in men. Conclusion: In conclusion, the CVD risk attributable to traditional risk factors has increased within the last decades. However, different methods of calculating the PAR have to be taken into account. These trends might influence public health policies focusing on the management of these risk factors in order to effectively prevent CVD.

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