Abstract
AimsVascular disease mortality has declined rapidly in most Western countries, against a background of improved treatments and falling prevalence of smoking, but rising obesity. We examined whether this decline differed by lifestyle risk factors for vascular disease.Methods and ResultsDuring 2001–2010, there were 9241 vascular disease deaths in a prospective study of 1.3 million women in middle age, about one-quarter of all UK women in the eligible age range (50–64 years in 1996–2001). We estimated percentage declines in mortality from coronary heart disease, cerebrovascular disease and other vascular diseases, overall and by age, smoking, alcohol consumption, adiposity, physical activity, socioeconomic status and age at leaving school. Over 10 years, coronary heart disease mortality fell by half (52%), cerebrovascular disease mortality by two-fifths (42%) and other vascular disease mortality by one-fifth (22%). Lean women experienced greater declines in coronary heart disease mortality than overweight or obese women (70%, 48% and 26%, respectively; P < 0.001 for heterogeneity) and women in the highest and middle thirds of socioeconomic status experienced greater declines in other (non-coronary, non-cerebrovascular) vascular disease mortality than women in the lowest third (41% and 42% and –9%, respectively; P = 0.001). After accounting for multiple testing, there were no other significant differences in vascular mortality trends by any lifestyle risk factor, including by smoking status.ConclusionVascular disease mortality trends varied in this cohort by adiposity and socioeconomic status, but not by smoking status or other lifestyle risk factors. Prevention and treatment of vascular disease appear not to have been equally effective in all subgroups of UK women.
Highlights
Vascular disease mortality has fallen greatly since the 1950s in both men and women in the UK, the USA and many other countries.[1]
The women were aged 56.4 years on average at baseline (Table 1). Those who died of vascular causes were, on average, slightly older at baseline than those who did not, had a higher body mass index (BMI), drank less alcohol, were less likely to engage in strenuous physical activity and were more likely to be current smokers, to have lower socioeconomic status and to have left school at an earlier age
The relative decline in vascular mortality during this 10-year period was 42% overall, but varied by specific cause of death (Figure 2)
Summary
Vascular disease mortality has fallen greatly since the 1950s in both men and women in the UK, the USA and many other countries.[1] The causes of this decline include improved treatments and changes over time in important risk factors such as smoking, blood pressure and cholesterol.[2,3,4,5] most of what is known about these trends is derived from population-level data. Some prospective studies have investigated socioeconomic differences in declining vascular mortality,[6,7,8,9,10,11,12] few have examined whether the decline has varied by specific, individual-level lifestyle characteristics.[8,13,14,15,16,17,18]. Two trends in lifestyle risk factors are of particular relevance to trends in vascular mortality.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
