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Twenty ‐ Five Year Secular Trends in Lipids and Modifiable Risk Factors in a Population ‐ Based Biracial Cohort: The Coronary Artery Risk Development in Young Adults ( CARDIA ) Study, 1985 – 2011

View Article: PubMed Central - PubMed

ABSTRACT

Background: Cross‐sectional analyses suggest that total and low‐density lipoprotein cholesterol (LDL‐c) trends that had been declining are now reversing. We examined longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to examine secular trends in total cholesterol, LDL‐c, high‐density lipoprotein cholesterol (HDL‐c), and triglycerides over 25 years. We also assessed whether modifiable lifestyle factors (body mass index, physical activity, alcohol consumption, smoking, and lipid‐lowering medications) are associated with these trends.

Methods and results: CARDIA recruited 5115 black and white men and women ages 18 to 30 years from 4 US communities in 1985–1986, and re‐examined them 5, 10, 15, 20, and 25 years later. Secular trends, modeled as age‐matched time trends, were estimated using repeated‐measures regression stratified on race and sex. Total cholesterol and LDL‐c initially decreased ≈5 to 8 mg/dL between visits before plateauing and moving toward adverse trends in all groups, except black women, by year 25. HDL‐c showed an upward secular trend of 1 to 3 mg/dL between visits starting at year 15 in all groups; triglyceride trends were largely flat. Obesity and use of lipid‐lowering medications, which both increased over follow‐up, had strong independent, but opposite, associations with lipid trends over time. In aggregate, associations of modifiable lifestyle factors counterbalanced one another, minimally influencing secular trends.

Conclusions: Over 25 years, initially favorable trends in total cholesterol and LDL‐c have leveled off and may be reversing, persisting after control for modifiable risk factors. Factors such as dietary changes over 25 years and poor adherence to medications are candidates for additional investigation.

No MeSH data available.


Related in: MedlinePlus

Secular trends in mean plasma lipid values by race and sex across 25 years of follow‐up after adjusting for age (age+age2): the CARDIA study, 1985–2011. BM indicates black men; BW, black women; CARDIA, Coronary Artery Risk Development in Young Adults; HDL‐c, high‐density lipoprotein cholesterol; LDL‐c, low‐density lipoprotein cholesterol; WM, white men; WW, white women.
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jah31613-fig-0002: Secular trends in mean plasma lipid values by race and sex across 25 years of follow‐up after adjusting for age (age+age2): the CARDIA study, 1985–2011. BM indicates black men; BW, black women; CARDIA, Coronary Artery Risk Development in Young Adults; HDL‐c, high‐density lipoprotein cholesterol; LDL‐c, low‐density lipoprotein cholesterol; WM, white men; WW, white women.

Mentions: Secular trends—time trends adjusted for aging—for lipids are presented by race and sex in Figure 2. Compared to the unadjusted means presented in Figure 1, secular trends in total cholesterol decreased over the 25 years of follow‐up, largely in the period from 1985 to 1995 (year 0 to year 10), with the suggestion of an upward trend between years 20 and 25 in all except black women. Similar trends were observed for LDL‐c. Controlling for age had little effect on HDL‐c trends, whereas the increasing mean triglyceride trends observed in the crude data were attenuated with control for age, particularly among blacks; whites, particularly women, exhibited increasing trends in triglycerides for both crude and age‐adjusted models.


Twenty ‐ Five Year Secular Trends in Lipids and Modifiable Risk Factors in a Population ‐ Based Biracial Cohort: The Coronary Artery Risk Development in Young Adults ( CARDIA ) Study, 1985 – 2011
Secular trends in mean plasma lipid values by race and sex across 25 years of follow‐up after adjusting for age (age+age2): the CARDIA study, 1985–2011. BM indicates black men; BW, black women; CARDIA, Coronary Artery Risk Development in Young Adults; HDL‐c, high‐density lipoprotein cholesterol; LDL‐c, low‐density lipoprotein cholesterol; WM, white men; WW, white women.
© Copyright Policy - creativeCommonsBy-nc
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5015376&req=5

jah31613-fig-0002: Secular trends in mean plasma lipid values by race and sex across 25 years of follow‐up after adjusting for age (age+age2): the CARDIA study, 1985–2011. BM indicates black men; BW, black women; CARDIA, Coronary Artery Risk Development in Young Adults; HDL‐c, high‐density lipoprotein cholesterol; LDL‐c, low‐density lipoprotein cholesterol; WM, white men; WW, white women.
Mentions: Secular trends—time trends adjusted for aging—for lipids are presented by race and sex in Figure 2. Compared to the unadjusted means presented in Figure 1, secular trends in total cholesterol decreased over the 25 years of follow‐up, largely in the period from 1985 to 1995 (year 0 to year 10), with the suggestion of an upward trend between years 20 and 25 in all except black women. Similar trends were observed for LDL‐c. Controlling for age had little effect on HDL‐c trends, whereas the increasing mean triglyceride trends observed in the crude data were attenuated with control for age, particularly among blacks; whites, particularly women, exhibited increasing trends in triglycerides for both crude and age‐adjusted models.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Cross‐sectional analyses suggest that total and low‐density lipoprotein cholesterol (LDL‐c) trends that had been declining are now reversing. We examined longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to examine secular trends in total cholesterol, LDL‐c, high‐density lipoprotein cholesterol (HDL‐c), and triglycerides over 25 years. We also assessed whether modifiable lifestyle factors (body mass index, physical activity, alcohol consumption, smoking, and lipid‐lowering medications) are associated with these trends.

Methods and results: CARDIA recruited 5115 black and white men and women ages 18 to 30 years from 4 US communities in 1985–1986, and re‐examined them 5, 10, 15, 20, and 25 years later. Secular trends, modeled as age‐matched time trends, were estimated using repeated‐measures regression stratified on race and sex. Total cholesterol and LDL‐c initially decreased ≈5 to 8 mg/dL between visits before plateauing and moving toward adverse trends in all groups, except black women, by year 25. HDL‐c showed an upward secular trend of 1 to 3 mg/dL between visits starting at year 15 in all groups; triglyceride trends were largely flat. Obesity and use of lipid‐lowering medications, which both increased over follow‐up, had strong independent, but opposite, associations with lipid trends over time. In aggregate, associations of modifiable lifestyle factors counterbalanced one another, minimally influencing secular trends.

Conclusions: Over 25 years, initially favorable trends in total cholesterol and LDL‐c have leveled off and may be reversing, persisting after control for modifiable risk factors. Factors such as dietary changes over 25 years and poor adherence to medications are candidates for additional investigation.

No MeSH data available.


Related in: MedlinePlus