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(Circulation. 2008;117:589-591.)
© 2008 American Heart Association, Inc.

Clinical Summaries

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	How Much of the Recent Decline in the Incidence of Myocardial Infarction in British Men Can Be Explained by Changes in Cardiovascular Risk Factors? Evidence From a Prospective Population-Based Study

 
The incidence of myocardial infarction (MI) in Britain has been falling since the 1970s. We have estimated that after adjustment for age, the incidence of first MI declined by 62% from 1979 to 2004 in a representative cohort of middle-aged British men. Few studies have investigated the contribution of changes in major cardiovascular risk factors to the decline in MI. Combining data on risk factor changes with data on MI incidence, we found that approximately half of the decline in MI incidence in this cohort of men could be explained by favorable population-wide time trends in cigarette smoking, systolic blood pressure, high-density lipoprotein (HDL) cholesterol, and non-HDL cholesterol together. A large fall in cigarette smoking prevalence explained the greatest single part of the decline (23%), followed by a fall in mean systolic blood pressure (13%), a rise in HDL cholesterol (12%), and a fall in non-HDL cholesterol (10%); however, these contributions may be underestimated owing to imprecision. A marked increase in mean body mass index is likely to have limited the extent of the decline. The results indicate that population-wide changes in risk factors have considerable potential for reducing MI incidence in the United Kingdom and in other locations. In the United Kingdom, although the future impact of smoking changes may be limited by the already low smoking prevalence, the potential benefits of further reductions in population systolic blood pressure and blood lipid levels, by a combination of dietary and drug management, are still considerable. See p 598.

	Pericardial Fat, Visceral Abdominal Fat, Cardiovascular Disease Risk Factors, and Vascular Calcification in a Community-Based Sample: The Framingham Heart Study

 
Pericardial . . . [Full Text of this Article]