Changes in Risk Factors Associated with Reduced MI and Stroke Incidence in Scotland

Pavankumar Kamat

Disclosures

June 23, 2021

Takeaway

Why this matters

  • Findings have implications for public health policy and healthcare provision.

Study details

  • The individual patient-level linkage study included Scottish patients (age, ≥30 years) with MI or IS between 1 January 1990 and 21 December 2014, followed-up until 31 December 2017.

  • Funding: British Heart Foundation.

Key results

  • Among 605,996 patients, 372,873 and 290,927 cases of index MI and IS, respectively, were recorded.

  • MI and IS incidence per 100,000 declined from 1069 (95% CI, 1024-1116) and 608 (95% CI, 581-636) to 276 (95% CI, 263-290) and 188 (95% CI, 188 (95% CI, 178-197), respectively.

  • Over 25 years, systolic blood pressure (SBP), smoking prevalence and cholesterol levels decreased but body mass index (BMI) and diabetes prevalence increased:

  • SBP: 140 (95% CI, 139-140) to 129 (95% CI, 129-130) mmHg;

  • smoking: 58% (95% CI, 54-63%) to 25% (95% CI, 24-26%);

  • cholesterol: 6.4 (95% CI, 6.2-6.6) to 5.1 (95% CI, 5.0-5.3) mmol/L;

  • BMI: 27.2 (95% CI, 27.0-27.4) to 28.1 (95% CI, 28.0-28.2) kg/m2; and

  • diabetes: 4% (95% CI, 3-5%) to 9% (95% CI, 8-9%).

  • Changes in risk factors was associated with a 74% and 68% reduction in MI and IS, respectively.

  • Risk of death with no interceding event following MI and stroke decreased from 30% to 20% and from 47% to 34%, respectively.

Limitations

  • Possible over-estimation of reduction in incidence of individual risk factors.

  • Predominantly White population.

  • Lag times between changes in risk factors and incident disease were not considered.
     

 

Shah ASV, Lee KK, Pérez JAR, Campbell D, Astengo F, Logue J, Gallacher PJ, Katikireddi SV, Bing R, Alam SR, Anand A, Sudlow C, Fischbacher CM, Lewsey J, Perel P, Newby DE, Mills NL, McAllister DA. Clinical burden, risk factor impact and outcomes following myocardial infarction and stroke: A 25-year individual patient level linkage study. Lancet Reg Health Eur. 2021 Jun 16 [Epub ahead of print]. doi: 10.1016/j.lanepe.2021.100141.  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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