Cardiovascular mortality ? Comparing risk factor associations within couples and in the total population ? The HUNT Study
Journal article, Peer reviewed
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Original versionInternational Journal of Cardiology. 2017, 232 127-133. 10.1016/j.ijcard.2017.01.041
Background To compare associations of conventional risk factors with cardiovascular death within couples and in the population as a whole. Methods We analysed baseline data (1995–97) from the HUNT2 Study in Norway linked to the national Causes of Death Registry. We compared risk within couples using stratified Cox regression. Results During 914776 person-years, 3964 cardiovascular deaths occurred, and 1658 of the deaths occurred among 1494 couples. There were consistently stronger associations of serum lipids and blood pressure with cardiovascular mortality within couples compared to the population as a whole. For instance, for systolic blood pressure (per 20 mm Hg), the hazard ratio (HR) within couples was 1.28 (95% confidence interval: 1.17, 1.40) compared to 1.16 (1.12, 1.20) in the total population, and for diastolic pressure (per 10 mm Hg), the corresponding HRs were 1.16 (1.07, 1.26) and 1.11 (1.08, 1.13). Anthropometric factors (BMI, waist circumference, waist-hip ratio) as well as diabetes, smoking, physical activity, and education, showed nearly identical positive associations within couples and in the total population. Conclusions Prospective population studies may tend to slightly underestimate associations of these factors with cardiovascular mortality.