Effect of secular trends on age-related trajectories of cardiovascular risk factors: The Whitehall II longitudinal study 1985-2009

Adam Hulmán, Adam G. Tabák, Tibor A. Nyári, Dorte Vistisen, Mika Kivimäki, Eric J. Brunner, Daniel R. Witte

Research output: Contribution to journalArticle

13 Citations (Scopus)


Background: Secular trends in cardiovascular risk factors have been described, but few studies have examined simultaneously the effects of both ageing and secular trends within the same cohort.Methods: Development of cardiovascular risk factors over the past three decades was analysed using serial measurements from 10 308 participants aged from 35 to 80 years over 25 years of follow-up from five clinical examination phases of the Whitehall II study. Changes of body mass index, waist circumference, blood pressure and total and high-density lipoprotein cholesterol distribution characteristics were analysed with quantile regression models in the 57-61 age group. Age-related trajectories of risk factors were assessed by fitting mixed-effects models with adjustment for year of birth to reveal secular trends.Results: Average body mass index and waist circumference increased faster with age in women than in men, but the unfavourable secular trend was more marked in men. Distributions showed a fattening of the right tail in each consecutive phase, meaning a stronger increase in higher percentiles. Despite the higher obesity levels in younger birth cohorts, total cholesterol decreased markedly in the 57-61 age group along the entire distribution rather than in higher extremes only.Conclusion: The past three decades brought strong and heterogeneous changes in cardiovascular risk factor distributions. Secular trends appear to modify age-related trajectories of cardiovascular risk factors, which may be a source of bias in longitudinal analyses.

Original languageEnglish
Article numberdyt279
Pages (from-to)866-877
Number of pages12
JournalInternational journal of epidemiology
Issue number3
Publication statusPublished - Jun 2014


  • Ageing
  • Blood pressure
  • Cholesterol
  • Obesity
  • Quantile regression
  • Secular trend

ASJC Scopus subject areas

  • Epidemiology

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