International Journal of Epidemiology 2003;32:461-468
© International Epidemiological Association 2003
Cardiovascular Disease |
Twelve-year changes in vascular risk factors and their associations with mortality in a cohort of 3499 Thais: the Electricity Generating Authority of Thailand Study
1 Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rajdevi, Bangkok 10400, Thailand.
2 Institute for International Health, University of Sydney, PO Box 576, Newtown, NSW 2042, Australia.
3 Medical and Health Office, Electricity Generating Authority of Thailand, 53 Jaransanitwong, Bangkruay, Nonthaburi 11130, Thailand.
4 Faculty of Medicine, Prince of Songkhla University, Hat Yai, Sonkhla 90110, Thailand.
Correspondence:
Piyamitr Sritara, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rajdevi, Bangkok 10400, Thailand. E-mail:
rapst{at}mahidol.ac.th
Background Vascular mortality is increasing in economically developing countries such as Thailand but reliable data about the determinants of these changes are few.
Methods In 1985, male and female employees of the Electricity Generating Authority of Thailand took part in a cardiovascular risk factor survey. In 1997, a follow-up survey was conducted and causes of death were determined for those subjects known to have died. Changes in levels of vascular risk factors over 12 years, and the associations of baseline risk factors with vascular mortality, were calculated.
Results The 1985 survey recruited 3499 volunteers (average age 43 years) of whom 23% were female. In 1997, vital status was determined for 3318 (95%) and 2967 (85%) of the study participants were resurveyed. Mean levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index, total cholesterol and high density lipoprotein (HDL) cholesterol all increased over the 12-year follow-up period. Over the same time, the prevalence of diabetes also rose but the proportion of current smokers decreased. Vascular diseases were the most frequent cause of death during follow-up (n = 46), were positively associated with baseline age, SBP, DBP, smoking, diabetes, male sex, and total cholesterol, and were negatively associated with HDL cholesterol.
Conclusions Levels of most vascular risk factors worsened over the 12-year period between 1985 and 1997. The associations between baseline risk factor levels and vascular mortality were consistent with those observed in other populations. Interventions that control vascular risk factors have the potential to avert much premature vascular disease in Thailand.
Keywords Cohort study, mortality, risk factors, Thailand, vascular diseases
Accepted 23 December 2002
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