The causal role of blood lipids in the aetiology of coronary heart disease – an epidemiologist's perspective

Abstract

Background. Cardiovascular (CVD) mortality decreased abruptly in Norway during WW II but increased faster than in other European countries from the 1950's. Mean life expectancy for middle-aged men declined during 1960's. Objectives. To give a short overview of CVD epidemiology, especially changes in coronary heart disease (CHD) mortality, total serum cholesterol and diet during the latter half of the 20th century. Methods. Review of mortality statistics, reports from the previous National Health Screening Service and papers concerning risk factor and dietary changes. Data on CHD morbidity are not available. Discussion and conclusions. CHD mortality reached its peak during 1966–1970. It declined during the next 30 years bringing Norwegian mortality rates to levels comparable to some Mediterranean countries. The main causes for the decline during the first twenty years of this time period are reduced total cholesterol levels from the 1970's to the 1990's, as well as a declined prevalence of smoking in the male population. Improved medical and interventional treatment are likely to explain the changes occurring during the last decade of the 20th century.

• Cardiovascular mortality
• cholesterol
• diet