Lifestyle and heart disease

The decline in cardiovascular disease (CVD) mortality since its peak in 1968 has been attributed to a number of factors, medical services and emergency care in particular. But around 50% of the improvement has come from prevention, including changes in behaviours.

Declines in smoking, decreases in dietary fat and salt intake and reductions in blood pressure have contributed, although it’s often difficult to tease out their effects from those of new medications.

Of the immediate risk factors, obesity is the one going the wrong way. Although we don’t have early data, surveys from around 1980 suggest that less than 10% of the population in 1968 would have been overweight or obese, compared with about 60% today.

If obesity has a direct link with CVD (and there is some doubt about this – it’s possible that the lifestyle leading to obesity, and not the obesity per se, is the direct cause) we would have expected a turn­around in