Cardiovascular risk factors, BMI and mortality in a cohort of Swiss males (1976-2001) with high-sum-assured life insurance cover.

Swiss Reinsurance Company, Zurich, Switzerland.
Journal of insurance medicine (New York, N.Y.) 02/2006; 38(1):44-53.
Source: PubMed


This long-term study investigates the influence of body mass index, blood pressure, smoking habits, impaired glucose metabolism and history of any disease on the mortality of Swiss males holding life insurance cover with high sums assured.
In a prospective study (1976-2001) including 22,927 Swiss insured males holding life insurance cover with high sums assured, the prevalence of overweight and obesity was compared with data from the general population. The relationship between BMI and all-cause mortality was assessed using a Cox proportional hazard model adjusted for age and calendar year, thereby controlling for mortality improvement over time. Multivariable models were used to investigate the impact of multiple cardiovascular risk factors on all-cause and cardiovascular mortality. The evolution of hazard ratios was assessed by dividing the observation period into two periods (1976-1985 vs 1986-2001).
The prevalence of overweight was 35.7% and of obesity 6.2%. The prevalence of both increased over time. The association between BMI and all-cause mortality showed a 'U'-shaped curve with the nadir at 22.0-23.9 kg/m2. Compared with this optimal range, a relative risk of 1.76 (CI 95%: 1.17-2.67) was found for a BMI in the range of 30.0-31.9 kg/m2, representing the lowest category of obese subjects. In the multivariable model, obese subjects had a hazard ratio of 1.76 (CI 95%: 1.34-2.30) compared against those with normal BMI. The hazard ratios for all-cause mortality associated with prehypertension, stage 1 and stage 2 hypertension were 1.58, 2.28 and 3.14, respectively, all of them being statistically significant. The results for cardiovascular mortality were more pronounced, however, with wider confidence intervals. Comparing the two observational periods, the hazard ratios for obese vs non-obese subjects were 1.57 (CI 95%: 1.08 to 2.28) in period 1 and 2.41 (CI 95%: 1.71-3.39) in period 2. Similarly, the hazard ratio for combined stages 1 and 2 hypertension vs the other categories of JNC7 were 1.52 (CI 95%: 1.15-2.01) and 1.96 (CI 95%: 1.49-2.58) for periods 1 and 2, respectively.
In this cohort of Swiss insured males holding life insurance cover with high sums assured, prevalence trends of elevated BMI are similar to those in the general population. The relative mortality risks associated with cardiovascular risk factors are higher than in the general population and, in the case of elevated BMI and high blood pressure, might exhibit an increase over time.

Download full-text


Available from: Claude Schwarz, Sep 03, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Journal of Human Hypertension is exclusively concerned with all clinical aspects of human hypertension. The journal publishes fully refereed original research papers from around the world.
    Journal of Human Hypertension 02/2007; 21(1):5-7. DOI:10.1038/sj.jhh.1002106 · 2.70 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Prehypertension--blood pressure between 120-139/80-89 mmHg--is a major public health concern. The condition is very prevalent (especially in obese young people), is often associated with other cardiovascular risk factors and independently increases the risk of hypertension and subsequent cardiovascular events. In the general population, prehypertension can be lowered, but not often reliably, by lifestyle modifications. Drug therapy for prehypertension is not yet recommended, except for individuals with diabetes, chronic kidney disease, and perhaps known coronary artery disease, because of short-term cost considerations and unproven long-term benefits. Ongoing research will probably identify which individuals with blood pressures in the prehypertensive range, but with no serious comorbidities, would benefit from treatment. In this Review, we attempt to summarize the recently published data concerning the epidemiology, attendant risks and potential treatment options for this important and growing public-health problem.
    Nature Clinical Practice Cardiovascular Medicine 11/2007; 4(10):538-48. DOI:10.1038/ncpcardio0989 · 7.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the prevalence, rates of awareness, treatment, and control, and risk factors of hypertension among the residents in Harbin, Heilongjiang Province. 5523 residents, 2325 males and 3198 females, aged 15 and over, underwent questionnaire survey to understand their general conditions, history of present disease, awareness of disease, treatment, working condition, etc, and measurement of blood pressure (BP), height, body mass, and serum glucose and triglyceride. The no-standardized prevalence of hypertension was 31.30% in general (1674/5348), 38.52% in the males (829/2152), and 26.44% in the females (845/3196). The corresponding standardized prevalence rates of hypertension were 24.91%, 37.72%, and 20.75% respectively. The rates of awareness, treatment, and control of hypertension were 57.41%, 32.74%, and 5.85% respectively. Multiple logistic regression analysis revealed that employment condition, family history of hypertension, alcohol consumption, body mass index, level of triglyceride and serum glucose were risk factors of hypertension. Hypertension is highly prevalent is highly prevalent and the rates of awareness, treatment, and control of hypertension are still rather low in Harbin.
    Zhonghua yi xue za zhi 12/2008; 88(42):2966-70.
Show more