Secular trends in social patterning of cardiovascular risk factor levels in Sweden. The Northern Sweden MONICA Study 1986-1994. Multinational Monitoring of Trends and Determinants in Cardiovascular Disease

J Intern Med. 1998 Jul;244(1):1-9. doi: 10.1046/j.1365-2796.1998.00289.x.


Objectives: In the Northern Sweden MONICA Study, levels of cardiovascular risk factors were determined in 1986, 1990 and 1994. The aim of this study was to assess the trends in cardiovascular risk factors, and to analyse the relationship between levels of risk factors and level of education.

Design: Cardiovascular risk factors were determined in cross-sectional population studies of randomly selected 25-64 year old men and women in 1986, 1990 and 1994 (a total of 4742 individuals).

Results: Throughout the years 1986 to 1994, cardiovascular risk factor levels showed a marked social pattern, generally being more favourable among people with a university education. Serum cholesterol levels declined in all educational groups, but blood pressure declined significantly only in women with a university education. Body mass index increased, most markedly in men with university and in women with a secondary school education. Prevalence of cigarette smoking decreased significantly in young men. It increased markedly in low-educated women so that the social gaps in smoking widened substantially over time. The improved level of education in the population at large was calculated to explain only a little of the risk factor changes between 1986 and 1994.

Conclusions: Trends in risk factor levels in different educational groups have been more diverging for women than for men. The most marked change in risk factor levels has been the decline in total serum cholesterol for both men and women in all educational groups.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology*
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Educational Status*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Population Surveillance
  • Risk Factors
  • Sex Factors
  • Smoking / adverse effects
  • Sweden


  • Cholesterol