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Generational changes in cardiometabolic disease incidence by risk factor strata in the UK Biobank

Denghui Hu1, Diana van Heemst2, J Wouter Jukema3

  • 1Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands.

Preventive Medicine
|April 14, 2026
PubMed

Insights

Incidence of coronary artery disease (CAD), peripheral artery disease (PAD), and type 2 diabetes (T2D) has declined in recent generations. Ischemic stroke rates remain stable, showing disease-specific prevention gains.

Area of Science:

  • Cardiovascular epidemiology
  • Public health research
  • Chronic disease trends

Background:

  • Generational trends in cardiovascular disease and type 2 diabetes incidence are not fully understood.
  • Risk factor strata may influence disease incidence across birth cohorts.

Purpose of the Study:

  • To assess generational changes in the incidence of coronary artery disease (CAD), acute myocardial infarction (AMI), ischemic stroke, peripheral artery disease (PAD), and type 2 diabetes (T2D).
  • To examine these changes across different risk factor strata.

Main Methods:

  • Utilized UK Biobank data from disease-free participants (2006-2010).
  • Calculated age-specific incidence rates for seven birth cohorts (1936-1940 to 1966-1970).
  • Applied Age-Period-Cohort models to analyze birth-cohort effects stratified by sex, genetics, socioeconomic status, smoking, and BMI.

Main Results:

  • Incidence of CAD, AMI, PAD, and T2D decreased in more recent generations for both sexes.
  • Ischemic stroke incidence remained stable across generations.
  • Declines in CAD and PAD were most pronounced in normal-weight, higher socioeconomic status, ever-smoked individuals; T2D declines were strongest in overweight/obese individuals.

Conclusions:

  • Coronary artery disease, acute myocardial infarction, peripheral artery disease, and type 2 diabetes incidences have declined in recent generations.
  • Stable ischemic stroke incidence and varied subgroup trends highlight disease-specific prevention effectiveness.
Abstract

Keywords:
Age-period-cohort effectBirth cohortCardiometabolic diseaseIncidenceRisk factors

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