National trends in risk factors for cardiovascular disease in Germany

National representative health surveys for Germany were conducted for the first time in 1984/85 and again in 1987/88 and 1990/91.

Data from these three independent population samples (ages 25-69 years) are used to describe national trends in cardiovascular risk factors. In addition, national cardiovascular disease mortality rates during this time period are presented.

A net rise in median total serum cholesterol level of 0.17 mmol/liter (6.6 mg/dl) for men and 0.08 mmol/liter (3.1 mg/dl) for women was observed. Also observed was an increase in high-density lipoprotein (HDL) cholesterol of 0.04 mmol/liter (1.5 mg/dl) for men and of 0.09 mmol/liter (3.5 mg/dl) for women. This resulted in a favorable increase in the HDL/total cholesterol quotient. There were no statistically significant changes in systolic and diastolic blood pressure, with the exception of a net increase of 2 mm Hg in systolic blood pressure for women. A net rise of 0.3 kg/m2 for men and 0.4 kg/m2 for women in body mass index was observed. The prevalence of male smokers declined during the observed period while the prevalence of female smokers increased.

Most of the measured risk factors increased in both sexes during the study period. This is not reflected in cardiovascular mortality, which has shown a steady downward trend for more than 20 years.