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Original article
Seasonality of cardiovascular risk factors: an analysis including over 230 000 participants in 15 countries
  1. Helena Marti-Soler1,
  2. Cédric Gubelmann1,
  3. Stefanie Aeschbacher2,
  4. Luis Alves3,4,
  5. Martin Bobak5,
  6. Vanina Bongard6,
  7. Els Clays7,
  8. Giovanni de Gaetano8,
  9. Augusto Di Castelnuovo8,
  10. Roberto Elosua9,
  11. Jean Ferrieres6,
  12. Idris Guessous1,10,
  13. Jannicke Igland11,
  14. Torben Jørgensen12,13,
  15. Yuri Nikitin14,
  16. Mark G O'Doherty15,
  17. Luigi Palmieri16,
  18. Rafel Ramos17,18,
  19. Judith Simons19,
  20. Gerhard Sulo11,
  21. Diego Vanuzzo20,
  22. Joan Vila9,
  23. Henrique Barros3,4,
  24. Anders Borglykke12,
  25. David Conen2,
  26. Dirk De Bacquer7,
  27. Chiara Donfrancesco16,
  28. Jean-Michel Gaspoz10,
  29. Simona Giampaoli16,
  30. Graham G Giles21,
  31. Licia Iacoviello8,
  32. Frank Kee15,
  33. Ruzena Kubinova22,
  34. Sofia Malyutina14,23,
  35. Jaume Marrugat9,
  36. Eva Prescott24,25,
  37. Jean Bernard Ruidavets6,
  38. Robert Scragg26,
  39. Leon A Simons18,
  40. Abdonas Tamosiunas27,
  41. Grethe S Tell11,
  42. Peter Vollenweider28,
  43. Pedro Marques-Vidal1
  1. 1Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
  2. 2Department of Medicine, University Hospital Basel, Basel, Switzerland
  3. 3Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
  4. 4Institute of Public Health of the University of Porto, Porto, Portugal
  5. 5Department of Epidemiology and Public Health, University College London, London, UK
  6. 6Department of Epidemiology, UMR 1027- INSERM, Toulouse University—CHU Toulouse, Toulouse, France
  7. 7Department of Public Health, Ghent University, Ghent, Belgium
  8. 8Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
  9. 9Cardiovascular and Genetic Epidemiology Research Group (ULEC-EGEC), Inflammatory and Cardiovascular Disease Programme (RICAD), IMIM, Barcelona, Spain
  10. 10Department of Community Medicine, Preventive care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
  11. 11Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  12. 12Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, Denmark
  13. 13Faculty of Health Science, University of Copenhagen, Denmark
  14. 14Laboratory of Internal Medicine, Institute of Internal Medicine, Siberian Branch RAMS, Novosibirsk, Russia
  15. 15UKCRC Centre of Excellence for Public Health, Queens University of Belfast, Belfast, UK
  16. 16Unit of Epidemiology of Cerebro and Cardiovascular Diseases, National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
  17. 17Research Unit and Docent Unit of Family Medicine Girona, Primary Care Research Institute Jordi Gol, Girona, Spain
  18. 18Departament of Medicine, Universitat de Girona, Girona, Spain
  19. 19Lipid Research Department, University of New South Wales, St Vincent's Hospital, Sydney, Australia
  20. 20Centro di Prevenzione Cardiovascolare, ASS 4 ‘Medio Friuli’, Udine, Italy
  21. 21Cancer Epidemiology Centre, Cancer Council Victoria, Victoria, Australia
  22. 22Centre for Health Monitoring, National Institute of Public Health, Prague, Czech Republic
  23. 23Novosibirsk State Medical University, Novosibirsk, Russia
  24. 24Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
  25. 25Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark
  26. 26School of Population Health, University of Auckland, Auckland, New Zealand
  27. 27Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
  28. 28Department of Internal Medicine, University Hospital and University of Lausanne, Lausanne, Switzerland
  1. Correspondence to Dr Pedro Marques-Vidal, Institut Universitaire de Médecine Sociale et Préventive, Bâtiment Biopôle 2. Route de la Corniche 10, 1010 Lausanne, Switzerland; Pedro-Manuel.Marques-Vidal{at}


Objective To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies.

Methods Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist circumference; systolic (SBP) and diastolic (DBP) blood pressure; total, high (HDL) and low (LDL) density lipoprotein cholesterol; triglycerides and glucose levels. Within each study, all data were adjusted for age, gender and current smoking. For blood pressure, lipids and glucose levels, further adjustments on BMI and drug treatment were performed.

Results In the Northern and Southern Hemispheres, CVRFs levels tended to be higher in winter and lower in summer months. These patterns were observed for most studies. In the Northern Hemisphere, the estimated seasonal variations were 0.26 kg/m2 for BMI, 0.6 cm for waist circumference, 2.9 mm Hg for SBP, 1.4 mm Hg for DBP, 0.02 mmol/L for triglycerides, 0.10 mmol/L for total cholesterol, 0.01 mmol/L for HDL cholesterol, 0.11 mmol/L for LDL cholesterol, and 0.07 mmol/L for glycaemia. Similar results were obtained when the analysis was restricted to studies collecting fasting blood samples. Similar seasonal variations were found for most CVRFs in the Southern Hemisphere, with the exception of waist circumference, HDL, and LDL cholesterol.

Conclusions CVRFs show a seasonal pattern characterised by higher levels in winter, and lower levels in summer. This pattern could contribute to the seasonality of CV mortality.

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