%0 Journal Article
%T Lifestyle variables and the risk of myocardial infarction in the General Practice Research Database
%A Joseph AC Delaney
%A Stella S Daskalopoulou
%A James M Brophy
%A Russell J Steele
%A Lucie Opatrny
%A Samy Suissa
%J BMC Cardiovascular Disorders
%D 2007
%I BioMed Central
%R 10.1186/1471-2261-7-38
%X This study was conducted in the general practice research database (GPRD) which is a database based on general practitioner records and is a representative sample of the United Kingdom population. We matched cases of first AMI as identified by diagnostic codes with up to 10 controls between January 1st, 2001 and December 31st, 2005 using incidence density sampling. We used multiple imputation to account for missing data.We identified 19,353 cases of first AMI which were matched on index date, GPRD practice and age to 192,821 controls. There was a modest amount of missing data in the database, and the patients with missing data had different risks than those with recorded values. We adjusted our analysis for each lifestyle variable jointly and also for age, sex, and number of hospitalizations in the past year. Although a record of underweight (BMI <18.0 kg/m2) did not alter the risk for AMI (adjusted odds ratio (OR): 1.00; 95% confidence interval (CI): 0.87每1.11) when compared with normal BMI (18.0每24.9 kg/m2), obesity (BMI ≡30 kg/m2) predicted an increased risk (adjusted OR: 1.41; 95% CI: 1.35每1.47). A history of smoking also predicted an increased risk of AMI (adjusted OR: 1.81; 95% CI: 1.75每1.87) as did heavy alcohol use (adjusted OR: 1.15; 95% CI: 1.06每1.26).This study illustrates that obesity, smoking and heavy alcohol use, as recorded during routine care by a general practitioner, are important predictors of an increased risk of a first AMI. In contrast, low BMI does not increase the risk of a first AMI.Obesity is a growing public health problem that is associated with an increased rate of cardiovascular events. About one in three patients admitted to hospital with acute coronary syndrome in Europe were obese with additionally half of the patient population being overweight [1].Clinical databases based on general practice records are a potentially useful source of information (when it is available) for studying the magnitude of risk factors such as obesity, smo
%U http://www.biomedcentral.com/1471-2261/7/38