DOI: 10.1161/CIRCULATIONAHA.113.008506 1 Temporal Trends in the Population Attributable Risk for Cardiovascular Disease: The Atherosclerosis Risk in Communities Study Running title: Cheng et al.; Temporal trends in attributable cardiovascular risk

DOI: 10.1161/CIRCULATIONAHA.113.008506 2 Background—The extent to which relative contributions of traditional cardiovascular factors risk to incident cardiovascular disease (CVD) may have changed over time remains unclear. Methods and Results—We studied 13,541 participants (56 % women, 26 % black) in the Atherosclerosis Risk in Communities Study, aged 52-66 years and free of CVD at exams in 1987-89, 1990-92, 1993-95, or 1996-98. At each exam, we estimated the population attributable risks (PAR) of traditional risk factors (hypertension, diabetes, obesity, hypercholesterolemia, and smoking) for the 10-year incidence of CVD. Overall, the PAR of all risk factors combined appeared to decrease from 1987-89 to 1996-98 (0.58 to 0.53). The combined PAR was higher in women than men in 1987-89 (0.68 vs. 0.51, P<0.001) but not by 1996-98 (0.58 vs. 0.48, P=0.08)