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Calculated Variables
Kidney Function | Physical Characteristics | Physical Function | Medical History | Behaviors | Exercise | Cognitive Function | ECG variables | Echocardiography | Baseline Status Variables | Adjusting for laboratory drift | Longitudinal data | Guidelines for categorizing selected continuous variables | Kilo-Calories of Physical Activity Re-calculated
Kidney Function
| Estimated glomerular filtration rate (eGFR) is calculated at Years 2, 5 and 9 based on creatinine and cystatin-C as shown below:
Creatinine: |
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| eGFRcreat(mL/min/1.73m2)=186.3*serum creatinineˆ-1.154*ageˆ-0.203*1.212 [if black]*0.742 [if female]
Reference: Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med. 1999;130(6):461-470. |
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| Cystatin-C: | |
| eGFRcys(mL/min/1.73m2)=76.7*cystatinCˆ-1.19
Reference: Stevens LA, Coresh J, Schmid CH, et al. Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis. 2008;51(3):395-406. |
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Physical Characteristics
| AVZMSYS | |
| Average zero muddler systolic blood pressure: average of first and second corrected reading (corrected for zero value). BL & YEAR 3 ONLY. | |
| AVZMDIA | |
| Average zero muddler diastolic blood pressure: average of first and second corrected reading (corrected for zero value). BL & YEAR 3 ONLY. | |
| AVESYS | |
| Average standard systolic blood pressure: average of first and second readings. YEARS 4 through 7, 9-11. | |
| AVEDIA | |
| Average standard diastolic blood pressure: average of first and second readings. YEARS 4 through 7, 9-11. | |
| ORTHOSTATIC HYPOTENSION | |
| Change in systolic blood pressure between supine and standing position ORTH = 0 Normal ORTH = 1 Abnormal: If drop in Systolic BP > 20 mmHg OR drop in Diastolic BP > 10 mmHg OR standing procedures not performed due to ppt dizziness |
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| ISOLATED SYSTOLIC HYPERTENSION (IHYPER) | |
| IHYPER = 4 Diastolic Hypertension: If Diastolic BP > 90 IHYPER = 3 Isolated Systolic Hypertension: If Systolic BP > 160 AND Diastolic BP < 90 IHYPER = 2 Borderline Isolated Systolic Hypertension: If Systolic BP 140 - 159 AND Diastolic BP > 90 IHYPER = 1 Normotensive |
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| BMI | |
| Body Mass Index = weight (kg)/height (m) squared. | |
| OVRWT120 | |
| Weight > 120% of ideal weight (BMI > 27 in males or 25 in females). | |
| OVRWT130 | |
| Weight > 130% of ideal weight (BMI > 29.613 in males or 27.311 in females). | |
| BSA | |
| Body Surface Area (BSA) has been computed using the following formula: BSA = 0.0071*EXP(0.725*LN(STHT13))*EXP(0.425*LN(WEIGHT13*0.4536)). | |
| BRACH | |
| Average of first and second brachial BP from Supine Ankle-Arm BP. | |
| RTIB | |
| Average of first and second right tibial BP from Supine A-A BP. | |
| LTIB | |
| Average of first and second left tibial BP from Supine A-A BP. | |
| RTAAI | |
| RTIB/BRACH. | |
| LTAAI | |
| LTIB/BRACH. | |
| AAI | |
| Minimum of RTAAI and LTAAI. | |
Physical Function
| ADL | |
| Activities of Daily Living: Number of tasks the participant has difficulty with from the following list: walking around the home, getting out of bed, eating, dressing, bathing, using the toilet. | |
| IADL | |
| Instrumental ADL's: Number of tasks the participant has difficulty with from the following list: heavy housework, light housework, shopping, preparing meals, paying bills, using the phone. | |
| UES | |
| Upper Extremity Score: Number of tasks the participant has difficulty with from the following list: lifting, reaching, gripping. | |
| DOMGRIP | |
| Average of three grip strength attempts in dominant hand. | |
Medical History
| COPD | |||||||||||||||||||||||||
| Chronic obstructive pulmonary disease is defined as self-reported physician diagnosis of chronic bronchitis, asthma or emphysema. | |||||||||||||||||||||||||
| VISPROB | |||||||||||||||||||||||||
| Vision problem: Coded yes if unable to see to drive, to watch TV or to recognize someone across a room with or without glasses. | |||||||||||||||||||||||||
| HEARPROB | |||||||||||||||||||||||||
| Hearing problem: Coded yes if unable to hear well enough to use the phone, listen to the radio or carry on a conversation in a crowded room, with or without a hearing aid. | |||||||||||||||||||||||||
| ROSEIC | |||||||||||||||||||||||||
| Intermittent claudication from Rose Questionnaire. | |||||||||||||||||||||||||
| ROSEANG | |||||||||||||||||||||||||
| Angina from Rose Questionnaire. | |||||||||||||||||||||||||
| CHFSYMPT | |||||||||||||||||||||||||
| Number (0-3) of the following CHF symptoms: sleep on >= 2 pillows to breathe, awakened at night by trouble breathing, swelling of feet and ankles during the day which goes down overnight. | |||||||||||||||||||||||||
| FAMILY HISTORY | |||||||||||||||||||||||||
| FHHA = 0 If No Heart Attack in siblings FHHA = 1 If Heart Attack in siblings FHHA = 9 If No siblings |
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| ASPIRIN USE | |||||||||||||||||||||||||
| ASPIRIN = 1 If reported using aspirin 3 or more days in past 2 weeks ASPIRIN = 0 Otherwise |
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| ESTROGEN USE | |||||||||||||||||||||||||
Two variables describing estrogen use at baseline have been added to the file BASEBOTH.SAV. At baseline for the original cohort, use was assessed by medicine bottle or by self-report of EVER use. Those who brought in meds were coded current users. Self-reported EVER use in the absence of meds was coded former use. If a participant answered "don't know" to the question of ever use and did not bring in a prescription for estrogen, information obtained in later years on former or current use and its duration was used to fill in the missing whenever possible. Otherwise, these "don't know" responders were coded as never users. The two variables are:
Both are coded:
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| HYPERTENSION | |||||||||||||||||||||||||
| HYPER = 3 Hypertensive Seated blood pressure average systolic >= 160 mmHG, OR seated blood pressure average diastolic >= 95 mmHG, OR hx of hypertension = Yes AND participant takes antihypertensive medication HYPER = 2 Borderline Hypertension Seated blood pressure average systolic = 140 - 159 mmHG, OR Seated blood pressure average diastolic = 90 - 94 mmHG HYPER = 1 Normotensive Note that the current protocol for defining hypertension includes both the CHS categories of "Borderline" and "Hypertensive" Antihypertensive medications: Beta-blockers, Calcium-channel blockers, Diuretics, Vasodilators, Beta-blockers with Diuretics, Angiotensin converting enzyme inhibitors, Angiotensin converting enzyme with diuretics, Vasodilators with Diuretics, Angiotensin Type 2 Antagonists, Angiotensin Type 2 Antagonists with Diuretics |
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| DIABETES | |||||||||||||||||||||||||
1. Baseline, both cohorts
2. Year 5, Year 9 both cohorts
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| NEUROLOGICAL HISTORY | |||||||||||||||||||||||||
There are six stroke/TIA variables which have been computed from the baseline Neurologic History Questionnaire. Values for the original cohort can be found in BASE2.zip and values for the African American cohort in YR5NEW.zip, along with other Record 22 variables for each cohort. The computed variables are based on six different symptoms, any of which can indicate a possible stroke or TIA. These symptoms and their variable names are:
For each symptom there are numerous questions about its location, duration, and other associated problems. Based on the responses to these questions, a value is computed for each symptom indicating the possible origin of a stroke or TIA. A zero value for a given symptom indicates either that 1) the symptom did not occur, or 2) if the symptom did occur, the subsequent responses did not suggest a stroke or TIA. Other possible values are:
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Behaviors
| BEER | |
| Number of 12oz cans of beer consumed per week. | |
| WINE | |
| Number of 6oz glasses of wine consumed per week. | |
| LIQUO | |
| Number of shots of liquor consumed per week. | |
| ALCOH | |
| Number of alcoholic beverages (beer, wine, or liquor) consumed per week. | |
| SMOKE AMOUNT (Passive, Light, Moderate, Heavy) | |
| SMKAMT = 1 Passive Smoker---If ANYONE08 = 1 AND Never Smoker (SMOKE) SMKAMT = 2 Light Smoker-----1-25 percentile of PKYRS = 1 - 13 SMKAMT = 3 Moderate Smoker--25-75 percentile of PKYRS = 14 - 50 SMKAMT = 4 Heavy Smoker-----75-100 percentile of PKYRS > 51 |
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Exercise
| KCAL | |
| Kilocalories expended in all physical activities listed in question 1 of record 4. (Note: the Year 5 variable is not directly comparable to the baseline KCAL, which included questions on tennis and racquetball that were not included at year 5.) | |
| KCAL2 | |
| Kilocalories expended in physical activities as above, but excluding household chores. | |
| EXINTENS | |
| Categorical exercise intensity variable, calculated from physical activities in question 1 of record 4. | |
| BLOCKS | |
| Blocks walked per week. This variable was truncated in year 2 and year 3 to permit a maximum value of 300. Other years were not affected. | |
Cognitive Function
| COGNITIVE FUNCTION - Based on 30 Point Mini-Mental Score (Baseline) | |
| COG = 4 Severe Impairment------0 - 17 COG = 3 Moderate Impairment---18 - 23 COG = 2 Mild impairment---------24 - 26 COG = 1 Normal------------------27+ |
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| SEASON = (Summer=1, Fall=2, Winter=3, Spring=4) BASELINE ONLY | |
| Summer---June 21, 1989-September 20, 1989 Fall------September 21, 1989-December 20, 1989 Winter---December 21, 1989 - March 20, 1990 Spring---(June 1, 1989-June 20, 1989)+(March 21, 1990-May 31, 1990) |
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| 3MSE (SCORE134) Years 3-11 | |
| All components of the 100 point scale 3MSE score are labeled as such in the CHS data files. Individual variables used to calculate a composite component (e.g. 4-legged animals) are not included in the data files, the composite component (e.g. animal) is provided | |
ECG variables
| Ventricular Conduction Defect | |
| VCD = 1 If Minnesota Code = 7-1, 7-2 or 7-4 VCD = 0 Otherwise |
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| Major Q-Wave Abnormalities | |
| QQS = 1 If Minnesota Code = 1-1 through 1-2 (except 1-2-8) QQS = 0 Otherwise |
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| Minor Q, QS Waves with ST-T abnormalities | |
| QST = 1 If Minnesota Code = (1-3 or 1-2-8) and (4-1 to 4-3 or 5-1 to 5-3) QST = 0 Otherwise |
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| Isolated ST-T Wave Abnormalities | |
| STT = 1 If Minnesota Code = 4-1, 4-2, 5-1, 5-2 without LVH or QQS STT = 0 Otherwise |
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| Left Ventricular Hypertrophy | |
| ECGLVH = 1 If Minnesota Code = (3-1, 3-3) and (4-1 to 4-3 or 5-1 to 5-3) ECGLVH = 0 Otherwise |
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| Atrial Fibrillation | |
| ECGAFIB = 1 If Minnesota Code = 8-3 ECGAFIB = 0 Otherwise |
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| First Degree Atrio-Ventricular (AV) Block | |
| AVB = 1 If Minnesota Code = 6-3 AVB = 0 Otherwise |
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| Major ECG Abnormalities | |
| MAJABN = 1 If any of the following abnormalities are present: (VCD, QQS, LVH, STT, AFIB, AVB). | |
| Minor ECG Abnormalites | |
| MINABN = 1 If any of the following abnormalities are present: Minor Q, QS waves; High R waves; Minor Isolated ST-T abnormalities; ST Elevation; Incomplete RBBB, RR1; Long QT Interval; Short PR; Right Axis Deviation; Left Axis Deviation. | |
Echocardiography
| A. CODING AND DEFINITONS FOR SELECTED CATEGORICAL VARIABLES FROM THE YEAR 7 ECHO | |||||||||||||
| MR43, AR43, TR43, MAC43, AOAC43, RWMA43, AOTHCK43 0 = CANT ASSESS 1 = NONE 2 = MILD 3 = MODERATE 4 = SEVERE For Mitral and Tricuspid Regurg (MR43 and TR43), MILD signifies maximal displacement of atrial area by the color flow jet in any view is less than 1/3. MODERATE signifies maximal displacement is 1/3 to 1/2, SEVERE means maximal displacement is > 1/2. For Aortic Regurg (AR43), MILD means the width of color flow jet in LV outflow tract is less than 1/2 of the LVOT width. MODERATE means the width of the jet is 1/2 to 3/4 LVOT width, SEVERE means the width of the jet > 3/4 LVOT width. For Qualitative Mitral Annular Calcification (MAC43), MILD signifies focal, limited increased echodensity of mitral annulus, MODERATE signifies marked echodensity involving more than 1/3 of ring, SEVERE signifies marked echodensity involving 1/2 or more of ring, with at least some compression of LV inflow tract. For Qualitative Aortic Ring Thickening/Calcification (AOAC43), MILD signifies focal, limited increased echodensity of aortic annulus, MODERATE signifies extensive echodensity involving more than 1/2 of ring circumference, but with preserved leaflet mobility, SEVERE indicates extensive echodensity involving entire circumference of aortic ring, with limitation of leaflet excursion. For Regional Wall Motion Abnormalities (RWMA43), NORMAL means no dyssynchronous LV wall segments, at least 75% of 16 segments available, MILD means hypokinesis of 1/3 or less of evaluable segments, MODERATE means hypokinesis of 1/2 to 2/3 of evaluable segments, or akinesis/dyskinesis of 1/3 of evaluable segments, SEVERE signifies akinesis/dyskinesis of 1/3 evaluable segments and hypokinesis of additional 1/3 or more. For Qualitative Aortic Leaflet Thickening (AOTHCK43), MILD means focal, limited increased echodensity of aortic leaflets, MODERATE indicates diffuse of extensive increased echodensity, some thin leaflet echos appreciable, SEVERE signifies diffuse "white out" of aortic valve tissue. For Qualitative Aortic Leaflet Excursion (AOEXC43), NORMAL signifies maximal cusp separation 1.5 cm or greater, MILD means cusp separation 1.0 to 1.4 cm, MODERATE indicates cusp separation 0.5 to 0.9 cm, SEVERE signifies cusp separation < 0.5 cm. For Qualitative LV Function (LVFNCT43), NORMAL signifies that the ejection fraction is estimated equal or more than 55%, MILD signifies ejection fraction equal to 45-54%, MODERATE signifies ejection fraction of 30-45%, and SEVERE indicates an ejection fraction < 30%. |
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| B. TO COMPARE YEAR 7 LV FUNCTION (LVFNCT43) AND THE YEAR 2 LV EJECTION FRACTION (LVEF43) USE THE FOLLOWING EQUIVALENTS: | |||||||||||||
| LVEF43 = LVFNCT43 Normal = Normal Borderline = Mild Decrease Abnormal = Moderate or Severe Decrease |
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| C. FORMULAE FOR COMPUTED BASELINE AND YEAR 7 ECHO VARIABLES | |||||||||||||
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| D. FORMULAE FOR ADJUSTING YEAR 7 VARIABLES TO BASELINE | |||||||||||||
| The Echo lab had done some duplicate reading of records, which were originally considered Quality Control readings but were meant to replace the original readings. The replacement has been done. In addition, for some of the Echo variables, there is an original value and an adjusted value. The adjustment value aligns the Yr 7 readings with the baseline ones for analyses examining change over time or for analyses combining the baseline and Yr 7 echo readings. The adjustment variables are indicated by an "AD" ending and the originals by the record "43" ending in the YR7 file. The adjustment variables are defined as follows:
DPMAPAD = (DPMAP43 + 3.24)/100 |
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Baseline Status Variables
| For each of the six major disease classifications in CHS there are two baseline status variables. The original status variable ends in BASE, and the updated status variable ends in BLMOD.
The *BASE variables use only information available at baseline, including self-report, exam, ECG's, and review of medical history. The coding of the *BASE variables is as follows: 0=no history The *BLMOD variables classify a participant according to whether or not they are at risk for an incident event. Anyone with a *BASE value of 1=definite past history has a *BLMOD value of 1=prevalent. Initially, possible past history and past unreported history are coded in *BLMOD as 0=at risk for an incident event. During the review of hospitalization records for our events adjudication process, it may become evident that a participant was prevalent for one of the six major diseases at baseline. If so, the baseline status is modified to incorporate this new information. Thus, the *BLMOD variables have changed over the years. For example, a participant with no history of MI at baseline will have MIBASE=0. If, during the review of records for a hospitalization after baseline, records were found indicating that an MI had occurred before the person was enrolled in CHS, the MIBLOD variable would be set to 1, while the MIBASE variable would remain 0. Both variables give prevalent disease status at baseline, but the *BLMOD variable reflects the latest and most accurate information we have about baseline status. The current values reflect the results of our adjudication of events through June 30, 2000. Composite CHD variable Subclinical Disease
The variables differ since echo was not done on the new cohort at baseline. 80th percentiles are based on the data available in each file. Frailty
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Adjusting for laboratory drift
| Blood constituent values were collected at years 2, 5 and 9. For many of the variables, longitudinal plots showed that the average change between visits was larger than expected. This change is presumed to be the result of "laboratory drift", that is continuous small changes in laboratory operating conditions and procedures that are noticeable in magnitude when comparing measurements 3-4 years apart. The variables which have been adjusted incorporate the letters "ADJ" in their names.
Adjusted variables are defined as follows:
C-reactive protein (CRP) was initially measured only on baseline bloods. Later, it was measured on year 5 bloods using a different assay. The values obtained from the two assays were not directly comparable without adjustment. The original baseline measurements were adjusted using the following formula:
Note: for the New Cohort, while all three CRP values (adjusted, original and year 5) contain valid data, they all originate from the same blood sample. It is only appropriate to consider change in CRP from baseline (year 2) to year 5 for the Original Cohort. |
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Longitudinal Data
The following variables have been added to each yearly file:
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Guidelines for categorizing selected continuous variables
| TOTAL CHOLESTEROL - NCEP Guidelines | |
| CHOL = 3 High------------------Cholesterol > 240 mg/dl CHOL = 2 Borderline High-------Cholesterol 200-239 mg/dl CHOL = 1 Desirable-------------Cholesterol < 200 mg/dl |
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| LDL - NCEP Guidelines | |
| LDL = 3 High------------------LDL > 160 mg/dl LDL = 2 Borderline High-------LDL 130-159 mg/dl LDL = 1 Desirable-------------LDL < 130 mg/dl |
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| HDL | |
| HDL = 2 Low----------HDL < 35 mg/dl HDL = 1 Desirable-----HDL > 35 mg/dl |
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| Ankle-Arm Index | |
| AAI < = 0.9 = low AAI > 0.9 = normal |
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| Depression score | |
| DEPSCR05 < 10 = normal DEPSCR05 > = 10 = at risk for clinical depression Reference: Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994 Mar-Apr;10(2):77-84. |
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| Renal Insufficiency | |
| Serum creatinine >=1.3 in women or >= 1.5 in men | |
Kilo-Calories of Physical Activity Re-calculated
CHS physical activity data – kilocalories variables (collected in Years 2, 5 and 9)
Physical activities asked on the questionnaires: walking, chores, mowing, raking, gardening, hiking, jogging, biking, cycle, dance, aerobics, bowling, golf, tennis, racquet ball, calisthenics/general exercise, swimming, other physical activities (open fields). Note: Questions on tennis and racquet ball were asked only in Year 2 and were not included in Years 5 and 9.
Kilocalories variables: kilocalories expended (kcal/wk)
A. Original calculation in CHS
- Calculated by (METS intensity score from Ainsworth et al. 1993) x (duration per session) x (number of sessions in the last 2 weeks)/2.
- Information from the "open" fields in the questionnaire (coded as "other activity") was not used.
- Delete unlikely high values (>15,000 kcal/wk) for KCAL and KCAL2.
- Calculated variables: KCAL, KCAL2, EXINTENS
- KCAL: total kcal from all listed activities
- KCAL2: total kcal from all listed activities, but excluding household chores
- EXINTENS: intensity variable
- 0: no activity
- 1: light activity (walking, chores, mowing, raking, gardening) only
- 2: some moderate activity (biking, cycle, dance, bowling, golf, general exercise), but no high activity
- 3: some high activity (hiking, jogging, aerobics, tennis, racquet ball, swimming)
B. New calculation by Karlijn van Stralen
- Calculated by (METS intensity score from Ainsworth et al. 2000) x (duration per session) x (number of sessions in the last 2 weeks)/2 x (number of months per year)/12.
- Information from the "open" fields in the questionnaire (coded as "other activity") was used.
- For each activity, partially missing items were imputed based on age, gender, race, BMI and the corresponding activity variables.
- For each activity, delete unlikely values (e.g., extremely high duration).
- Calculated variables: KCALTOT, KCALSPORT, SPORTINTENS
- KCALTOT: total kcal from all activities
- KCALSPORT: total kcal from all sports activities (i.e., excluding chores, mowing, raking, gardening, non-sports other activity)
- SPORTINTENS: intensity variable
- 0: no sports activity
- 1: light sports activity (MET < 4) only
- 2: some moderate sports activity (MET >=4 & <6), but no high sports activity
- 3: some high sports activity (MET >= 6)
C. METS intensity score
| Original calculation | New calculation | |
|---|---|---|
| Walking | 3.5 | 2.0 – 6.3 (depending on walking pace) |
| Chores | 4.5 | 2.5 |
| Mowing | 4.5 | 4.5 |
| Raking | 4.0 | 4.0 |
| Gardening | 4.5 | 4.0 |
| Hiking | 6.0 | 6.0 |
| Jogging | 6.0 | 7.0 |
| Biking | 4.0 | 6.0 |
| Exercise cycle | 5.0 | 4.0 |
| Dance | 5.5 | 4.5 |
| Aerobics | 6.0 | 6.5 |
| Bowling | 3.0 | 3.0 |
| Golf | 4.5 | 4.5 |
| Tennis | 8.0 | 7.0 |
| Racquet ball | 7.0 | 7.0 |
| General exercise | 4.5 | 3.5 |
| Swimming | 6.0 | 6.0 |
| Other | N/A | Depending on activity |
Descriptive statistics
| Year | Total N | Mean | SD | Min | Max |
|---|---|---|---|---|---|
| 2 KCAL_y2 | 5185 | 1818 | 2093 | 0 | 14805 |
| KCAL2_y2 | 5196 | 1243 | 1642 | 0 | 14160 |
| KCALTOT_y2 | 5197 | 1370 | 1771 | 0 | 25988† |
| 5 KCAL_y5 | 5023 | 1392 | 1740 | 0 | 13965 |
| KCAL2_y5 | 5030 | 1022 | 1475 | 0 | 14841 |
| KCALTOT_y5 | 5043 | 1021 | 1483 | 0 | 21018† |
| KCALSPORT_y5 | 5043 | 578 | 1036 | 0 | 15180 |
| 9 KCAL_y9 | 4001 | 1164 | 1616 | 0 | 14760 |
| KCAL2_y9 | 4003 | 856 | 1311 | 0 | 12390 |
| KCALTOT_y9 | 4005 | 870 | 1420 | 0 | 30250† |
| KCALSPORT_y9 | 4005 | 497 | 880 | 0 | 13440 |
† Number of participants with > 15000 kcal/wk: 8 (yr2), 3 (yr5), 3 (yr9)
| Year | Total N | Category 0 (%) | 1 (%) | 2 (%) | 3 (%) |
|---|---|---|---|---|---|
| 2 EXINTEN_y2 | 5197 | 8.5 | 47.2 | 33.7 | 10.6 |
| SPORTINTENS_y2 | 5201 | 27.7 | 29.0 | 32.1 | 11.3 |
| 5 EXINTEN_y5 | 5043 | 11.5 | 44.3 | 35.1 | 9.1 |
| SPORTINTENS_y2 | 5043 | 29.5 | 26.7 | 33.0 | 10.7 |
| 9 EXINTEN_y9 | 4006 | 15.8 | 41.9 | 34.1 | 8.2 |
| SPORTINTENS_y2 | 4005 | 32.1 | 25.6 | 31.9 | 10.4 |
Participants with low values of the original KCAL variable and high values of the new KCALTOT at each year reported "other activities" that have now been coded. These activities include carpentry, home repair or building, farm work and child care.