Title | 10-year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the Cardiovascular Health Study. |
Publication Type | Journal Article |
Year of Publication | 2006 |
Authors | Kuller, LH, Arnold, AM, Psaty, BM, Robbins, JA, O'Leary, DH, Tracy, RP, Burke, GL, Manolio, TA, Chaves, PHM |
Journal | Arch Intern Med |
Volume | 166 |
Issue | 1 |
Pagination | 71-8 |
Date Published | 2006 Jan 09 |
ISSN | 0003-9926 |
Keywords | African Continental Ancestry Group, Aged, Blood Chemical Analysis, Cardiovascular Diseases, Comorbidity, Coronary Disease, Echocardiography, European Continental Ancestry Group, Female, Follow-Up Studies, Humans, Incidence, Male, Multivariate Analysis, Prevalence, Proportional Hazards Models, Regression Analysis, Risk Factors, Sex Distribution, United States |
Abstract | <p><b>BACKGROUND: </b>The incidence of coronary heart disease (CHD) is very high among individuals 65 years or older.</p><p><b>METHODS: </b>We evaluated the relationships between measurements of subclinical disease at baseline (1989-1990) and at the third-year follow-up examination (1992-1993) and subsequent incidence of cardiovascular disease and total mortality as of June 2001. Approximately 61% of the participants without clinical cardiovascular disease at baseline had subclinical disease based on our previously described criteria from the Cardiovascular Health Study.</p><p><b>RESULTS: </b>The incidence of CHD was substantially increased for participants with subclinical disease compared with those who had no subclinical disease: 30.5 per 1000 person-years with and 16.3 per 1000 person-years without for white individuals, and 31.2 per 1000 person-years with and 12.5 per 1000 person-years without for black individuals. The risk persisted over the entire follow-up period. Incidence rates were higher for men than for women with or without subclinical disease, but there was little difference in rates for black individuals and white individuals.</p><p><b>CONCLUSIONS: </b>In multivariable models, subclinical disease at baseline remained a significant predictor of CHD in both men and women; the hazard ratios (95% confidence intervals) of their relative risks were 1.64 (1.30-2.06) and 1.49 (1.21-1.84), respectively. The presence of subclinical disease substantially increased the risk of subsequent CHD for participants with hypertension, diabetes mellitus, or elevated C-reactive protein. In summary, subclinical disease is very prevalent among older individuals, is independently associated with risk of CHD even over a 10-year follow-up period, and substantially increases the risk of CHD among participants with hypertension or diabetes mellitus.</p> |
DOI | 10.1001/archinte.166.1.71 |
Alternate Journal | Arch Intern Med |
PubMed ID | 16401813 |
Grant List | N01-85079 / / PHS HHS / United States N01-HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-15129 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States |