Coronary heart disease risk factors in men and women aged 60 years and older - Findings from the systolic hypertension in the elderly program

被引:50
作者
Frost, PH
Davis, BR
Burlando, AJ
Curb, JD
Guthrie, GP
Isaacsohn, JL
WassertheilSmoller, S
Wilson, AC
Stamler, J
机构
[1] UNIV TEXAS, SCH PUBL HLTH, HOUSTON, TX USA
[2] KAISER PERMANENTE MED CTR, SACRAMENTO, CA USA
[3] UNIV HAWAII, SCH MED, HONOLULU, HI 96822 USA
[4] UNIV KENTUCKY, COLL MED, LEXINGTON, KY USA
[5] CHRIST HOSP, CINCINNATI, OH 45219 USA
[6] ALBERT EINSTEIN COLL MED, BRONX, NY 10467 USA
[7] UNIV MED & DENT NEW JERSEY, NEW BRUNSWICK, NJ USA
[8] NORTHWESTERN UNIV, SCH MED, CHICAGO, IL USA
关键词
aging; coronary disease; risk factors; hypertension;
D O I
10.1161/01.CIR.94.1.26
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Coronary heart disease (CHD) is the most common cause of death in men and women aged 60 years and older. Although a number of studies support the concept that CHD risk factors that have been defined in younger adults are significantly associated with CHD events in older adults, others do not support this thesis, and further definition of the risk-factor concept in older adults is required. Methods and Results The Systolic Hypertension in the Elderly Program recruited 4736 persons (mean age, 72 years); 14% were black, and 43% were men. Mean systolic and diastolic blood pressures were 170 and 77 mm Hg, respectively. About 13% of participants were current smokers. 10% had a history of diabetes; 5%, a prior myocardial infarction; 5%, angina pectoris, 2.3%, intermittent claudication; and 7%; a carotid bruit. Mean total cholesterol value was 6.11 mmol/L. Mean follow-up was 4.5 years. In multivariate Cox regression analyses for CHD. variables that were significant were baseline total cholesterol value, smoking, history of diabetes, presence of carotid bruit, and treatment group in the trial. Active treatment yielded a 27% reduction in CHD risk. For each 1.03 mmol/L increase in total cholesterol value, there was an increase in risk of about 20%. Current smokers had a 73% increase, diabetics a 121% increase, and those with carotid bruit a 113% increase in CHD risk. Conclusions The results of this study support the concept that CHD risk factors are important in older men and women with isolated systolic hypertension.
引用
收藏
页码:26 / 34
页数:9
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