10-Year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the cardiovascular health study

Lewis H. Kuller, Alice M. Arnold, Bruce M. Psaty, John A. Robbins, Daniel H. O'Leary, Russell P. Tracy, Gregory L. Burke, Teri A. Manolio, Paolo H M Chaves

Research output: Contribution to journalArticle

Abstract

Background: The incidence of coronary heart disease (CHD) is very high among individuals 65 years or older. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)71-78
Number of pages8
JournalArchives of Internal Medicine
Volume166
Issue number1
DOIs
StatePublished - Jan 9 2006

Fingerprint

Coronary Disease
Cardiovascular Diseases
Health
Incidence
Diabetes Mellitus
Hypertension
Cerebral Palsy
C-Reactive Protein
Confidence Intervals
Mortality

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Kuller, L. H., Arnold, A. M., Psaty, B. M., Robbins, J. A., O'Leary, D. H., Tracy, R. P., ... Chaves, P. H. M. (2006). 10-Year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the cardiovascular health study. Archives of Internal Medicine, 166(1), 71-78. https://doi.org/10.1001/archinte.166.1.71

10-Year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the cardiovascular health study. / Kuller, Lewis H.; Arnold, Alice M.; Psaty, Bruce M.; Robbins, John A.; O'Leary, Daniel H.; Tracy, Russell P.; Burke, Gregory L.; Manolio, Teri A.; Chaves, Paolo H M.

In: Archives of Internal Medicine, Vol. 166, No. 1, 09.01.2006, p. 71-78.

Research output: Contribution to journalArticle

Kuller, LH, Arnold, AM, Psaty, BM, Robbins, JA, O'Leary, DH, Tracy, RP, Burke, GL, Manolio, TA & Chaves, PHM 2006, '10-Year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the cardiovascular health study', Archives of Internal Medicine, vol. 166, no. 1, pp. 71-78. https://doi.org/10.1001/archinte.166.1.71
Kuller, Lewis H. ; Arnold, Alice M. ; Psaty, Bruce M. ; Robbins, John A. ; O'Leary, Daniel H. ; Tracy, Russell P. ; Burke, Gregory L. ; Manolio, Teri A. ; Chaves, Paolo H M. / 10-Year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the cardiovascular health study. In: Archives of Internal Medicine. 2006 ; Vol. 166, No. 1. pp. 71-78.
@article{cf2da94e4fc64875bf800c9ad852a6cf,
title = "10-Year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the cardiovascular health study",
abstract = "Background: The incidence of coronary heart disease (CHD) is very high among individuals 65 years or older. Methods: 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. Results: 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. Conclusions: 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.",
author = "Kuller, {Lewis H.} and Arnold, {Alice M.} and Psaty, {Bruce M.} and Robbins, {John A.} and O'Leary, {Daniel H.} and Tracy, {Russell P.} and Burke, {Gregory L.} and Manolio, {Teri A.} and Chaves, {Paolo H M}",
year = "2006",
month = "1",
day = "9",
doi = "10.1001/archinte.166.1.71",
language = "English (US)",
volume = "166",
pages = "71--78",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "1",

}

TY - JOUR

T1 - 10-Year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the cardiovascular health study

AU - Kuller, Lewis H.

AU - Arnold, Alice M.

AU - Psaty, Bruce M.

AU - Robbins, John A.

AU - O'Leary, Daniel H.

AU - Tracy, Russell P.

AU - Burke, Gregory L.

AU - Manolio, Teri A.

AU - Chaves, Paolo H M

PY - 2006/1/9

Y1 - 2006/1/9

N2 - Background: The incidence of coronary heart disease (CHD) is very high among individuals 65 years or older. Methods: 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. Results: 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. Conclusions: 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.

AB - Background: The incidence of coronary heart disease (CHD) is very high among individuals 65 years or older. Methods: 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. Results: 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. Conclusions: 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.

UR - http://www.scopus.com/inward/record.url?scp=30344452589&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=30344452589&partnerID=8YFLogxK

U2 - 10.1001/archinte.166.1.71

DO - 10.1001/archinte.166.1.71

M3 - Article

VL - 166

SP - 71

EP - 78

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 1

ER -