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Titolo:
Traditional risk factors and subclinical disease measures as predictors offirst myocardial infarction in older adults - The cardiovascular health study
Autore:
Psaty, BM; Furberg, CD; Kuller, LH; Bild, DE; Rautaharju, PM; Polak, JF; Bovill, E; Gottdiener, JS;
Indirizzi:
Cardiovasc Hlth Study, Coordinating Ctr, Seattle, WA 98101 USA Cardiovasc Hlth Study Seattle WA USA 98101 ing Ctr, Seattle, WA 98101 USA Univ Washington, Dept Med, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USAUniv Washington Seattle WA USA 98195 Hlth Res Unit, Seattle, WA 98195 USA Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ept Epidemiol, Seattle, WA 98195 USA Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ept Hlth Serv, Seattle, WA 98195 USA WakeCForest Univ, Bowman Gray Sch Med, Dept Publ Hlth Sci, Winston Salem, N Wake Forest Univ Winston Salem NC USA 27103 bl Hlth Sci, Winston Salem, N Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA Univ PittsburghPittsburgh PA USA 15261 idemiol, Pittsburgh, PA 15261 USA NHLBI, Div Epidemiol & Clin Applicat, Bethesda, MD 20892 USA NHLBI Bethesda MD USA 20892 emiol & Clin Applicat, Bethesda, MD 20892 USA Brigham & Womens Hosp, Dept Radiol, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 pt Radiol, Boston, MA 02115 USA Univ Vermont, Dept Pathol, Colchester, Essex, England Univ Vermont Colchester Essex England Pathol, Colchester, Essex, England Georgetown Univ, Med Ctr, Div Cardiol, Washington, DC 20007 USA GeorgetownUniv Washington DC USA 20007 Cardiol, Washington, DC 20007 USA
Titolo Testata:
ARCHIVES OF INTERNAL MEDICINE
fascicolo: 12, volume: 159, anno: 1999,
pagine: 1339 - 1347
SICI:
0003-9926(19990628)159:12<1339:TRFASD>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; LEFT-VENTRICULAR MASS; FACTOR INTERVENTION TRIAL; SERUM-CHOLESTEROL LEVELS; BLOOD-PRESSURE; SYSTOLIC HYPERTENSION; MORTALITY RISK; MEN; WOMEN; STROKE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
56
Recensione:
Indirizzi per estratti:
Indirizzo: Psaty, BM CardiovascWAlth Study, Coordinating Ctr, Suite 2105,1501 4th Ave, Seattle, Cardiovasc Hlth Study Suite 2105,1501 4th Ave Seattle WA USA 98101
Citazione:
B.M. Psaty et al., "Traditional risk factors and subclinical disease measures as predictors offirst myocardial infarction in older adults - The cardiovascular health study", ARCH IN MED, 159(12), 1999, pp. 1339-1347

Abstract

Background: Risk factors for myocardial infarction (MI) have not been wellcharacterized in older adults, and in estimating risk, we sought to assessthe individual and joint contributions made by both traditional risk factors and measures of subclinical disease. Methods: In the Cardiovascular Health Study, we recruited 5888 adults aged65 years and older from 4 US centers. At baseline in 1989-1990, participants underwent an extensive examination that included traditional risk factors such as blood pressure and fasting glucose level and measures of subclinical disease as assessed by electrocardiography, carotid ultrasonography, echocardiography, pulmonary function, and ankle-arm index. Participants were followed up with semiannual contacts, and all cardiovascular events were classified by the Morbidity and Mortality Committee. The main analytic technique was the Cox proportional hazards model. Results: At baseline, 1967 men and 2979 women had no history of an MI. After follow-up for an average of 4.8 years, there were 302 coronary events, which included 263 patients with MI and 39 with definite fatal coronary disease. The incidence was higher in men (20.7 per 1000 person-years) than women (7.9 per 1000 person-years). In all subjects, the incidence was strongly associated with age, increasing from 7.8 per 1000 person-years in subjects aged 65 to 69 years to 25.6 per 1000 person-years in subjects aged 85 yearsand older. Glucose level and systolic blood pressure were associated with the incidence of MI, but smoking and lipid measures were not. After adjustment for age and sex, the significant subclinical disease predictors of MI were borderline or abnormal ejection fraction by echocardiography, high levels of intimal-medial thickness of the internal carotid artery, and a low ankle-arm index. Forced vital capacity and electrocardiographic left ventricular mass did not enter the stepwise model. Excluding subjects with clinicalcardiovascular diseases such as prior angina or congestive heart failure at baseline had little effect on these results. Risk factors were generally similar in men and women. Conclusions: After follow-up of 4.8 years, systolic blood pressure, fasting glucose level, and selected subclinical disease measures were important predictors of the incidence of MI in older adults. Uncontrolled high blood pressure may explain about one quarter of the coronary events in this population.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/12/20 alle ore 00:05:36