Preventive cardiologyRisk Factor Burden in Middle Age and Lifetime Risks for Cardiovascular and Non-Cardiovascular Death (Chicago Heart Association Detection Project in Industry)
Section snippets
Study sample
The entry criteria and methods of the CHA study have been published previously.6 Briefly, from November 1967 to January 1973, the CHA study screened 39,523 men and women aged ≥18 years of varied socioeconomic backgrounds and ethnicities employed at 84 Chicago-area businesses and organizations. As previously reported in detail, standardized examination methods were used.7, 8 Trained staff members measured supine blood pressure using a standard mercury sphygmomanometer and serum total cholesterol
Study sample
The study sample included 8,033 men and 6,493 women aged 40 to 59 years, including 414 black men and 368 black women. During 409,987 person-years of follow-up, there were 2,582 deaths due to CVD and 3,955 non-CVD deaths. Table 1 lists the numbers of men and women and the number of CVD deaths during follow-up in each stratum of risk factor burden. Overall, 17.5% of men and 23.3% of women had favorable risk factor profiles or no elevated risk factors, whereas >75% of men and women had ≥1 elevated
Discussion
In this large cohort, we observed that men and women with favorable risk factor profiles in middle age had low remaining lifetime risk for CVD death and prolonged survival. In contrast, greater risk factor burden in middle age was associated with higher risk for CVD and non-CVD death. Despite the higher competing risk for non-CVD death in those with greater CVD risk factor burdens in middle age, remaining lifetime risk for CVD death was substantially higher and median overall survival
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This study was supported by the American Heart Association, Dallas, Texas, and its Chicago and Illinois affiliates; by Grants R01-HL 15174, R01-HL 21010, and R01-HL 03387 from the National Heart, Lung, and Blood Institute, Bethesda, MD; and by the Chicago Health Research Foundation, Chicago, Illinois.