November 14, 2008
View Full PaperDoes the Predictive Value of Baseline Coronary Risk Factors Change over a 30-Year Follow-Up?
Key Result
Serum cholesterol and smoking >9 cigarettes daily strongly predicted CHD death (n=450) over 30 years, while systolic blood pressure lost predictive value after 20 years.
Study Design
Type
Cohort (n=1,619)
Structured PICO
Do baseline coronary risk factors (cholesterol, blood pressure, smoking, BMI) maintain their predictive value for CHD mortality over a 30-year follow-up in middle-aged men?
P
Population
1,619 men aged 40-59 at baseline
O
Outcome
Coronary heart disease (CHD) mortalityhard clinical
The long-term predictive power of classical coronary risk factors varies significantly over a 30-year period, with cholesterol and smoking remaining strong predictors while blood pressure and BMI show time-dependent associations.
Abstract
The association of baseline serum total cholesterol, systolic blood pressure, smoking and body mass index with coronary heart disease (CHD) mortality was analyzed among 1,619 men aged 40-59 at baseline. Analyses were made separately for the first, second and third decade of follow-up. Serum cholesterol and smoking more than 9 cigarettes daily were strong predictors of risk of CHD death (n = 450) occurring early and late during the 30-year follow-up. After 20 years of follow-up, systolic blood pressure was no longer associated with CHD risk. In contrast, highest tertile of body mass index (over 24.7 kg/m2) was only then associated with increased CHD risk. The correlations between the baseline and the 30-year risk factor values were 0.42 for serum cholesterol (n = 444), 0.28 for systolic blood pressure (n = 444) and 0.57 for body mass index (n = 429). Our results showed large differences in the long-term predictive power of the classical coronary risk factors. The reasons for these differences are discussed.