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. 2001 Nov;93(11):423–429.

Incidence and predictors of coronary heart disease among older African Americans--the Cardiovascular Health Study.

S A Jackson 1, G L Burke 1, C Thach 1, M Cushman 1, D Ives 1, N Powe 1, T A Manolio 1
PMCID: PMC2594007  PMID: 11730114

Abstract

Although coronary heart disease (CHD) is the leading cause of death and morbidity in older African Americans, relatively little is known about the incidence and predictors of CHD in this population. This study was undertaken to determine the incidence and predictors of CHD in African-American men and women aged 65 years and older. The participants in this study included a total of 924 African-American men and women aged 65 years of age and older who participated in the Cardiovascular Health Study (CHS). The overall CHD incidence was 26.6 per 1,000 person-years of risk. Rates were higher in men than women (35.3 vs. 21.6) and in those 75 years or older than in those less than 75 years (31.3 vs. 24.5). In multivariate analysis, factors associated with higher risk of incident disease were male gender [relative risk (RR) = 1.8, 95% confidence interval (CI) = 1.1, 2.7], diabetes mellitus (RR = 1.9, 95% CI = 1.2, 2.9), total cholesterol (RR for 40 mg/dL increment = 1.3, 95% CI = 1.0, 1.5), and low (i.e., <0.9) ankle-arm index (RR = 2.1, 95% CI = 1.3, 3.4) after adjusting for age. Within this cohort of older African Americans, male gender, diabetes mellitus, total cholesterol, and low ankle-arm index and were independently predictive of incident events. These results suggest that the ankle-arm index, a measure of advanced atherosclerosis, should be further evaluated for its efficacy in identifying older African Americans at risk for incident clinical events.

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Selected References

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  1. Benfante R., Reed D. Is elevated serum cholesterol level a risk factor for coronary heart disease in the elderly? JAMA. 1990 Jan 19;263(3):393–396. [PubMed] [Google Scholar]
  2. Cassel J., Heyen S., Bartel A. G., Kaplan B. H., Tyroler H. A., Cornoni J. C., Hames C. G. Incidence of coronary heart disease by ethnic group, social class, and sex. Arch Intern Med. 1971 Dec;128(6):901–906. [PubMed] [Google Scholar]
  3. Castelli W. P., Doyle J. T., Gordon T., Hames C. G., Hjortland M. C., Hulley S. B., Kagan A., Zukel W. J. HDL cholesterol and other lipids in coronary heart disease. The cooperative lipoprotein phenotyping study. Circulation. 1977 May;55(5):767–772. doi: 10.1161/01.cir.55.5.767. [DOI] [PubMed] [Google Scholar]
  4. Centers for Disease Control (CDC) Coronary heart disease incidence, by sex--United States, 1971-1987. MMWR Morb Mortal Wkly Rep. 1992 Jul 24;41(29):526–529. [PubMed] [Google Scholar]
  5. Corti M. C., Guralnik J. M., Salive M. E., Harris T., Field T. S., Wallace R. B., Berkman L. F., Seeman T. E., Glynn R. J., Hennekens C. H. HDL cholesterol predicts coronary heart disease mortality in older persons. JAMA. 1995 Aug 16;274(7):539–544. [PubMed] [Google Scholar]
  6. Criqui M. H., Langer R. D., Fronek A., Feigelson H. S., Klauber M. R., McCann T. J., Browner D. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med. 1992 Feb 6;326(6):381–386. doi: 10.1056/NEJM199202063260605. [DOI] [PubMed] [Google Scholar]
  7. Cushman M., Cornell E. S., Howard P. R., Bovill E. G., Tracy R. P. Laboratory methods and quality assurance in the Cardiovascular Health Study. Clin Chem. 1995 Feb;41(2):264–270. [PubMed] [Google Scholar]
  8. Fried L. P., Borhani N. O., Enright P., Furberg C. D., Gardin J. M., Kronmal R. A., Kuller L. H., Manolio T. A., Mittelmark M. B., Newman A. The Cardiovascular Health Study: design and rationale. Ann Epidemiol. 1991 Feb;1(3):263–276. doi: 10.1016/1047-2797(91)90005-w. [DOI] [PubMed] [Google Scholar]
  9. Hagstrom R. M., Federspiel C. F., Ho Y. C. Incidence of myocardial infarction and sudden death from coronary heart disease in Nashville, Tennessee. Circulation. 1971 Nov;44(5):884–890. doi: 10.1161/01.cir.44.5.884. [DOI] [PubMed] [Google Scholar]
  10. Ives D. G., Fitzpatrick A. L., Bild D. E., Psaty B. M., Kuller L. H., Crowley P. M., Cruise R. G., Theroux S. Surveillance and ascertainment of cardiovascular events. The Cardiovascular Health Study. Ann Epidemiol. 1995 Jul;5(4):278–285. doi: 10.1016/1047-2797(94)00093-9. [DOI] [PubMed] [Google Scholar]
  11. Keil J. E., Sutherland S. E., Knapp R. G., Gazes P. C. Serum cholesterol--risk factor for coronary disease mortality in younger and older blacks and whites. The Charleston Heart Study, 1960-1988. Ann Epidemiol. 1992 Jan-Mar;2(1-2):93–99. [PubMed] [Google Scholar]
  12. Kornitzer M., Dramaix M., Sobolski J., Degre S., De Backer G. Ankle/arm pressure index in asymptomatic middle-aged males: an independent predictor of ten-year coronary heart disease mortality. Angiology. 1995 Mar;46(3):211–219. doi: 10.1177/000331979504600304. [DOI] [PubMed] [Google Scholar]
  13. Kronmal R. A., Cain K. C., Ye Z., Omenn G. S. Total serum cholesterol levels and mortality risk as a function of age. A report based on the Framingham data. Arch Intern Med. 1993 May 10;153(9):1065–1073. [PubMed] [Google Scholar]
  14. Kuller L. H., Shemanski L., Psaty B. M., Borhani N. O., Gardin J., Haan M. N., O'Leary D. H., Savage P. J., Tell G. S., Tracy R. Subclinical disease as an independent risk factor for cardiovascular disease. Circulation. 1995 Aug 15;92(4):720–726. doi: 10.1161/01.cir.92.4.720. [DOI] [PubMed] [Google Scholar]
  15. Kuller L., Fisher L., McClelland R., Fried L., Cushman M., Jackson S., Manolio T. Differences in prevalence of and risk factors for subclinical vascular disease among black and white participants in the Cardiovascular Health Study. Arterioscler Thromb Vasc Biol. 1998 Feb;18(2):283–293. doi: 10.1161/01.atv.18.2.283. [DOI] [PubMed] [Google Scholar]
  16. Manolio T. A., Burke G. L., Psaty B. M., Newman A. B., Haan M., Powe N., Tracy R. P., O'Leary D. H. Black-white differences in subclinical cardiovascular disease among older adults: the Cardiovascular Health Study. CHS Collaborative Research Group. J Clin Epidemiol. 1995 Sep;48(9):1141–1152. doi: 10.1016/0895-4356(94)00240-q. [DOI] [PubMed] [Google Scholar]
  17. Manolio T. A., Pearson T. A., Wenger N. K., Barrett-Connor E., Payne G. H., Harlan W. R. Cholesterol and heart disease in older persons and women. Review of an NHLBI workshop. Ann Epidemiol. 1992 Jan-Mar;2(1-2):161–176. doi: 10.1016/1047-2797(92)90051-q. [DOI] [PubMed] [Google Scholar]
  18. Newman A. B., Shemanski L., Manolio T. A., Cushman M., Mittelmark M., Polak J. F., Powe N. R., Siscovick D. Ankle-arm index as a predictor of cardiovascular disease and mortality in the Cardiovascular Health Study. The Cardiovascular Health Study Group. Arterioscler Thromb Vasc Biol. 1999 Mar;19(3):538–545. doi: 10.1161/01.atv.19.3.538. [DOI] [PubMed] [Google Scholar]
  19. Psaty B. M., Kuller L. H., Bild D., Burke G. L., Kittner S. J., Mittelmark M., Price T. R., Rautaharju P. M., Robbins J. Methods of assessing prevalent cardiovascular disease in the Cardiovascular Health Study. Ann Epidemiol. 1995 Jul;5(4):270–277. doi: 10.1016/1047-2797(94)00092-8. [DOI] [PubMed] [Google Scholar]
  20. Tyroler H. A., Heyen S., Bartel A., Cassel J., Cornoni J. C., Hames C. G., Kleinbaum D. Blood pressure and cholesterol as coronary heart disease risk factors. Arch Intern Med. 1971 Dec;128(6):907–914. [PubMed] [Google Scholar]
  21. Weisse A. B., Abiuso P. D., Thind I. S. Acute myocardial infarction in Newark, N.J. A study of racial incidence. Arch Intern Med. 1977 Oct;137(10):1402–1405. [PubMed] [Google Scholar]
  22. White A. D., Hames C. G., Tyroler H. A. Serum cholesterol and 20-year mortality in black and white men and women aged 65 and older in the Evans County Heart Study. Ann Epidemiol. 1992 Jan-Mar;2(1-2):85–91. doi: 10.1016/1047-2797(92)90041-n. [DOI] [PubMed] [Google Scholar]

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