American Journal of Epidemiology Vol. 126, No. 3: 385-399
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
PREDICTORS OF CARDIOVASCULAR EVENTS AND MORTALITY IN THE SYSTOLIC HYPERTENSION IN THE ELDERLY PROGRAM PILOT PROJECT
1Department of Epidemiology and International Health and the Institute for Health Policy Studies University of California, San Francisco, CA
2Department of Medicine, University of California San Francisco, San Francisco, CA
3Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
4Department of Epidemiology, Graduate School of Public Health University of California, Berkeley, Berkeley, CA
5Center for Aging, University of Alabama Birmingham, Birmingham, AL
6Department of Preventive Medicine Rush Presbyterian-St. Luke's Medical Center, Chicago, IL
Reprint requests to Dr.David Siegel, Clinical Epidemiology Program, Building 1, Room 201, San Francisco General Hospital, San Francisco, CA 94110
Siegel, D. (Clinical Epidemiology Program, San Francisco General Hospital, San Francisco, CA 94110), L. Kuller, N. B. Lazarus, D. Black, D. Feigal, G. Hughes, J. A. Schoenberger, and S. B. Hulley. Predictors of cardiovascular events and mortality in the Systolic Hypertension in the Elderly Program pilot project. Am J Epidemiol 1987;126:385-99.
Do the established cardiovascular risk factors for younger persons remain important predictors of cardiovascular disease events and mortality in those who are older? The authors examined this question in the Systolic Hypertension in the Elderly Program pilot project which prospectively followed 551 men and women 60 years of age and older with pretreatment systolic blood pressure 
160 mmHg and diastolic blood pressure <90 mmHg who were enrolled between May 1981 and July 1982. Mean age was 72 years, 37% were men, 82% were white, and 24% had attended college. The vital status of all 551 participants was known at the end of follow-up, an average of 34 months after entry; there were 39 deaths from all causes, 66 first cardiovascular events, 18 strokes, and 20 episodes of myocardial infarction/sudden death. Univariate Cox proportional hazard analysis revealed that age was a predictor (p < 0.05) of all-cause mortality, first cardio vascular event, and stroke. Less than college education was a predictor of all-cause mortality and first cardiovascular event, smoking was a predictor of first cardiovascular event and myocardial infarction/sudden death, cholesterol was a predictor of first cardiovascular event, and lower body mass index was a predictor of increased all-cause mortality. After adjustment for covanables, age, lower education, lower body mass index, and baseline electrocardiographic abnormal ities were significant predictors of all-cause mortality, and age, lower education, history of cardiovascular event, and smoking remained significant predictors of first cardiovascular event. Sex was not a risk factor, and the ability to examine hypertension as a risk factor was impaired by the fact that the entire cohort had systolic hypertension at baseline, and most were treated. These findings, com bined with prior evidence, suggest that smoking, low education level, and perhaps serum cholesterol are risk factors for cardiovascular disease in the elderly. Although the excess risk conveyed by these factors is large, its reversibility needs to be demonstrated by intervention studies.
cerebrovascular disorders; geriatrics; hypertension; mortality; myocardial infarction
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. C. Thurston, L. D. Kubzansky, I. Kawachi, and L. F. Berkman Do Depression and Anxiety Mediate the Link Between Educational Attainment and CHD? Psychosom Med, January 1, 2006; 68(1): 25 - 32. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. S. Aronow Management of the Elderly Person After Myocardial Infarction J. Gerontol. A Biol. Sci. Med. Sci., November 1, 2004; 59(11): 1173 - 1185. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. Ravnskov High cholesterol may protect against infections and atherosclerosis QJM, December 1, 2003; 96(12): 927 - 934. [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Beck and A. H. Katcher Future Directions in Human-Animal Bond Research American Behavioral Scientist, September 1, 2003; 47(1): 79 - 93. [Abstract] [PDF]
|
|
|
|
 |
|
 A. I. Qureshi, M. F. K. Suri, Y. Mohammad, L. R. Guterman, and L. N. Hopkins Isolated and Borderline Isolated Systolic Hypertension Relative to Long-Term Risk and Type of Stroke: A 20-Year Follow-Up of the National Health and Nutrition Survey Stroke, December 1, 2002; 33(12): 2781 - 2788. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. G. Druss, W. D. Bradford, R. A. Rosenheck, M. J. Radford, and H. M. Krumholz Quality of Medical Care and Excess Mortality in Older Patients With Mental Disorders Arch Gen Psychiatry, June 1, 2001; 58(6): 565 - 572. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Glynn, C. U. Chae, J. M. Guralnik, J. O. Taylor, and C. H. Hennekens Pulse Pressure and Mortality in Older People Arch Intern Med, October 9, 2000; 160(18): 2765 - 2772. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Grundy, J. I. Cleeman, B. M. Rifkind, L. H. Kuller, and for the Coordinating Committee of the National Cho Cholesterol Lowering in the Elderly Population Arch Intern Med, August 9, 1999; 159(15): 1670 - 1678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Alli, F. Avanzini, G. Bettelli, F. Colombo, V. Torri, G. Tognoni, and and general practitioners of SPAA The Long-term Prognostic Significance of Repeated Blood Pressure Measurements in the Elderly: SPAA (Studio sulla Pressione Arteriosa nell'Anziano) 10-Year Follow-up Arch Intern Med, June 14, 1999; 159(11): 1205 - 1212. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. I. Qureshi, W. H. Giles, and J. B. Croft Racial differences in the incidence of intracerebral hemorrhage: Effects of blood pressure and education Neurology, May 1, 1999; 52(8): 1617 - 1617. [Abstract] [Full Text]
|
|
|
|
|
|
A. E. Kunst, M. del Rios, F. Groenhof, and J. P. Mackenbach Socioeconomic Inequalities in Stroke Mortality Among Middle-Aged Men : An International Overview Stroke, November 1, 1998; 29(11): 2285 - 2291. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Curb, R. D. Abbott, C. J. MacLean, B. L. Rodriguez, C. M. Burchfiel, D. S. Sharp, G. W. Ross, and K. Yano Age-Related Changes in Stroke Risk in Men With Hypertension and Normal Blood Pressure Stroke, May 1, 1996; 27(5): 819 - 824. [Abstract] [Full Text]
|
|
|
|
 |
|
 D. Siegel and S. B. Hulley Diuretics, Potassium, and Ventricular Arrhythmias-Reply JAMA, July 1, 1992; 268(1): 53 - 53. [Abstract] [PDF]
|
|
|
|
 |
|
 S. M. Rubin, S. Sidney, D. M. Black, W. S. Browner, S. B. Hulley, and S. R. Cummings High Blood Cholesterol in Elderly Men and the Excess Risk for Coronary Heart Disease Ann Intern Med, December 15, 1990; 113(12): 916 - 920. [Abstract] [PDF]
|
|