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American Journal of Epidemiology Vol. 139, No. 12: 1164-1179
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health


research-article

Prevalence of Subclinical Atherosclerosis and Cardiovascular Disease and Association with Risk Factors in the Cardiovascular Health Study

Lewis Kuller1,, Nemat Borthani2, Curt Furberg3, Julius Gardin4, Teri Manolio5, Daniel O'Leary6, Bruce Psaty2 and John Robbins7

1University of Pittsburgh, Department of Epidemiology Pittsburgh, PA
2Cardiovascular Health Study Coordinating Center Seattle, WA
3Bowman Gray School of Medicine, Department of Public Health Sciences Winston-Salem, NC
4University of California-Irvine Medical Center Orange, CA
5National Heart, Lung, and Blood Institute Bethesda, MD
6Geisinger Medical Center Danville, PA
7University of California-Davis, Cardiovascular Health Study Field Center Sacramento, CA

Reprint requests to Dr. Lewis H. Kuller, Department of Epidemiology, Graduate School of Public Hearth, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261

The prevalence of subclinical atherosclerosis and cardiovascular disease was evaluated among the 5,201 adults aged ≥65 years in four communities participating in the Cardiovascular Health Study from June 1989 through May 1990. A combined index based on electrocardiogram and echocardiogram abnormalities, carotid artery wall thickness and stenosis based on carotid ultrasound, decreased ankle-brachial blood pressure, and positive response to a Rose Questionnaire for angina or intermittent claudication defined subclinical disease. The prevalence of subclinical disease was 36% in women and 38.7% in men and increased with age. Among women, low-density lipoprotein cholesterol, systolic blood pressure, blood glucose, and cigarette smoking were positively associated, and high-density lipoprotein cholesterol negatively associated, with subclinical disease. In men, systolic blood pressure, blood glucose, and ciga-rette smoking were independent risk factors in multiple logistic regression analyses. The risk factors for subclinical disease are, therefore, similar to those for clinical disease at younger ages, especially among women. It is possible that older individuals with subclinical disease are at very high risk of developing clinical disease and that more aggressive interventions to prevent clinical disease should be oriented to individuals with subclinical disease.

aging; atherosclerosis; cardiovascular diseases; carotid artery diseases; coronary disease; risk factors


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Arterioscler. Thromb. Vasc. Bio.Home page
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Fibrinogen and Factor VIII, but Not Factor VII, Are Associated With Measures of Subclinical Cardiovascular Disease in the Elderly : Results From the Cardiovascular Health Study
Arterioscler Thromb Vasc Biol, September 1, 1995; 15(9): 1269 - 1279.
[Abstract] [Full Text]


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CirculationHome page
L.H. Kuller, L. Shemanski, B.M. Psaty, N.O. Borhani, J. Gardin, M.N. Haan, D.H. O'Leary, P.J. Savage, G.S. Tell, and R. Tracy
Subclinical Disease as an Independent Risk Factor for Cardiovascular Disease
Circulation, August 15, 1995; 92(4): 720 - 726.
[Abstract] [Full Text]



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