Incidence of Cardiovascular Disease in Older Americans: The Cardiovascular Health Study

doi:10.1111/j.1532-5415.2005.53105.x

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Wiley InterScience

Journal of the American Geriatrics Society

Volume 53 Issue 2, Pages 211 - 218

Published Online: 26 Jan 2005

Journal compilation 2010 The American Geriatrics Society/Wiley Periodicals, Inc.

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Incidence of Cardiovascular Disease in Older Americans: The Cardiovascular Health Study

Alice M. Arnold, PhD ^* , Bruce M. Psaty, MD, PhD ^†‡ , Lewis H. Kuller, MD, DrPH ^§ , Gregory L. Burke, MD, MS ^∥ , Teri A. Manolio, MD, MHS ^¶ , Linda P. Fried, MD, MPH ^# , John A. Robbins, MD, MHS ^** and Richard A. Kronmal, PhD ^*

From the Departments of ^*Biostatistics, ^†Medicine, and ^‡Epidemiology, University of Washington, Seattle, Washington; ^§Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; ^∥Department of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina; ^¶Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Maryland; ^#Departments of Medicine, Epidemiology and Health Policy, Johns Hopkins Medical Institutions, Baltimore, Maryland; ^**Department of Internal Medicine, University of California at Davis, Sacramento, California.

Correspondence to Alice M. Arnold, PhD, Collaborative Health Studies Coordinating Center, Building 29, Suite 310, 6200 NE 74th Street, Seattle, WA 98155. E-mail: arnolda@u.washington.edu

The research reported in this article was supported by Contracts N01-;HC-85079 through N01-HC-85086, N01-HC-35129, and N01 HC-15103 from the National Heart, Lung, and Blood Institute.

KEYWORDS

cardiovascular disease • incidence • congestive heart failure • coronary heart disease • stroke

ABSTRACT

Objectives: To estimate incidence rates of major cardiovascular disease (CVD) in older Americans.

Design: Longitudinal cohort study using prospectively collected data on cardiovascular events.

Setting: Four U.S. communities in the Cardiovascular Health Study (CHS).

Participants: Five thousand eight hundred eighty-eight participants in CHS, aged 65 or older at enrollment, including 3,393 women (581 African American) and 2,495 men (343 African American).

Measurements: At semiannual contacts, participants reported any occurrence of clinical CVD. Medical records were obtained and adjudicated to confirm diagnosis of CVD.

Results: During 10 years of follow-up, incidence of coronary heart disease (CHD) per 1,000 person-years was 39.6 (95% confidence interval (CI)=36.4–43.1) in men and 22.3 (95% CI=20.4–24.2) in women. Cumulative event rates for CHD and myocardial infarction for women aged 75 and older at baseline were similar to those for men aged 65 to 74. The overall incidence of stroke was similar for men and women (14.7 (95% CI=13.0–16.6) and 13.7 (95% CI=12.4–15.1) per 1,000 person-years, respectively), but the risk of stroke increased with age more rapidly in women, resulting in a greater cumulative event rate for stroke in women than in men aged 75 and older. The incidence of congestive heart failure increased 9% with each year of age over 65 and was greater than 6% per year in Caucasian men and women aged 85 and older at baseline. Rates were similar in African Americans and Caucasians.

Conclusion: The occurrence of new CVD in older Americans is high, indicating that preventive efforts need to be maintained into older ages.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1532-5415.2005.53105.x About DOI