Related Experiment Videos
Age-related changes in risk factor effects on the incidence of coronary heart disease
Robert D Abbott1, J David Curb, Beatriz L Rodriguez
1Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VA, USA. Rda3e@virginia.edu
Insights
Risk factor effects on coronary heart disease (CHD) change with age. While hypertension risk decreased in older adults, diabetes risk remained consistent, highlighting the need for age-specific prevention strategies.
Area of Science:
- Cardiology
- Gerontology
- Epidemiology
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality globally.
- Understanding how cardiovascular risk factors influence CHD incidence across different age groups is crucial for effective prevention.
Purpose of the Study:
- To investigate the age-dependent effects of various risk factors on the incidence of coronary heart disease (CHD).
- To determine if risk factor associations with CHD change from middle adulthood to late life.
Main Methods:
- Longitudinal study of men in the Honolulu Heart Program with repeated risk factor measurements over 26 years.
- Follow-up assessments allowed analysis of risk factor effects as participants aged from 45 to 93 years.
Main Results:
- Hypertension's association with CHD significantly declined with age, with increased risk in the oldest men (75-93) without hypertension.
- Diabetes conferred a consistent 2-fold excess CHD risk across all ages.
- Body mass index association shifted from positive in younger men to negative in the oldest; smoking effects weakened with age.
- Sedentary lifestyle effects appeared stronger in the oldest men.
Conclusions:
- The impact of cardiovascular risk factors on CHD incidence varies significantly with advancing age.
- Current CHD prevention strategies may need adaptation to account for age-related changes in risk factor efficacy.
Purpose:
The purpose of this report is to examine the potential for risk factor effects on the incidence of CHD to change over a broad range of ages from middle adulthood to late-life.
Methods:
Findings are based on repeated risk factor measurements at four examinations over a 26-year period in men enrolled in the Honolulu Heart Program. After each examination, six years of follow-up were available to assess risk factor effects as the cohort aged from 45 to 93 years.
Results:
Based on 18,456 person intervals of follow-up, 677 men developed CHD (3.7%). After risk factor adjustment, a positive relation between hypertension and CHD declined significantly with age (p = 0.013), primarily due to a large increase in the risk of CHD in elderly men (75 to 93) without hypertension. Effects of total cholesterol on CHD also seemed to decline with advancing age, although changes were not statistically significant. In contrast, men with diabetes had a consistent 2-fold excess risk of CHD across all age groups, while a positive association with body mass index in younger men (45 to 54) became negative in those who were the oldest (75 to 93). Due to infrequent smoking in the elderly, associations between smoking and CHD weakened with age. In the oldest men (75 to 93), alcohol intake was unrelated to CHD, while effects of sedentary life-styles on promoting CHD appeared stronger than in those who were younger.
Conclusion:
Findings suggest that changes in risk factor effects on the incidence of CHD with advancing age may require updated strategies for CHD prevention as aging occurs.