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Case-control study of coronary heart disease risk factors in the elderly
W B Applegate1, J P Hughes, R Vander Zwaag
1Department of Medicine, University of Tennessee, Memphis.
Insights
Traditional cardiovascular risk factors like diabetes and smoking predict coronary artery disease (CAD) in both elderly and younger adults. While significant in older populations, their predictive power for CAD is slightly lower in the elderly.
Area of Science:
- Cardiology
- Geriatric Medicine
- Epidemiology
Background:
- Cardiovascular risk factors are well-established in younger populations.
- Their predictive value in elderly individuals with coronary artery disease (CAD) requires further investigation.
Purpose of the Study:
- To compare the predictive power of traditional cardiovascular risk factors for angiographically-proven CAD in elderly versus younger patients.
Main Methods:
- A case-control study was conducted using a large coronary arteriography database.
- Logistic regression analysis was employed to assess risk factors in different age groups (≥65 years vs. 35-49 years).
Main Results:
- Age, male sex, diabetes, smoking, hypertension, high total cholesterol, and left ventricular hypertrophy were significant risk factors for CAD in both age groups.
- Odds ratios for these risk factors were generally lower in the elderly cohort compared to the younger cohort.
- Gender subgroup analyses showed similar trends, though with limited statistical power in elderly males.
Conclusions:
- Most traditional cardiovascular risk factors are correlated with angiographically-proven CAD in older patients, similar to younger populations.
- The predictive significance of these factors may be slightly diminished in the elderly.
Abstract:
We undertook a case-control study utilizing a large coronary arteriography database to determine if traditional cardiovascular risk factors are as predictive of the presence of angiographically-proven coronary artery disease (CAD) in elderly patients as in younger patients. Among the patients aged 65 years or more, there were 2120 cases and 193 controls, while for the patients aged 35-49 years there were 1493 cases and 707 controls. Odds ratios obtained from logistic regression indicated that age, male sex, diabetes, cigarette smoking, hypertension, total cholesterol and left ventricular hypertrophy were all significant risk factors for CAD in both age groups, although the odds ratios tended to be somewhat lower in the elderly. Logistic regression analysis for gender subgroups generally revealed similar findings when compared with the combined (males + females) age groups, although power was limited for the subgroup of elderly males which had few controls. We conclude that most of the traditional cardiovascular risk factors which have been described as correlated with the presence of CAD in younger populations are also correlated with angiographically-proven CAD in older patients.