[A nested case-control study of risk factors for circulatory disease--correlation of initial medical examination findings with mortality and their progression]
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1Institute of Health Sciences, School of Medicine, Hiroshima University.
Insights
This study on cerebrovascular disease (CVD) and heart disease (HD) found high blood pressure and ECG abnormalities are key risk factors. Tracking changes over time, especially ECG abnormalities, is crucial for managing circulatory disease risk.
Area of Science:
- Cardiovascular epidemiology
- Public health research
- Longitudinal cohort studies
Context:
- Prospective study of 2112 individuals aged 30-59 in Nishi-izu, Shizuoka Prefecture.
- Baseline examinations conducted 1964-1966, with follow-up until 1985.
- Identified 93 cerebrovascular disease (CVD) and 64 heart disease (HD) cases.
Purpose:
- To identify risk factors for CVD and HD.
- To compare risk variables at last examination and their progression over time.
- To assess the utility of serial health examinations for circulatory disease management.
Summary:
- A nested case-control design compared risk variables in 157 cases (CVD/HD) with 314 matched controls.
- Significant cross-sectional risk factors for CVD included high blood pressure and ECG abnormalities.
- Significant cross-sectional risk factors for HD included ocular fundus changes and ECG abnormalities.
- Progression analysis revealed ECG abnormalities as the most significant risk variable for both CVD and HD.
Impact:
- Highlights the importance of monitoring blood pressure and ECG findings for CVD risk.
- Emphasizes the value of serial health examinations in identifying and managing HD risk factors, including ocular changes.
- Suggests that tracking the progression of health findings provides valuable insights for public health management of circulatory diseases.
Abstract:
Risk factors for cerebrovascular disease (CVD) and heart disease (HD) were studied prospectively in 2112 men and women, aged 30-59, initially without history of either disease, living in the Nishi-izu district of Shizuoka Prefecture. Baseline medical examinations were performed in 1964-1966 and subjects were followed until 1985. There were 93 CVD cases and 64 HD cases identified by death certificate during the follow-up period. Using a nested case-control design, risk variables at the last medical examination before death of the 157 cases (93 CVD cases and 64 HD cases) were compared to examination results of 314 controls (survivors) matched for gender, age (+/- 2 years), and residential district. Using the same design, the progression of risk variables over the 5 +/- 1 years prior to the last examination was followed to identify factors associated with circulatory disease. From conditional logistic regression analysis using findings at the last health examination, significant risk variables for CVD were found to be high blood pressure and abnormality in electrocardiogram (ECG), while risk variables for HD were hypertensive or arteriosclerotic changes in ocular fundus, and ECG abnormalities. From the same multivariate analysis using the progression of findings, the most significant risk variable for either CVD or HD was abnormalities in ECG. The present study suggests that in addition to cross-sectional findings on a given occasion, following the progression of findings through serial health examinations yields useful information for management of the health of residents.