Related Experiment Videos
Methods of assessing prevalent cardiovascular disease in the Cardiovascular Health Study
B M Psaty1, L H Kuller, D Bild
1Department of Medicine, University of Washington, Seattle, USA.
Insights
This study assessed cardiovascular conditions in older adults using the Cardiovascular Health Study (CHS). Methods involved validating self-reported conditions against medical records and examinations, revealing common underreporting.
Area of Science:
- Cardiology
- Epidemiology
- Geriatrics
Background:
- Cardiovascular diseases are a leading cause of morbidity and mortality in older adults.
- Accurate assessment of cardiovascular conditions is crucial for understanding risk factors and disease progression.
- The Cardiovascular Health Study (CHS) is a major cohort study investigating coronary heart disease and stroke in the elderly.
Purpose of the Study:
- To describe the methodologies employed in the Cardiovascular Health Study (CHS) for assessing cardiovascular conditions in an elderly cohort.
- To evaluate the accuracy of self-reported cardiovascular conditions and identify potential underreporting.
- To establish a robust framework for epidemiological research on cardiovascular disease in older populations.
Main Methods:
- A representative sample of 5201 community-dwelling elderly individuals was recruited from four US communities.
- Standardized questionnaires and comprehensive clinic examinations were administered at baseline.
- Self-reported cardiovascular conditions were validated using baseline examination data, medical record reviews, or physician surveys.
Main Results:
- Confirmation rates for self-reported myocardial infarction were 75.5% in men and 60.6% in women.
- Confirmation rates for self-reported congestive heart failure were 73.3% in men and 76.6% in women.
- Confirmation rates for stroke were 59.6% in men and 53.8% in women; for transient ischemic attack, 41.5% in men and 37.0% in women.
- Prospective follow-up revealed significant underreporting, with 1-4% of investigated individuals found to have had pre-existing conditions.
Conclusions:
- Validation of self-reported cardiovascular conditions is essential due to varying confirmation rates.
- Underreporting of cardiovascular conditions is prevalent in older adults, necessitating careful assessment methods.
- The CHS methodology provides a reliable approach for studying cardiovascular disease risk factors and outcomes in elderly populations.
Abstract:
The objective of this article is to describe the methods of assessing cardiovascular conditions among older adults recruited to the Cardiovascular Health Study (CHS), a cohort study of risk factors for coronary disease and stroke. Medicare eligibility lists from four US communities were used to obtain a representative sample of 5201 community-dwelling elderly, who answered standardized questionnaires and underwent an extensive clinic examination at baseline. For each cardiovascular condition, self-reports were confirmed by components of the baseline examination or, if necessary, by a validation protocol that included either the review of medical records or surveys of treating physicians. Potential underreporting of a condition was detected either by the review of medical records at baseline for other self-reported conditions or, during prospective follow-up, by the investigation of potential incident events. For myocardial infarction, 75.5% of the self-reports in men and 60.6% in women were confirmed. Self-reported congestive heart failure was confirmed in 73.3% of men and 76.6% of women; stroke, in 59.6% of men and 53.8% of women; and transient ischemic attack, in 41.5% of men and 37.0% of women. Underreporting was also common. During prospective follow-up of an average of about 3 years per person, approximately 50% of men and 38% of women were hospitalized or investigated for at least one potential incident event; for each cardiovascular condition, about 1 to 4% of those investigated during prospective follow-up were found to have had the cardiovascular condition prior to entry into the cohort.(ABSTRACT TRUNCATED AT 250 WORDS)