Seven conventional risk factors explain 80–90% of coronary heart disease in the community — 21-year follow-up of the Copenhagen City heart study

P126 Objective: To assess characteristics and severity of coronary heart disease (CHD) predisposing to ischemic stroke, beyond conventional vascular risk factors. Methods: We prospectively followed up 3,122 patients with documented CHD included in a secondary prevention trial of lipid modification, the Bezafibrate Infarction Prevention trial. Patients had CHD documented by a history of myocardial infarction ≥6 months and <5 years before enrollment and/or stable angina pectoris confirmed by ancillary diagnostic testing, and a selected lipid profile. Patients with severe heart failure or unstable angina upon enrollment were excluded. Results: During a mean follow-up period of 8.2 years, 186 patients developed an ischemic stroke. The rate of ischemic stroke was 8.8% among patients with an active anginal syndrome[class ≥2 according to the Canadian Cardiovascular Society angina Classification, (CCSC)]vs. 5.1% in patients with a CCSC class of 1 (p<0.001). Patients with heart failure according to class ≥2 of the New York Heart Association classification had a 7.7% rate of ischemic stroke vs. 5.5% among patients with a class of 1 (no limitation of physical activity; p=0.03). In a Cox Proportional Hazard model adjusting for conventional risk factors, CCSC angina class ≥2 remained an independent predictor of ischemic stroke (Hazard ratio 1.43; 95%CI 1.05–1.96) and hospitalization for a confirmed diagnosis of unstable angina during follow-up conferred an additional independent increased risk (Hazard ratio 1.7; 95%CI 1.04–2.87). Hazard ratios of conventional risk factors, for comparison, where 1.49 for a 10 year age increment, 2.29 for diabetes mellitus, 1.75 for current smoking, 1.81 for peripheral vascular disease, and 1.14 for a 10 mmHg increase in systolic blood pressure. Conclusion: Active angina (CCSC class ≥2)and hospitalization for unstable angina during follow-up among CHD patients,confer an independent increased risk of ischemic stroke, beyond conventional vascular risk factors.

Download Full-text

Which Hemostatic Markers Add to the Predictive Value of Conventional Risk Factors for Coronary Heart Disease and Ischemic Stroke? The Caerphilly Study

Yearbook of Neurology and Neurosurgery ◽

10.1016/s0513-5117(08)70187-x ◽

2007 ◽

Vol 2007 ◽

pp. 272-273

Author(s):

G.J. Zipfel

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Ischemic Stroke ◽

Predictive Value ◽

Hemostatic Markers ◽

Conventional Risk Factors

Download Full-text

Impact of persistence and non-persistence in leisure time physical activity on coronary heart disease and all-cause mortality: The Copenhagen City Heart Study

European Journal of Preventive Cardiology ◽

10.1177/2047487317721021 ◽

2017 ◽

Vol 24 (15) ◽

pp. 1615-1623 ◽

Cited By ~ 19

Author(s):

Peter Schnohr ◽

James H O’Keefe ◽

Peter Lange ◽

Gorm Boje Jensen ◽

Jacob Louis Marott

Keyword(s):

Physical Activity ◽

Coronary Heart Disease ◽

Heart Disease ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Heart Study ◽

All Cause Mortality ◽

Copenhagen City Heart Study

Download Full-text

Comparability of risk factors for coronary heart disease among blacks and whites in the NHANES-I Epidemiologic follow-up study

Annals of Epidemiology ◽

10.1016/1047-2797(92)90008-e ◽

1992 ◽

Vol 2 (5) ◽

pp. 637-645 ◽

Cited By ~ 34

Author(s):

Richard S. Cooper ◽

Earl Ford

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Follow Up Study ◽

Blacks And Whites ◽

Nhanes I

Download Full-text

Abstract P323: Pulse Pressure and Incident Acute Coronary Heart Disease Events in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽

10.1161/circ.127.suppl_12.ap323 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Stephen P Glasser ◽

Daniel L Halberg ◽

Charles Sands ◽

Paul Muntner ◽

Monika Safford

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Racial Differences ◽

Pulse Pressure ◽

Proportional Hazards ◽

Linear Trend ◽

Cox Proportional Hazards ◽

Cvd Risk

Background: Increased attention has been given to pulse pressure (PP) as a potential independent risk factor of cardiovascular disease. We examined the relationship between PP and incident acute coronary heart disease (CHD). Methods: We used data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) national cohort study of 30,239 black and white participants aged 45 years or older and enrolled between 2003 and 2007. Baseline data included a 45-minute interview and in-home visit during which blood pressure was assessed and recorded as the average of two measurements obtained after a 5 minute seated rest. PP (SBP-DBP) was classified into 4 groups (<45, 45-54, 54.1-64, >64.1 mmHg). Telephone follow-up occurred every six months for self or proxy-reported suspected events, triggering medical record retrieval and adjudication by experts. Cox-proportional hazards models examined the association of incident CHD with PP groups, adjusting for socio-demographic and clinical risk factors. Results: This analysis included 22,909 participants free of CHD at baseline, with mean age 64.7±9.4 years; 40.4%were black, 44.6% were male and they experienced a total of 515 incident CHD events over a mean 3.4 yrs of follow-up (maximum 6 years). In unadjusted analyses, compared with PP<45 mmHg, each higher PP group had incrementally higher hazard ratios (HR) for incident CHD (HR 1.28 {95% CI 1.02-1.60}, 2.05 {1.63-2.56}, 3.82 {3.08-4.74}, p<0.001 for linear trend). This relationship persisted after fully adjusting including SBP for the highest PP group (HR 0.96 {0.75-1.21}, 1.12 {0.86-1.46}, 1.51 {1.09-2.10}, p trend <0.0001). Conclusions: High PP was associated with incident CHD, even when accounting for SBP and numerous other CVD risk factors.

Download Full-text