scholarly journals Coronary Heart Disease Risk in Blood or Marrow Transplant Survivors

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 17-18
Author(s):  
Radhika Gangaraju ◽  
Yanjun Chen ◽  
Lindsey Hageman ◽  
Jessica Wu ◽  
Liton F. Francisco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cumulative Incidence ◽  
Research Funding ◽  
Comparison Group ◽  
Marrow Transplant ◽  
Allogeneic Bmt ◽  
History Of ◽  
Male Sex

INTRODUCTION: Exposure to total body irradiation (TBI) increases the risk for cardiovascular risk factors (CVRFs) such as diabetes, hypertension and dyslipidemia in Blood or Marrow Transplant (BMT) survivors with the potential to increase the risk of post-BMT Coronary Heart Disease (CHD). Chest radiation is associated with accelerated atherosclerosis in conventionally treated patients. These factors, with or without additional factors such as smoking likely place BMT survivors at a high risk for CHD. Yet, a comprehensive evaluation of the risk of late-occurring CHD in BMT survivors is lacking. We addressed this gap using the resources offered by the BMT survivor study (BMTSS). METHODS: BMTSS includes patients transplanted between 1974 and 2014 at 3 US sites, and who had survived ≥2 years after BMT, and were alive and ≥18 years at BMTSS survey completion. The BMTSS survey asked participants to report chronic health conditions diagnosed by their healthcare provider (including CHD, diabetes, hypertension and dyslipidemia), along with age at diagnosis. The participants self-reported sociodemographics and health behaviors. Information regarding primary cancer diagnosis, therapeutic exposures, donor type, stem cell source, and history of chronic graft vs. host disease (GvHD; for allogeneic BMT recipients) was abstracted from medical records. A cohort of 1,131 siblings completed the BMTSS survey and served as a comparison group. We obtained informed consent from all participants. RESULTS: The study included 3,479 BMT survivors; 50.3% had received an allogeneic BMT, 54.8% were males, and 71.4% were non-Hispanic whites. Median age at study participation was 59 years (interquartile range [IQR]: 48-66 years) for BMT survivors and 57 years (IQR: 46-64 years) for siblings. BMT survivors were followed for a median of 9 years (range: 2-41 years) from BMT. CHD developed after BMT in 122 BMT survivors (52 allogeneic, 70 autologous). BMT recipients compared with siblings: After adjusting for sociodemographics and comorbidities, allogeneic BMT survivors were at a 7.2-fold higher odds (95%CI: 4.0-13.0, p<0.0001) and autologous BMT recipients at a 11.7-fold higher odds (95%CI: 6.8-20.2, p<0.0001) of reporting CHD as compared to siblings. Allogeneic BMT survivors: The 20 year cumulative incidence of CHD was 4.7% for allogeneic BMT recipients. Increasing age at BMT (HR=1.05/year, 95%CI: 1.02-1.07, p<0.0001), male sex (HR=2.09, 95%CI: 1.14-3.82, p=0.017), history of CVRFs (HR=3.6, 95%CI: 1.72-7.41, p=0.0006), and pre-BMT targeted chemotherapy such as tyrosine kinase inhibitors (HR=2.7, 95%CI: 1.10-6.77, p=0.030) were associated with increased CHD risk. The 20 year cumulative incidence of CHD among patients with CVRFs was 6.6% vs. 1.9% (p=0.005) among those who did not have CVRFs (Fig 1). Autologous BMT survivors: The 20 year cumulative incidence of CHD was 9.1% for autologous BMT recipients. The risk factors for CHD in autologous BMT survivors included: increasing age at BMT (HR=1.06/year, 95%CI: 1.03-1.09, p<0.0001), male sex (HR=2.3, 95%CI: 1.30-3.90, p=0.004), history of smoking (HR=1.66, 95%CI: 1.03-2.67, p=0.038), CVRFs (HR=1.77, 95%CI: 1.04-3.01, p=0.036), arrhythmia (HR=1.85, 95%CI: 1.01-3.42, p=0.048) and history of pre-BMT chest radiation (HR=4.56, 95%CI: 2.1-9.88, p=0.0001). For every 1 Gray increase in the dose of chest radiation, there was a 4% increase in the risk of CHD, p=0.0002. The 20 year cumulative incidence of CHD among patients with CVRFs was 10.2% vs. 7.4% among those who did not have CVRFs (p=0.04) (Fig 2). CONCLUSION: BMT survivors are at a 7-fold to 12-fold higher risk of CHD compared with a sibling comparison group. CVRFs are independent risk factors for CHD both among allogeneic and autologous BMT recipients. Pre-BMT chest radiation further increases this risk in autologous BMT recipients. These findings suggest a need for aggressive management of CVRFs in BMT recipients to prevent CHD-related morbidity. Disclosures Gangaraju: Sanofi Genzyme, Consultant for Cold Agglutinin Disease: Consultancy. Weisdorf:FATE Therapeutics: Consultancy; Incyte: Research Funding. Arora:Pharmacyclics: Research Funding; Kadmon: Research Funding; Syndax: Research Funding; Fate Therapeutics: Consultancy.

scholarly journals Coronary heart disease, hypertension and use of biomass fuel among women: comparative cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030881 ◽  
Author(s):  
Zafar Fatmi ◽  
Georgia Ntani ◽  
David Coggon
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Heart Attack ◽  
Comparison Group ◽  
Cross Sectional Study ◽  
Biomass Fuel ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of

ObjectivesTo explore the associations of hypertension and coronary heart disease (CHD) with use of biomass fuel for cooking.DesignComparative cross-sectional study.SettingRural villages in Sindh, Pakistan.ParticipantsWomen aged ≥40 years who had used biomass fuel for cooking for at least the last year (n=436), and a comparison group (n=414) who had cooked only with non-biomass fuel during the last year were recruited through door-to-door visits. None of those who were invited to take part declined.Primary and secondary outcome measuresHypertension was determined from blood pressure measurements and use of medication. CHD was assessed by three measures: history of angina (Rose angina questionnaire), previous history of ‘heart attack’, and definite or probable changes of CHD on ECG. Potentially confounding risk factors were ascertained by questionnaire and anthropometry. Associations of hypertension and CHD with use of biomass and other risk factors were assessed by logistic regression, and summarised by ORs with 95% CIs.ResultsAfter adjustment for potential confounders, there was no association of hypertension (OR: 1.0, 95% CI 0.8 to 1.4) angina (OR: 1.0, 95% CI 0.8 to 1.4), heart attack (OR: 1.2, 95% 0.7 to 2.2) or ECG changes of CHD (OR: 0.8, 95% CI 0.6 to 1.2) with current use of biomass for cooking. Nor were any associations apparent when analyses were restricted to long-term (≥10 years) users and non-users of biomass fuel.ConclusionsA linked air monitoring study indicated substantially higher airborne concentrations of fine particulate matter in kitchens where biomass was used for cooking. It is possible that associations with CHD and hypertension were missed because most of the comparison group had used biomass for cooking at some time in the past, and risk remains elevated for many years after last exposure.

scholarly journals Faktor Risiko Terjadinya Penyakit Jantung Koroner pada Pasien di Unit Rawat Jalan Rumah Sakit Panti Rapih Yogyakarta

2020 ◽  
Vol 1 (1) ◽  
pp. 21-30
Author(s):  
Deviana Widayanti ◽  
Chatarina Setya Widyastuti
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Family History ◽  
Disease Risk ◽  
Sampling Technique ◽  
Excess Body Weight ◽  
History Of ◽  
Lack Of Exercise

Background: Coronary Heart Disease (CHD) Is a condition when the arteries that supply blood to the heart wall experience hardening and narrowing. It is estimated that 30% of coronary heart disease causes death worldwide. Objective: This study aims to determine the risk factors for CHD in Panti Rapih Hospital. Methods: This descriptive study aims to determine the risk factors for CHD in outpatients at Panti Rapih Hospital. The population is patients who have been diagnosed with coronary heart disease and the sample was taken by 50 respondents with non-random accidental sampling technique. This research take the data use questionnaire and make univariat analysis. Results: Risk factors for CHD are a number of factors that cannot be changed: family history of 42%, age = 40 years 95% in men and 95% age = 65 years in women. Factors that can be changed are: Smoking 78%, history of hypertension 68%, history of diabetes mellitus 28%, dyslipidemic 90%, excess body weight42% and lack of exercise 38%. Conclusion: Risk factors for CHD that cannot be changed: family history of 42%, age = 40 years 95% in men and 95% age = 65 years in women. Factors that can be changed are: Smoking 78%, history of hypertension 68%, history of diabetes mellitus 28%, dyslipidemic 90%, excess body weight 42% and lack of exercise 38%.     Keywords: coronary heart disease, risk factors

Atrial Fibrillation in Patients with Chronic Lymphocytic Leukemia (CLL)

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2950-2950 ◽  
Author(s):  
Tait D. Shanafelt ◽  
Kari G. Chaffee ◽  
Timothy G. Call ◽  
Sameer A. Parikh ◽  
Susan M. Schwager ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Research Funding ◽  
Newly Diagnosed ◽  
Advisory Committees ◽  
Increased Risk ◽  
History Of ◽  
Male Sex

Abstract BACKGROUND: Consistent with the advanced age at diagnosis (median age ~70 years), most patients with CLL have co-existent health problems. These co-morbidities influence the ability of many CLL patients to tolerate aggressive chemotherapy-based treatment and can also contribute to treatment-related side effects. The recent development of novel signaling inhibitors, particularly the Bruton's tyrosine kinase inhibitor ibrutinib, has been a major treatment advance for patients with CLL. While these agents generally have favorable toxicity profiles relative to standard chemotherapy-based treatments, they are chronic therapies which patients typically stay on for an extended period. Preliminary data suggests ibrutinib may be associated with an increased risk of atrial fibrillation (Afib). In one randomized trial comparing ibrutinib to ofatumumab in patient with relapsed CLL, incident grade 3+ Afib occurred in 3% of ibrutinib treated patients compared to 0% of ofatumumab treated patients (NEJM 371:213). Despite these observations, the baseline frequency of Afib in patients with CLL is not well described - particularly incident atrial fibrillation acquired during the course of the disease. METHODS: We used the Mayo Clinic CLL database to evaluate the prevalence of Afib at the time of CLL diagnosis as well as the incidence of Afib during follow-up. All patients with a new diagnosis of CLL after January 1995 who were seen at Mayo within 12 months of diagnosis were included in the analysis. Afib was identified by chart review and by billing search using ICD9 codes. Data on co-morbid conditions associated with risk of Afib was also abstracted (e.g. hypertension, coronary artery disease [CAD], valvular heart disease, cardiomyopathy, diabetes mellitus, pulmonary disease). RESULTS: A total of 2444 patients with newly diagnosed and previously untreated CLL were seen at Mayo Clinic within 12 months of diagnosis between 1/1995 and 4/2015.Median age at diagnosis was 65 years and 1626 (66.5%) patients were men. A history of Afib was present at the time of CLL diagnosis in 148 (6.1%) patients. Four additional patients had Afib documented in the record but the precise date of onset (e.g. prior to or after CLL diagnosis date) could not be determined. Age, male sex and history of CAD, valvular heart disease, cardiomyopathy, hypertension, and diabetes were associated with a greater likelihood of having a history of Afib at the time of CLL diagnosis (all p<0.01). Among the 2292 patients without a history of Afib at CLL diagnosis, 139 (6.1%) had incident Afib during the course of follow-up for their CLL. The incidence of Afib among patients without a history of Afib at diagnosis was approximately 1%/year (Figure 1A). Considering both Afib present at the time of CLL diagnosis or acquired during the course of the disease, 291 (11.9%) of the 2444 patients in this cohort experienced Afib (median follow-up: 59 months). Among patients without Afib at the time of CLL diagnosis, the following characteristics at the time of CLL diagnosis were associated with an increased risk of incident Afib on multivariate analysis: older age (age 65-74 HR=2.4, p<0.001; age ≥75 HR=3.6, p<0.001), male sex (HR=1.8, p=0.004); valvular heart disease (HR=2.4, p=0.007), and hypertension (HR=1.5; p=0.02). A predictive model for acquired Afib was subsequently constructed based on the independent factors in the Cox regression model. An individual weighted risk score was assigned to each independent factor based on the regression coefficients of the HRs. The Afib risk score (range 0-7) was defined as the sum of the scores of these independent factors. The risk of incident Afib among patients with risk scores of 0-1, 2-3, 4, and 5+ is shown in Figure 1B. Rates for these 4 groups were significantly different (p<0.001), with the 10-year Afib rates (95% C.I.) for those with a score of 0-1, 2-3, 4, and 5+: 4% (2-6%), 9% (6-13%), 17% (11-23%), and 33% (20-43%), respectively. CONCLUSIONS: A history of Afib is present in approximately 1 out of every 16 patients with newly diagnosed CLL. Among patients without Afib at diagnosis, the incidence rate of Afib is ~1%/year. The risk of incident Afib in newly diagnosed CLL patients can be predicted based on age, sex, and co-morbid health conditions present at diagnosis. These data provide context to help interpret data on the frequency of Afib in CLL patients treated with ibrutinib and other novel agents. Disclosures Shanafelt: Janssen: Research Funding; Polyphenon E Int'l: Research Funding; Glaxo-Smith_Kline: Research Funding; Cephalon: Research Funding; Genentech: Research Funding; Hospira: Research Funding; Celgene: Research Funding; Pharmactckucs: Research Funding. Ding:Merek: Research Funding. Kay:Tolero Pharm: Research Funding; Hospira: Research Funding; Genentech: Research Funding; Pharmacyclics: Research Funding; Gilead: Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding.

scholarly journals Risk factors of coronary heart disease in children and young adults with parental history of premature coronary heart disease

2016 ◽  
Vol 43 (2) ◽  
pp. 51
Author(s):  
Murti Andriastuti ◽  
Sudigdo Sastroasmoro ◽  
Agus Firmansyah
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Young Adults ◽  
Heart Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Parental History ◽  
Passive Smoker ◽  
History Of ◽  
Children And Young Adults

Background Morbidity and mortality of coronary heart disease(CHD) are recently increasing. This is related to changes in lifestyle,such as lack of activity and high consumption of fatty diet. Themain cause of CHD is atherosclerosis. The development of ath-erosclerosis takes a long time, is asymptomatic, and might beginin childhood. The important risk factors that have roles in increas-ing the likelihood of atherosclerosis are family history of prematureCHD, hypertension, hyperlipidemia, obesity, smoking and irregu-lar activity.Objective The aim of this study was to find out the prevalence ofCHD risk factors in children and young adults who had parentalhistory of premature CHD.Methods This was a descriptive cross sectional study conductedon offspring of premature CHD patients who were admitted in theintensive cardiology care unit (ICCU) of Cipto MangunkusumoHospital between January 1999 to December 2001 and of prema-ture CHD patients who visited the Cardiology Clinic of the Depart-ment of Internal Medicine, Cipto Mangunkusumo Hospital duringMarch and April 2002. Subjects were aged 12 to 25 year-old.Results Among the subjects, 40% had hyperlipidemia, 8% hadhypertension, 11% were obese, 21% were active smokers, 41%were passive smokers, and 73% had irregular activity. Ninety-sevenpercents subjects had more than 1 risk factors.Conclusions The prevalence of hyperlipidemia, hypertension,obesity, passive smoker, active smoker and irregular activity inchildren and young adults with parental history of premature CHDin this study were higher than those in the normal population.Most had more than 1 risk factor, increasing the likelihood of CHD.A screening test should be performed on children with parentalhistory of premature CHD so that early preventive measures mightbe done to minimize the risk factors

scholarly journals Stroke Risk in Blood or Marrow Transplant (BMT) Survivors - a Report from the BMT Survivor Study (BMTSS)

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3298-3298
Author(s):  
Radhika Gangaraju ◽  
Yanjun Chen ◽  
Lindsey Hageman ◽  
Jessica Wu ◽  
Wendy Landier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Stroke Risk ◽  
Comparison Group ◽  
Lymphoblastic Leukemia ◽  
Late Complication ◽  
Primary Cancer ◽  
Allogeneic Bmt ◽  
Increased Risk ◽  
History Of

BACKGROUND: BMT recipients are vulnerable to accelerated atherosclerosis due to prior exposure to radiation with or without chemotherapy, and consequent long-term cardiovascular morbidity, such as stroke. A comprehensive evaluation of the risk of late-occurring stroke in adult BMT survivors and the associated risk factors has not been performed. We addressed this gap using the resources offered by the BMTSS. METHODS: BMTSS includes patients transplanted between 1974 and 2014 at 3 US sites who survived ≥2y after BMT, were alive and ≥18y at BMTSS survey completion. The survey asked participants to report if a healthcare provider had diagnosed specific chronic health conditions (including stroke), or relapse of primary cancer or development of new cancer, along with age at diagnosis. The participants provided information on sociodemographics, health behaviors and medication use. Medical record abstraction was used for information regarding primary cancer diagnosis, therapeutic exposures (pre-BMT chemotherapy/radiation, transplant preparative regimens), stem cell source (autologous, allogeneic), graft type (bone marrow, cord blood or peripheral blood stem cells), and history of chronic graft vs. host disease (GvHD). A cohort of 908 siblings also completed the BMTSS survey and served as a comparison group. Informed consent was obtained from all participants. RESULTS: The study included 3,479 BMT survivors; 50.3% had received an allogeneic BMT, 54.8% were males; 71.4% were non-Hispanic whites. Median age at study participation was 59y (range: 18-89y) for BMT survivors and 57y (range: 18-90y) for siblings. Patient characteristics are shown in Table 1. BMT survivors were followed for a median of 9y (range: 2-41 y) from BMT. Stroke was reported by 136 BMT survivors (67 allogeneic, 69 autologous); of these, 75 (55%) patients developed stroke ≥2y after BMT. Conditional on surviving ≥2y after BMT, the 10y cumulative incidence of stroke was 3.8% (Fig 1), and was comparable for allogeneic (3.4±0.5%) and autologous (4.2±0.6%) BMT recipients, p=0.3. Stroke in BMT recipients compared with siblings: Using logistic regression, and after adjusting for sociodemographics, physical activity and relevant comorbidities, we found that allogeneic BMT survivors were at a 2.1-fold higher odds of reporting stroke as compared to siblings (95%CI: 1.2-3.7, p=0.01), and autologous BMT recipients were at a 1.7-fold higher odds of reporting stroke compared to siblings (95%CI: 0.9-3.0, p=0.09). Stroke after Allogeneic BMT: History of hypertension (HR=2.2, 95%CI: 1.2-3.9, p=0.007), venous thromboembolism (HR=3.4, 95%CI: 1.6-7.1, p=0.002), diagnosis of acute lymphoblastic leukemia (HR=4.9, 95%CI: 1.6-15.0, p=0.006), acute myeloid leukemia/ myelodysplastic syndrome (HR=5.2, 95%CI: 1.4-19.0, p=0.013) (ref: non Hodgkin lymphoma), pre-BMT exposure to alkylating agents (HR=3.3, 95%CI: 1.3-8.5, p=0.01) and pre-BMT neck radiation (HR=5.4, 95%CI: 1.2-23.8, p=0.03) were associated with increased stroke risk. Exercise was associated with lower stroke risk (HR: 0.5, 95%CI: 0.3-0.9, p=0.01). Stroke after Autologous BMT: The risk factors for stroke in autologous BMT survivors included: increasing age at BMT (HR=1.02/y, 95%CI: 1.0-1.1, p=0.05), history of hypertension (HR=1.8, 95%CI: 1.1-3.2, p=0.03), coronary heart disease (HR=2.8, 95%CI: 1.3-6.4, p=0.01) and venous thromboembolism (HR=2.3, 95%CI: 1.1-4.7, p=0.02). Relapse of primary disease or development of new cancer were not associated with increased stroke risk in either autologous or allogeneic BMT recipients. CONCLUSION: In this large study, we found that the incidence of stroke was 4% among BMT survivors, and that they are at an increased risk of developing stroke when compared to an unaffected comparison group. The study also identified subgroups among BMT survivors at increased risk of stroke such as those who received neck radiation and those with cardiovascular comorbidity. These findings suggest a need for increased awareness of stroke as a late complication of BMT, such that aggressive management of cardiovascular risk factors can be instituted among those at highest risk. Disclosures Weisdorf: Incyte: Research Funding; Fate Therapeutics: Consultancy; Pharmacyclics: Consultancy.

scholarly journals Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors

2023 ◽  
Vol 83 ◽  
Author(s):  
R. Muzaffar ◽  
M. A. Khan ◽  
M. H. Mushtaq ◽  
M. Nasir ◽  
A. Khan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Logistic Regression ◽  
Risk Factor ◽  
Heart Disease ◽  
Independent Risk Factor ◽  
Plasma Homocysteine ◽  
History Of ◽  
The Mean ◽  
Conventional Risk Factors

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.

scholarly journals High carbohydrate intake increases risk of coronary heart disease in adults: a prospective cohort study

2019 ◽  
Vol 38 (2) ◽  
pp. 90
Author(s):  
Sulistyowati Tuminah Darjoko ◽  
Tri Wahyuningsih ◽  
Sudikno Sudikno
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Total Energy ◽  
Carbohydrate Intake ◽  
Health Examination ◽  
Chd Risk ◽  
History Of ◽  
Chd Risk Factors

Background<br />Coronary heart disease (CHD) ranks second after diabetes mellitus (DM) based on hazard rate, and after stroke (based on number of deaths caused). Our aim was to determine the risk factor and magnitude of CHD among adults. <br /><br />Methods <br />A cohort study on risk factors of non-communicable diseases (CS-RFNCD) was conducted on subjects aged ≥25 years. Initiated by screening, follow-up (FU) was done 3 times yearly and complete health examination every 2 years. CHD cases screened by electrocardiographic examination on subjects aged ≥40 years and &lt;40 years with history of hypertension and/or heart disease. Screening results found 840 of 5690 subjects with CHD diagnosis who were excluded from cohort study sample. Non-CHD subjects and those aged &lt;40 years without a history of hypertension and/or heart disease, totalling 4840 people, were included in study sample and followed up for 6 years. Data were analyzed using Cox regression.<br /><br />Results<br />Carbohydrate intake of ≥60% of total energy had a 2.8-fold higher CHD risk [HR=2.790; 95% CI: 1.962 - 3.967; p=0.000] than that of an intake of &lt;60% of total energy. Age of ≥55 years had 2.6-fold higher CHD risk [HR=2.573; 95% CI: 1.803 - 3.671; p=0.000] than age of &lt;55 years. Blood total cholesterol of <span style="text-decoration: underline;">≥</span>200 mg/dL had 1.9-fold higher CHD risk [HR=1.893; 95% CI: 1.319 - 2.715; p=0.001] than that of &lt;200 mg/dL.<br /><br />Conclusion<br />Higher intake of carbohydrate increases CHD incidence among adults. Efforts in controlling CHD risk factors are still needed especially in consumption behavior through a family approach.

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