Impact of Multiple Risk Factor Profiles on Determining Cardiovascular Disease Risk

Background.We examined the association between clustering of risk factors and the risk for coronary heart disease, stroke, and all-cause mortality. Methods.Data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study (N= 12,932) were used to estimate the relativ...

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Bibliographic Details
Published in:Preventive medicine 1998-01, Vol.27 (1), p.1-9
Main Authors: Yusuf, Hussain R., Giles, Wayne H., Croft, Janet B., Anda, Robert F., Casper, Michele L.
Format: Article
Language:English
Subjects:
Adult
Aged
cardiovascular disease
Cardiovascular Diseases - epidemiology
Cerebrovascular Disorders - epidemiology
Cerebrovascular Disorders - etiology
Cluster Analysis
Coronary Disease - epidemiology
Coronary Disease - etiology
coronary heart disease
epidemiology
Female
Follow-Up Studies
Humans
Hypertension - complications
Male
Middle Aged
morbidity
Mortality
Nutrition Surveys
Obesity - complications
Risk Factors
Smoking - adverse effects
stroke
United States - epidemiology
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Summary:Background.We examined the association between clustering of risk factors and the risk for coronary heart disease, stroke, and all-cause mortality. Methods.Data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study (N= 12,932) were used to estimate the relative risk for coronary heart disease (N= 2,255), stroke (N= 929), and death from any cause (N= 4,506) by the number of cardiovascular disease risk factors present. Risk factors included current smoking, overweight, hypertension, high blood cholesterol, and diabetes. Results.The proportions of respondents with 0, 1, 2, 3, or ≥4 risk factors were 25.0, 32.8, 27.8, 12.3, and 2.1%, respectively. Relative risks for coronary heart disease associated with having 1, 2, 3, and ≥4 risk factors were 1.6 (95% confidence interval [CI] 1.4,1.9), 2.2 (95% CI 1.9,2.6), 3.1 (95% CI 2.6,3.6), and 5.0 (95% CI 3.9,6.3), respectively. Relative risks for stroke associated with the same risk levels were 1.4 (95% CI 1.1,1.8), 1.9 (95% CI 1.5,2.4), 2.3 (95% CI 1.7,3.0), and 4.3 (95% CI 3.0,6.3), respectively. Similar results were observed for all-cause mortality. Conclusions.Risk for cardiovascular disease and all-cause mortality increased substantially with each additional risk factor. This supports the continued need for primary prevention of cardiovascular disease risk factors.
ISSN:0091-7435
1096-0260
DOI:10.1006/pmed.1997.0268