RISK-FACTORS OF CORONARY HEART-DISEASE AND TOTAL MORTALITY AMONG ELDERLY MEN WITH AND WITHOUT PREEXISTING CORONARY HEART-DISEASE - FINNISH COHORTS OF THE 7 COUNTRIES STUDY

Objectives. We attempted to determine whether elevated levels of the c lassic coronary heart disease risk factors are associated with increas ed coronary risk and all-cause mortality among elderly men with and wi thout coronary heart disease at baseline. Background. The strength of any association between the classic coronary risk factors and survival among elderly men with and without coronary heart disease has not bee n established. Methods. The classic coronary risk factor levels and ri sk of coronary events and total mortality during a 5-year follow-up in terval were studied among men aged 65 to 84 years. Coronary events wer e fatal myocardial infarction (n = 71), any myocardial infarction (n = 96) and, among the men without disease, other nonfatal coronary heart disease events (n = 80). Results. Among the 171 men with prevalent co ronary heart disease, significant (p < 0.05) risk factors for fatal my ocardial infarction (n = 42) in multivariate analyses were low high de nsity lipoprotein cholesterol (odds ratio [OR] 0.2, 95% confidence int erval [CI] 0.1 to 0.8 for 1-mmol/liter increase), high ratio of total to high density lipoprotein cholesterol (OR 1.4, 95% CI 1.1 to 1.7 for 1-U increase), and smoking more than nine cigarettes daily (OR 6.0, 9 5% CI 1.5 to 24.9 vs. values in men who had never smoked). Among the 4 76 men without prevalent coronary heart disease, only high serum total cholesterol was a risk factor for fatal myocardial infarction (n = 29 ) (OR 1.4, 95% CI 1.0 to 2.0 for 1-mmol/liter increase). Among men,vit h prevalent coronary heart disease, the only significant (p < 0.05) ri sk factor for total mortality was smoking more than nine cigarettes da ily (OR 3.9, 95% CI 1.1 to 13.4 vs. values among men who had never smo ked). Among men without prevalent coronary heart disease, only the use of antihypertensive medication (OR 2.0, 95% CI 1.2 to 3.3 between men with and without such medication) was a risk factor for total mortali ty. Conclusions. The classic risk factors for coronary heart disease a ppear to be of importance even in old age, especially among men with p revalent coronary heart disease. (J Am Coll Cardiol 1995;26:1623-9)