CORONARY HEART-DISEASE RISK-FACTORS IN MEN AND WOMEN AGED 60 YEARS AND OLDER - FINDINGS FROM THE SYSTOLIC HYPERTENSION IN THE ELDERLY PROGRAM

Background Coronary heart disease (CHD) is the most common cause of de ath in men and women aged 60 years and older. Although a number of stu dies support the concept that CHD risk factors that have been defined in younger adults are significantly associated with CHD events in olde r adults, others do not support this thesis, and further definition of the risk-factor concept in older adults is required. Methods and Resu lts The Systolic Hypertension in the Elderly Program recruited 4736 pe rsons (mean age, 72 years); 14% were black, and 43% were men. Mean sys tolic and diastolic blood pressures were 170 and 77 mm Hg, respectivel y. About 13% of participants were current smokers. 10% had a history o f diabetes; 5%, a prior myocardial infarction; 5%, angina pectoris, 2. 3%, intermittent claudication; and 7%; a carotid bruit. Mean total cho lesterol value was 6.11 mmol/L. Mean follow-up was 4.5 years. In multi variate Cox regression analyses for CHD. variables that were significa nt were baseline total cholesterol value, smoking, history of diabetes , presence of carotid bruit, and treatment group in the trial. Active treatment yielded a 27% reduction in CHD risk. For each 1.03 mmol/L in crease in total cholesterol value, there was an increase in risk of ab out 20%. Current smokers had a 73% increase, diabetics a 121% increase , and those with carotid bruit a 113% increase in CHD risk. Conclusion s The results of this study support the concept that CHD risk factors are important in older men and women with isolated systolic hypertensi on.