SERUM-ALBUMIN, CORONARY HEART-DISEASE RISK, AND MORTALITY IN AN ELDERLY COHORT

We investigated associations of serum albumin with the incidence and m ortality of coronary heart disease among men from the Zutphen Elderly Study. In 1985, 820 men were randomly selected from a population age 6 4-84 years and were followed for 5 years. We adjusted relative risks f or traditional risk factors (age, body mass index, diastolic blood pre ssure, total and high density lipoprotein cholesterol, smoking, and al cohol consumption) and also for baseline health status indicators (whi te blood cell count, physician's health score, self-rated health, and history of relevant diseases). Albumin was inversely associated with t he incidence of coronary heart disease only among men with elevated to tal cholesterol levels (greater than or equal to 6.5 mmol per liter). The relative risk for a 1-standard deviation increase (2.5 gm per lite r) in albumin was 0.60 [95% confidence interval (CI) = 0.38-0.96] and was not altered after additional adjustment for baseline health status . In all men, the relative risk for death due to coronary heart diseas e was 0.67 (95% CI = 0.49-0.92), and the relative risk was reduced to 0.84 (95% CI = 0.61-1.15) after adjustment for health status. We found comparable health status adjusted relative risks for mortality from c ardiovascular diseases (relative risk = 0.83; 95% CI = 0.67-1.02) and for mortality from all causes (relative risk = 0.86; 0.73-0.99). Indep endent of traditional risk factors, moderately low serum albumin is pr edictive of coronary heart disease and all-cause mortality in elderly men. Only part of this relation could be explained by baseline health status.