THE WEST-POINT-STUDY - 40 YEARS OF FOLLOW-UP

Completion of cardiovascular evaluations of 387 members marked the end of 40 years of follow-up in the West Point Study. Coronary artery dis ease (CAD) caused 4 cases of sudden death, 14 cases of myocardial infa rction (MI), 13 cases of angina, and 17 cases of silent CAD. Using ris k factors (serum cholesterol, estimated HDL-cholesterol, systolic bloo d pressure, and smoking status) measured before age 28, we derived a m ultivariate regression formula for predicting which members of the stu dy, had they been pilots, would have been grounded far CAD before age 55. This derivation used data from only those subjects with CAD or wit h no evidence of CAD. We then used the formula to compute a risk-relat ed score for each member of the study. In the tertile group with the h ighest risk-related scores, 17% manifested CAD by age 55 and the first event occurred at age 39. In the tertile group of lowest scores, 2% e xperienced CAD by age 55 and the first event occurred at age 51. We co nclude that it is possible to select pilot candidates with the lowest risk for CAD.