Short- and long-term prediction of clinical and subclinical atherosclerosis by traditional risk factors

This study compares the cross-sectional and longitudinal associations of ca rdiovascular risk factors with clinical coronary heart disease (CHD) and wi th subclinical carotid atherosclerosis measured by ultrasound. The study po pulation were 1410 participants in the Atherosclerotic Risk in Community (A RIC) Study (1987-1989) who also participated in a 1974 community hearth sur vey. Smoking in 1974 was associated with increased CHD prevalence in 1987-1 989 (adjusted prevalence ratio = 2.2), whereas the corresponding cross-sect ional association was practically absent. For hypercholesterolemia and hype rtension, the longitudinal associations with CHD were also stronger than th e cross sectional associations. In contrast, the strength of the longitudin al and cross sectional associations with carotid atherosclerosis was genera lly similar; These results underscore the advantages of using subclinical m easures of atherosclerosis in cross-sectional studies. In addition, they su ggest that the presence of smoking, hypertension, or hypercholesterolemia i n mid-adulthood may have some persisting effects on the development of athe rosclerotic disease in later life. (C) 1999 Elsevier Science Inc.