Background: Few studies have evaluated the long-term predictive capacity of
risk factors for death from coronary heart disease in men younger than 40
years of age.
Objective: To assess the predictive capacity and discriminatory ability of
major coronary risk factors in predicting death from coronary heart disease
in young men.
Design: Prospective cohort study with 20 years of follow-up.
Setting: 84 companies in the Chicago area that participated in the Chicago
Heart Association Detection Project in Industry (1967-1973).
Participants: 11 016 men 18 to 39 years of age (mean age, 29.7 years) at ba
seline were the primary focus of this report; 8955 men 40 to 59 years of ag
e at baseline served as a reference group.
Measurements: The main end point was death from coronary heart disease.
Results: All major risk factors-age, serum cholesterol level, systolic bloo
d pressure, and cigarette smoking-were significantly associated with death
from coronary heart disease over 20 years in young men. Relative risks for
the major risk factors were of generally similar magnitude in young and mid
dle-aged men. Receiver-operating characteristic curves for the best predict
ive model yielded an area under the curve of 0.82, indicating that standard
risk factors were highly predictive of long-term outcome in young men.
Conclusions: Major coronary disease risk factors, many of which are modifia
ble, are strong contributors to prediction of future risk, even in young me
n. These data may help in formulating appropriate strategies to identify yo
ung men at heightened risk for death from coronary heart disease in later a
dulthood.