Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations
CirculationPublished 28 September 1999Open access
Scott M. Grundy, Richard C. Pasternak, Philip Greenland, Sidney C. Smith, Valentı́n Fuster
Citations1,312
SJR quartileQ1
SJR score8.67
SNIP8.30
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The approaches described in this statement can be used for guidance at several levels of primary prevention; however, the statement does not attempt to specifically link risk assessment to treatment guidelines for particular risk factors, but provides critical background information that could be used in the development of new treatment guidelines.
Abstract
HomeCirculationVol. 100, No. 13Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations
Keywords
MedicineEconomics, Econometrics and Finance
JAMASummary of the Second Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II)
27,886 Citations1993Scott M. Grundy
Dairy therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD, and the fundamental approach to treatment is comparable.
New England Journal of MedicineThe Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus
24,537 Citations1993David M. Nathan
Intensive therapy effectively delays the onset and slows the progression of diabetic retinopathy, nephropathy, and neuropathy in patients with IDDM.
The LancetIntensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)
20,069 Citations1998
The effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
Medical Entomology and ZoologyThe Metabolic and Molecular Bases of Inherited Disease
12,176 Citations1995R Charles Scriver
The author revealed that within the next decade, the number of children born with autism in the United States will more than double from the current number of births, and the average age will increase from 7 to 11 years old.
CirculationPrediction of Coronary Heart Disease Using Risk Factor Categories
9,621 Citations1998Peter W.F. Wilson, Ralph B. D’Agostino +4 more
A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD.
New England Journal of MedicineThe Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels
7,491 Citations1996Frank M. Sacks, Marc A. Pfeffer +10 more
It is demonstrated that the benefit of cholesterol-lowering therapy extends to the majority of patients with coronary disease who have average cholesterol levels and was also greater in patients with higher pretreatment levels of LDL cholesterol.
New England Journal of MedicinePrevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia
7,453 Citations1995James Shepherd, Stuart M. Cobbe +6 more
Treatment with pravastatin significantly reduced the incidence of myocardial infarction and death from cardiovascular causes without adversely affecting the risk of death from noncardiovascular causes in men with moderate hypercholesterolemia and no history of my Cardiac Infarction.
New England Journal of MedicineMortality from Coronary Heart Disease in Subjects with Type 2 Diabetes and in Nondiabetic Subjects with and without Prior Myocardial Infarction
7,008 Citations1998Steven M. Haffner, Seppo Lehto +3 more
It is suggested that diabetic patients without previous myocardial infarction have as high a risk of myocardia infarctions as nondiabetic patients with previous my Cardiac Arrest.
Archives of Internal MedicineThe sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure
5,669 Citations1997
PsycEXTRA DatasetPhysical Activity and Health: A Report of the Surgeon General
5,511 Citations1995
This report is the first report of the Surgeon General on physical activity and health, and strong evidence is shown to indicate that regular physical activity will provide clear and substantial health gains.
New England Journal of MedicinePrevention of Cardiovascular Events and Death with Pravastatin in Patients with Coronary Heart Disease and a Broad Range of Initial Cholesterol Levels
5,299 Citations1998The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group
Pravastatin therapy reduced mortality from coronary heart disease and overall mortality, as compared with the rates in the placebo group, as well as the incidence of all prespecified cardiovascular events in patients with a history of myocardial infarction or unstable angina who had a broad range of initial cholesterol levels.
JAMAPrimary Prevention of Acute Coronary Events With Lovastatin in Men and Women With Average Cholesterol Levels
5,269 Citations1998John R. Downs, Michael Clearfield +8 more
Lovastatin reduces the risk for the first acute major coronary event in men and women with average TC and LDL-C levels and below-average HDL- C levels and supports the inclusion of HDL-C in risk-factor assessment and the need for reassessment of the National Cholesterol Program guidelines.
Diabetes CareInsulin Resistance: A Multifaceted Syndrome Responsible for NIDDM, Obesity, Hypertension, Dyslipidemia, and Atherosclerotic Cardiovascular Disease
4,552 Citations1991Ralph A. DeFronzo, Eleuterio Ferrannini
In summary, insulin resistance appears to be a syndrome that is associated with a clustering of metabolic disorders, including non-insulin-dependent diabetes mellitus, obesity, hypertension, lipid abnormalities, and atherosclerotic cardiovascular disease.
JAMADiabetes and cardiovascular disease. The Framingham study
3,983 Citations1979William B. Kannel
For each of the cardiovascular diseases (CVD), morbidity and mortality were higher for diabetic women than for nondiabetic men and for CVD death and CHF, it was greater for women.
PREVENTION OF CORONARY HEART DISEASE WITH PRAVASTATIN IN MEN WITH HYPERCHOLESTEROLEMIA
3,460 Citations1995J Ames S Hepherd, S Tuart M. C Obbe +7 more
New England Journal of MedicineBody Weight and Mortality among Women
1,989 Citations1995JoAnn E. Manson, Walter C. Willett +6 more
CirculationC-Reactive Protein, a Sensitive Marker of Inflammation, Predicts Future Risk of Coronary Heart Disease in Initially Healthy Middle-Aged Men
1,947 Citations1999Wolfgang Köenig, M. Sund +6 more
These results confirm the prognostic relevance of CRP, a sensitive systemic marker of inflammation, to the risk of CHD in a large, randomly selected cohort of initially healthy middle-aged men and suggest that low-grade inflammation is involved in pathogenesis of atherosclerosis, especially its thrombo-occlusive complications.
JAMAChanges in Physical Fitness and All-Cause Mortality
1,944 Citations1995Steven N. Blair
Men who maintained or improved adequate physical fitness were less likely to die from all causes and from cardiovascular disease during follow-up than persistently unfit men.
CirculationAn updated coronary risk profile. A statement for health professionals.
1,864 Citations1991Keaven M. Anderson, P W Wilson +2 more
Using a simple worksheet, a patient's 5- and 10-year CHD risks can be estimated using components of the profile selected because they are objective and strongly and independently related to CHD.
PubMedPlasma homocysteine as a risk factor for vascular disease. The European Concerted Action Project.
1,757 Citations1997Ian M. Graham, L E Daly +23 more
An increased plasma total homocysteine level confers an independent risk of vascular disease similar to that of smoking or hyperlipidemia, and compared with nonusers of vitamin supplements, the small number of subjects taking such vitamins appeared to have a substantially lower risk ofascular disease, a proportion of which was attributable to lower plasma homocy steine levels.
The LancetAntibodies to glutamic acid decarboxylase as predictors of insulin-dependent diabetes mellitus before clinical onset of disease
1,698 Citations1994J. Tuomilehto, Gabriele Vidgrén +8 more
Anti-GAD is a valuable early predictive marker and is associated with a very high risk for development of IDDM, and was measured in prediabetic sera from 151 women aged 20-39 years with newly diagnosed diabetes mellitus who had been identified through a nationwide diabetes register.
Diabetes CareCholesterol Lowering With Simvastatin Improves Prognosis of Diabetic Patients With Coronary Heart Disease: A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S)
1,639 Citations1997Kalevi Pyörälà, Terje R. Pedersen +5 more
It is suggested that cholesterol lowering with simvastatin improves the prognosis of diabetic patients with CHD and the absolute clinical benefit achieved by cholesterol lowering may be greater in diabetic than in nondiabetic patients withCHD because diabetic patients have a higher absolute risk of recurrent CHD events and other atherosclerotic events.
CirculationAtherogenic lipoprotein phenotype. A proposed genetic marker for coronary heart disease risk.
1,421 Citations1990M A Austin, Mary‐Claire King +2 more
The proposed genetic locus responsible for LDL subclass phenotypes also results in an atherogenic lipoprotein phenotype, found to be closely associated with variations in plasma levels of other lipid, lipop protein, and apolipoprotein measurements.
Current Atherosclerosis ReportsDiabetes and cardiovascular disease
1,390 Citations2000Barbara V. Howard, Michelle Magee
The impact of diabetes on CVD is examined, and LDL cholesterol and albuminuria should be the targets of preventive strategies, and promising new areas such as cytokines, growth factor, and the role of infection should be further explored.
CirculationDiabetes and cardiovascular risk factors: the Framingham study.
1,333 Citations1979W B Kannel, Dan McGee
The role of diabetes as a cardiovascular risk factor does not derive from an altered ability to contend with known risk factors and there is no indication that the relationship of risk factors to the subsequent development of cardiovascular disease is different for diabetics and non-diabetics.
JAMAIs Relationship Between Serum Cholesterol and Risk of Premature Death From Coronary Heart Disease Continuous and Graded?
1,297 Citations1986Jeremiah Stamler
The data of high precision show that the relationship between serum cholesterol and CHD is not a threshold one, with increased risk confined to the two highest quintiles, but rather is a continuously graded one that powerfully affects risk for the great majority of middle-aged American men.
AtherosclerosisPrevention of coronary heart disease in clinical practice: Recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention1European Society of Cardiology, European Atherosclerosis Society, European Society of Hypertension, International Society of Behavioural Medicine, European Society of General Practice/Family Medicine, European Heart Network.1,2Published simultaneously in the European Heart Journal 1998;19:1434–1503 and the Journal of Hypertension (Summary only) 1998;16(10).2
1,264 Citations1998David Wood, Guy De Backer +4 more
The Task Force has summarized the most important clinical issues on coronary heart disease prevention on which there is good agreement in order to give cardiologists and physicians, and other health care professionals, the best possible advice to facilitate their work on coronaryHeart disease prevention.
Diabetes CareDiabetes and Glucose Tolerance as Risk Factors for Cardiovascular Disease: The Framingham Study
1,206 Citations1979W B Kannel, Dan McGee
Present evidence suggests that alleviation of associated cardiovascular risk factors is the most promising course in reducing cardiovascular sequelae in diabetic patients.
European Heart JournalPrevention of coronary heart disease in clinical practice Recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention
1,126 Citations1998Second Joint Task Force of European
The American Journal of CardiologyHypertriglyceridemia as a Cardiovascular Risk Factor
1,073 Citations1998Melissa A. Austin, John E. Hokanson +1 more
Three recent prospective epidemiologic studies have shown that plasma triglyceride and low-density lipoprotein particle size predict subsequent coronary artery disease in Caucasian populations, demonstrating the importance of triglyceride levels as a risk factor for cardiovascular disease.
CirculationCardiovascular Events and Their Reduction With Pravastatin in Diabetic and Glucose-Intolerant Myocardial Infarction Survivors With Average Cholesterol Levels
991 Citations1998Ronald Goldberg, Margot J. Mellies +8 more
Diabetic patients and nondiabetic patients with impaired fasting glucose are at high risk of recurrent coronary events that can be substantially reduced by pravastatin treatment.
American Journal of EpidemiologyBody Size and Fat Distribution as Predictors of Coronary Heart Disease among Middle-aged and Older US Men
838 Citations1995Eric B. Rimm, Meir J. Stampfer +5 more
For younger men, obesity, independent offat distribution, is a strong risk factor for coronary heart disease, and for older men, measures of fat distribution may be better than body mass index at predicting risk of coronary disease.
JAMAAssociation of Small Low-Density Lipoprotein Particles With the Incidence of Coronary Artery Disease in Men and Women
830 Citations1996Christopher D. Gardner
Diabetes CareManagement of Dyslipidemia in Adults With Diabetes
796 Citations1998Steven M. Haffner
Reduction of LDL levels should take priority over reduction of triglycerides in combined hyperlipidemia because of the proven safety of the statin class of drugs as well as greater reduction in CHD incidence.
Journal of Clinical InvestigationRelationships of generalized and regional adiposity to insulin sensitivity in men.
762 Citations1995Nicola Abate, Anurag Garg +3 more
Subcutaneous truncal fat plays a major role in obesity-related insulin resistance in men, whereas intraperitoneal fat and retroperitoneAL fat have a lesser role.
Archives of Internal MedicineSome Health Benefits of Physical Activity
752 Citations1979William B. Kannel
Overall mortality and mortality due to cardiovascular and ischemic heart disease were inversely related to the level of physical activity for men and little correlation was noted between physical activity level (at the generally low level found) and thelevel of major risk factors.
CirculationSurvival of medically treated patients in the coronary artery surgery study (CASS) registry.
746 Citations1982Michael B. Mock, Ivar Ringqvist +11 more
Physical Activity, Fitness, and Health
742 Citations2012
Diabetes mellitus : a fundamental and clinical text
703 Citations2004Derek LeRoith, Simeon I. Taylor +1 more
This Third Edition encompasses the most recent advances in molecular and cellular research and describes the newest therapeutic modalities for type 1 and type 2 diabetes mellitus.
Arteriosclerosis and Thrombosis A Journal of Vascular BiologyPlasma triglyceride and coronary heart disease.
701 Citations1991M A Austin
Although the literature on epidemiological associations between plasma triglyceride and CHD is not completely consistent, trends do emerge from the studies described here, and important statistical properties must be taken into consideration in evaluating triglyceride as a risk factor for CHD.
New England Journal of MedicineIncreased Glucose Transport–Phosphorylation and Muscle Glycogen Synthesis after Exercise Training in Insulin-Resistant Subjects
692 Citations1996Gianluca Perseghin, Thomas B. Price +6 more
Exercise increases insulin sensitivity in both normal subjects and the insulin-resistant offspring of diabetic parents because of a twofold increase in insulin-stimulated glycogen synthesis in muscle, due to an increase in Diabetes mellitus-related glucose transport-phosphorylation.
Acta Medica ScandinavicaReduction of Mortality in the Stockholm Ischaemic Heart Disease Secondary Prevention Study by Combined Treatment with Clofibrate and Nicotinic Acid
689 Citations1988Lars A. Carlson, G. Rosenhamer
The fact that the decrease in IHD deaths was directly related to the degree of serum triglyceride lowering indicates that it was the drug effect on serum lipids that was responsible for the beneficial effect of the treatment.
American Heart JournalThe triglyceride issue: A view from Framingham
669 Citations1986William P. Castelli
Triglyceride elevations are a highly significant independent risk factor for coronary heart disease (CHD) in women and appear to be important in men with low high-density lipoprotein (HDL) cholesterol (less than 40 ml/dl).
CirculationSymposium on Research on Acute Myocardial Infarction
621 Citations1970Stuart Bondurant
The breadth of investigation of myocardial infarction has increased substantially, and a range of disciplines have been directed toward the problem, and particular areas that seemed to individual investigators to be most promising for further investigation are identified.
CirculationA Longitudinal Study of Coronary Heart Disease
619 Citations1963Oglesby Paul, Mark H. Lepper +5 more
No relation was encountered between body weight, mean blood sugar levels, lipoprotein lipase levels, or diet (other than coffee), and the development of coronary heart disease, and there was no association with job type and no certain relation to physical activity off the job.
CirculationPrimary Prevention of Coronary Heart Disease: Guidance From Framingham
613 Citations1998Scott M. Grundy, Gary Balady +13 more
Although Framingham data have already been influential in the development of national guidelines for risk factors management, the opportunity may exist for both cholesterol and blood pressure programs to draw more extensively from Framingham results when formulating improved risk assessment guidelines and recommending more specific strategies for risk factor modification.
CirculationLong-term survival of medically treated patients in the Coronary Artery Surgery Study (CASS) Registry.
556 Citations1994Mary J. Emond, Michael B. Mock +7 more
High myocardial jeopardy, high anginal class, and two or three proximal diseased vessels characterize the profile of patients most likely to have received surgical treatment during follow-up.
Preventive MedicineThe seven countries study: 2,289 deaths in 15 years
552 Citations1984Ancel Keys, Alessandro Menotti +16 more
Expectations for coronary death from the experience in the United States and northern Europe greatly exceeded observed deaths in southern Europe for men of their age, serum cholesterol, blood pressure, smoking habits, physical activity, and relative weight.
American Journal of EpidemiologyEPIDEMIOLOGIC STUDIES OF CORONARY HEART DISEASE AND STROKE IN JAPANESE MEN LIVING IN JAPAN, HAWAII AND CALIFORNIA
547 Citations1973Hiroo Kato, J Tillotson +3 more
CirculationCigarette Smoking, Cardiovascular Disease, and Stroke
540 Citations1997Ira S. Ockene, Nancy Houston Miller
The provision of smoking cessation advice is associated with a 50% long-term smoking cessation rate in patients who have been hospitalized with a coronary event, and even modest telephone-based counseling can increase this percentage to ≥70% in …
The American Journal of CardiologyHypertriglyceridemia, Atherogenic Dyslipidemia, and the Metabolic Syndrome
531 Citations1998Scott M. Grundy
The clinical approach to treatment of patients with hypertriglyceridemia requires a broad-based strategy that includes reduction of atherogenic triglyceride-rich lipoproteins, reversal of the lipid triad, and favorable modification of the metabolic syndrome.
Journal of the American College of CardiologyHomocysteine and coronary atherosclerosis
529 Citations1996Ellen Mayer, Donald W. Jacobsen +1 more
Clinical and basic scientific evidence supporting the risk and mechanisms of vascular disease associated with elevated homocysteine concentrations are presented as well as the results of preliminary therapeutic trials.
Journal of the American College of CardiologyThe effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: Contribution of both coronary disease and diastolic left ventricular dysfunction to the adverse prognosis
519 Citations1989Peter H. Stone, James E. Muller +10 more
The factors responsible for the increased incidence of adverse outcomes among diabetic patients may be related to an acceleration of the atherosclerotic process, diastolic left ventricular dysfunction associated with diabetic cardiomyopathy or other unidentified unfavorable processes.
JAMAA Prospective Study of Lipoprotein(a) and the Risk of Myocardial Infarction
499 Citations1993Paul M. Ridker
The data do not support the use of Lp(a) level as a screening tool to define cardiovascular risk among this population of predominantly middle-aged white men, and no evidence of association between Lp-a level and risk of future MI is found.
American Journal of EpidemiologyEPIDEMIOLOGIC STUDIES OF CORONARY HEART DISEASE AND STROKE IN JAPANESE MEN LIVING IN JAPAN, HAWAII AND CALIFORNIA: PREVALENCE OF CORONARY AND HYPERTENSIVE HEART DISEASE AND ASSOCIATED RISK FACTORS1
409 Citations1975Michael Marmot, S. Leonard Syme +4 more
At each blood pressure level and at each cholesterol level, the greater prevalence of CHD in California persisted, suggesting that conventional risk factors only partly explain the observed gradient in CHD.
American Heart JournalParental history is an independent risk factor for coronary artery disease: The Framingham Study
396 Citations1990Richard H. Myers, Dan K. Kiely +2 more
It is suggested that CAD among persons who are predicted to be at low risk by standard risk factors may have a substantial genetic component and that the risk associated with parental history may not be reduced by modification of these factors.
JAMAElevated Plasma Lipoprotein(a) and Coronary Heart Disease in Men Aged 55 Years and Younger
394 Citations1996Andrew G. Bostom
Elevated plasma Lp(a) is an independent risk factor for the development of premature CHD in men, comparable in magnitude and prevalence (ie, attributable risk) to a total cholesterol level of 6.2 mmol/L (240 mg/dL) or more, or an HDL level less than 0.3%.
Annals of Internal MedicineShort-Term Medical Benefits and Adverse Effects of Weight Loss
393 Citations1993F. Xavier Pi‐Sunyer
The Framingham study, a prospective, epidemiologic study of a typical American town, showed that blood pressure decreased with weight loss and an improvement in prevailing blood glucose levels is shown by a decrease in the levels of glycated hemoglobin.
Diabetes CareThe Dense LDL Phenotype: Association with plasma lipoprotein levels, visceral obesity, and hyperinsulinemia in men
329 Citations1996André Tchernof, Benoı̂t Lamarche +6 more
It appears that the high TG–low HDL cholesterol dyslipidemia frequently found in visceral obesity and in a hyperinsulinemic state is a strong correlate of the small dense LDL phenotype.
Journal of Clinical InvestigationPrognostic value of angiographic indices of coronary artery disease from the Coronary Artery Surgery Study (CASS).
320 Citations1983Ivar Ringqvist, Lloyd D. Fisher +12 more
The analysis shows that good prediction from angiographic data results from a combination of left ventricular function and arteriographic extent of disease, and prognostic value for survival without early elective surgery varies between 93 and 16% depending upon the values of these three indices.
Annals of Internal MedicineEpidemiological Studies of Cardiovascular Disease in a Total Community—Tecumseh, Michigan
314 Citations1965Frederick H. Epstein, LEON D. OSTRANDER +5 more
This work presents a meta-analysis of data on prevalence, incidence, and mortality of coronary heart disease in Europe over a 25-year period from 1997 to 2002 that shows clear trends in prevalence and mortality.
BMJSystematic underestimation of association between serum cholesterol concentration and ischaemic heart disease in observational studies: data from the BUPA study
306 Citations1994M R Law, Nicholas Wald +3 more
The association between serum cholesterol concentration and ischaemic heart disease is materially stronger than directly inferred from prospective studies and has important implications for the health benefit of achieving low cholesterol concentrations.
New England Journal of MedicineCigarette Smoking and Coronary Heart Disease
267 Citations1962Joseph T. Doyle, Thomas R. Dawber +3 more
With the exception of the reports from the Albany Cardiovascular Health Center and the Framingham Study, reliable information relating morbidity from coronary heart disease to the use of tobacco has not yet been published.
Archives of Internal MedicineExcess body weight. An underrecognized contributor to high blood cholesterol levels in white American men
264 Citations1993Margo A. Denke
Higher BMI was associated at all ages with higher plasma triglyceride level, lower HDL cholesterol level, and higher total and non-HDL cholesterol levels, and in young men, the higher total cholesterol level was reflected mainly in the LDL cholesterol level; in middle-aged and older men, in the non- HDL fraction.
PubMedFibrinogen and coronary heart disease--what does it mean?
260 Citations1998Gerd Assmann
The Prospective Cardiovascular Münster (PROCAM) study showed that fasting levels of triglycerides were an independent risk factor for CHD events, irrespective of serum levels of high density lipoprotein cholesterol (HDL-C) or low density cholesterol (LDL-L), and that individuals with potentially atherogenic lipid profiles should be managed initially through the introduction of lifestyle changes.
American Heart JournalInsulin resistance and compensatory hyperinsulinemia: Role in hypertension, dyslipidemia, and coronary heart disease
251 Citations1991Gerald M. Reaven
Evidence is summarized in support of the hypothesis that resistance to insulin-stimulated glucose uptake and hyperinsulinemia may play a central role in the cause and clinical course of patients with non-insulin-dependent diabetes mellitus, high blood pressure, abnormalities of lipoprotein metabolism, and coronary heart disease.
Journal of the American College of CardiologyEvaluation of C-reactive protein, an inflammatory marker, and infectious serology as risk factors for coronary artery disease and myocardial infarction
231 Citations1998Jeffrey L. Anderson, John F. Carlquist +3 more
CRP is elevated in patients with CAD and in those with MI (fourfold) and Infectious serology may be less predictive than previously suggested, but the cause of inflammation in CAD and MI deserves further study.
Journal of Chronic DiseasesPrevalence and incidence of coronary heart disease in strata of the labor force of a Chicago industrial corporation
228 Citations1960Jeremiah Stamler, Howard A. Lindberg +4 more
Coronary heart disease incidence rates are high in all strata of the middle-aged male population in the United States, with the exception that significantly lower rates were observed in the foreign-born than in the native-born.
American Journal of EpidemiologyEPIDEMIOLOGIC STUDIES OF CORONARY HEART DISEASE AND STROKE IN JAPANESE MEN LIVING IN JAPAN, HAWAII AND CALIFORNIA: MORTALITY1
222 Citations1975Robert M. Worth, Hiroo Kato +3 more
Stroke, coronary heart disease (CHD) and total mortality are evaluated from death certificates in enumerated cohorts of 45-64-year old Japanese men in Hiroshima and Nagasaki, in Homolulu, and in the San Francisco area.
AtherosclerosisLp(a) lipoprotein in cardiovascular disease
218 Citations1994Gösta Dahlén
The article summarizes the increased knowledge about the enigmatic Lp(a) lipoprotein and its clinical importance over the past 20 years and suggests that an autoimmune process might especially occur in individuals with inherited high Lp (a) levels and certain HLA class II genotypes, triggered by a concurrent infection.
CirculationGuide to Primary Prevention of Cardiovascular Diseases
213 Citations1997Scott M. Grundy, Gary Balady +13 more
The clinical and public health approaches to primary prevention are complementary and physicians can contribute to the public health approach through patient education.
Journal of Internal MedicinePlasma homocysteine in acute myocardial infarction: homocysteine‐lowering effect of folic acid
208 Citations1995F Landgren, Bo Israelsson +4 more
It is found that moderate hyperhomocysteinaemia is an independent risk factor for cardiovascular disease which may be causal and treatment with oral folic acid was effective in lowering homocysteine levels in patients with myocardial infarction.
American Heart JournalPhysical activity and physical demand on the job and risk of cardiovascular disease and death: The Framingham Study
206 Citations1986William B. Kannel, Albert J. Belanger +2 more
There is a clear trend of improved overall, cardiovascular, and coronary mortality with increased level of physical activity at all ages, including the elderly, and the mortality benefits apply both in those with and without intervening overt cardiovascular disease.
American Journal of EpidemiologyLEISURE TIME PHYSICAL ACTIVITY IN THE FRAMINGHAM OFFSPRING STUDY
190 Citations1989Andrew L. Dannenberg, Jacob B. Keller +2 more
Results substantiate previous reports of an inverse relation between physical activity levels and cardiovascular risk, and suggest seasonal variation in activity levels should be considered in future studies which explore the relation betweenPhysical activity and cardiovascular disease.
American Heart JournalEpidemiological assessment of the role of physical activity and fitness in development of cardiovascular disease
190 Citations1985William B. Kannel, Peter W.F. Wilson +1 more
98. Aspirin Myocardial infarction Study Research Group: A randomized controlled trial of persons recovered from myocardialinfarction.
Archives of Internal MedicineBody Mass Index and Body Girths as Predictors of Mortality in Black and White Women
188 Citations1992June Stevens
The failure of BMI and fat patterning to predict mortality in black women challenges previously held assumptions regarding the role of overweight in the higher mortality experienced by black women.
Archives of Internal MedicineExcess body weight. An under-recognized contributor to dyslipidemia in white American women
166 Citations1994M A Denke
For young women, excess body weight was associated with higher total, non-HDL and LDL-cholesterol levels, higher triglyceride levels, and lower HDL-ch cholesterol levels, while in older women, although similar differences in triglyceride Levels and HDL-Cholesterol levels were observed, excessBody weight wasassociated with smaller differences in total,Non-HDl, and LDL cholesterol.
American Journal of Kidney DiseasesDiabetes mellitus and coronary heart disease
165 Citations1998Peter W. Wilson
Data concerning the prevalence of diabetes mellitus and its impact on coronary heart disease (CHD) are reviewed, and the impact of coronary risk factors in diabetics is considered for glycemic control, arterial pressure, microalbuminuria, and lipids.
Journal of Clinical Laboratory AnalysisDevelopment of a new microparticle-enhanced turbidimetric assay for C-reactive protein with superior features in analytical sensitivity and dynamic range
164 Citations1998Shinichi Eda, Jörg Kaufmann +2 more
This new microparticle‐based CRP assay provides the accuracy and precision that are required to determine CRP at low concentrations where new clinical implications such as prognosis of cardiovascular diseases are envisaged and will additionally lead to a reduction in the number of repeated analyses, thus improving the efficiency of CRP determinations in clinical laboratories.
The American Journal of CardiologyDense low density lipoproteins and coronary artery disease
159 Citations1995Ronald M. Krauss
In vitro findings have indicated increased susceptibility of small, dense LDL to oxidative modification and relatively greater binding of these particles to arterial wall proteoglycans, and its presence may indicate the potential for benefit from specific therapeutic interventions.
Psychosomatic MedicineCynical hostility and cardiovascular reactivity during self-disclosure.
150 Citations1993Alan J. Christensen, Timothy W. Smith
Among subjects participating in the self‐disclosure discussion task, hostile individuals displayed significantly greater blood pressure reactivity compared with subjects low in hostility, support the psychophysiological reactivity model of hostility and health, and underscore the potential importance of social context in the psychosomatic process.
Archives of Internal MedicineExcess Body Weight
148 Citations1993Margo A. Denke
Higher BMI was associated at all ages with higher plasma triglyceride level, lower HDL cholesterol level, and higher total and non- HDL cholesterol levels; in young men, the higher total cholesterol level was reflected mainly in the LDL cholesterol level; in middle-aged and older men, in the non-HDL fraction.
CirculationPhysical activity and 23-year incidence of coronary heart disease morbidity and mortality among middle-aged men. The Honolulu Heart Program.
146 Citations1994Beatriz L. Rodríguez, J. David Curb +5 more
The results suggest that the impact of physical activity index on coronary heart disease is mediated through its effects on hypertension, diabetes, cholesterol, and body mass index and suggest that physical activity interventions in middle-aged men, by improving cardiovascular risk factor levels, may have significant public health implications in the prevention of coronaryHeart disease.
Arteriosclerosis Thrombosis and Vascular BiologyCoronary Artery Disease in IDDM
146 Citations1996Cathy E. Lloyd, Lewis H. Kuller +4 more
While 4-year incidence of CAD in IDDM varies little by sex in this population, the predictive risk factors vary considerably and the effect of renal disease was stronger in men, while the cluster of physical activity, waist-to-hip ratio, and depressive symptomatology were more important in women.
Diabetes CareRenal assessment practices and the effect of nurse case management of health maintenance organization patients with diabetes.
139 Citations1999Rishi Sikka, Jennifer A. Waters +4 more
A higher degree of adherence to recommendations for renal testing than has been reported previously is found and the inverse association between ACE inhibitor usage and microalbumin testing highlights a potentially ambiguous area of current clinical pathways.
The American Journal of CardiologyComparison of Factors Associated With 30-Day Mortality After Coronary Artery Bypass Grafting in Patients With Versus Without Diabetes Mellitus
136 Citations1998Yael Cohen, Itamar Raz +2 more
Differences in patterns of risk factors for post-CABG mortality between diabetics and nondiabetics were found, and left ventricular dysfunction was found to effect a greater risk among diabetic patients, whereas chronic renal failure was associated with greaterrisk among nondiabetic patients.
Journal of Clinical InvestigationRelationship between obesity and maximal insulin-stimulated glucose uptake in vivo and in vitro in Pima Indians.
133 Citations1984C. Bogardus, Stephen Lillioja +4 more
Arteriosclerosis Thrombosis and Vascular BiologyNo Association Between Plasma Lipoprotein(a) Concentrations and the Presence or Absence of Coronary Atherosclerosis in African-Americans
126 Citations1995David J. Moliterno, Eero Jokinen +6 more
The results suggest that the plasma concentration of Lp(a) is not an independent risk factor for coronary artery disease in African-Americans.
DiabetesIsolated Low HDL Cholesterol: An Insulin-Resistant State
119 Citations1994Pauli Karhapää, Mari Malkki +1 more
It is concluded that patients with low HDL cholesterol are insulin resistant independently of TG levels.
International Journal of EpidemiologyCoronary Risk in a British Punjabi Population: Comparative Profile of Non-Biochemical Factors
113 Citations1994Rory Williams, Raj Bhopal +1 more
There was evidence in support of three newer hypotheses for the high incidence of coronary heart disease (CHD), namely, insulin resistance, stress, and socioeconomic deprivation.
Clinical ChemistryResults of B-vitamin supplementation study used in a prediction model to define a reference range for plasma homocysteine
109 Citations1995Job Ubbink, Piet Becker +2 more
A mathematical prediction model is developed that can predict that plasma homocysteine concentrations will approach a normal frequency distribution with a 95% reference range (mean +/- 2 SD) of 4.9-11.7 mumol/L, provided the vitamin status of the study population is improved.
Biomedicine & PharmacotherapyPreventive Nutrition. The Comprehensive Guide for Health Professionals
108 Citations1997
American Journal of HypertensionMechanisms in Obesity-related Hypertension: Role of Insulin and Catecholamines
107 Citations1988Diane Krieger, Lewis Landsberg
The hypothesis presented here emphasizes the important role of diet in the treatment of obese hypertensive subjects and the efficacy of caloric restriction, weight loss, and exercise in reducing blood pressure in the obese is linked to diminished insulin and SNS activity and may be viewed as evidence in favor of this hypothesis.
Arteriosclerosis Thrombosis and Vascular BiologyVisceral Fat Accumulation Is an Important Determinant of PAI-1 Levels in Young, Nonobese Men and Women
88 Citations1998Erik J. Giltay, Jolanda M. H. Elbers +5 more
It is concluded that in young, nonobese men and women, visceral fat area is an important determinant of plasma PAI-1 levels, and after cross-sex hormone administration, this association was no longer demonstrable.
Cardiology ClinicsCIGARETTE SMOKING AND CORONARY HEART DISEASE
87 Citations1996Nancy A. Rigotti, Richard C. Pasternak
This article outlines a simple protocol that has been demonstrated to be effective for counseling smokers and dramatically increases the smoking-cessation rate of patients hospitalized with myocardial infarction and is highly cost effective.
The American Journal of CardiologyRelation between baseline lipid and lipoprotein values and the incidence of coronary heart disease in the Helsinki Heart Study
79 Citations1989Vesa Manninen, Jussi K. Huttunen +3 more
The Helsinki Heart Study results suggest that subjects with low HDL cholesterol and type IIB hyperlipoproteinemia (and possibly type IV hyperlipoinemia) would benefit from treatment with gemfibrozil.
CirculationGreater Incidence of Hospitalized Myocardial Infarction Among Mexican Americans Than Non-Hispanic Whites
79 Citations1997David C. Goff, Milton Z. Nichaman +4 more
This is the first report documenting greater incidence of hospitalized myocardial infarction among Mexican Americans than among non-Hispanic whites, a biologically plausible finding given the risk factor patterns observed in the Mexican-American population.
…