Ingar Holme1, Serena Tonstad. 1. Klinikk for forebyggende medisin, Senter for preventiv kardiologi, Oslo universitetssykehus, Ullevål, Norway. Ingar.holme@uus.no
Abstract
BACKGROUND: We have investigated the significance of a single measurement of risk factors for cardiovascular disease and total mortality for different time periods. MATERIAL AND METHODS: The 14 846 men (without disease) who were screened in the Oslo Health Study in 1972-73 have been followed for 33 years. Cox and logistic regression analyses were used to estimate associations between risk factors and mortality for the four time periods 0-12, 12-24, 24-33 and 0-33 years. The predictivity of Westlund's score was compared to risk score functions based on three classical and some other risk factors. RESULTS: In a multivariate analysis the following there factors were the best predictors of total mortality in the period 0-12 years: total cholesterol, blood pressure and smoking. Triglycerides, glucose, body mass index, physical activity at work and little physical activity at leisure were more weakly, but consistently associated with mortality. With longer follow-up, predictivity decreased for total cholesterol and blood pressure in contrast to smoking (hazard ratio 1.41; 95% confidence interval 1.38-1.45), which also was the best discriminator between survival and death. Westlund's score performed worse than the 3-factor score. Use of a score based on eight factors did not result in a clinically significant increase in predictivity. INTERPRETATION: The classical risk factors predicted mortality over all follow-up periods. Smoking was the most important discriminator between survival and death. The 3- factor score resulted in adequate predictivity in comparison with the 8-factor score.
BACKGROUND: We have investigated the significance of a single measurement of risk factors for cardiovascular disease and total mortality for different time periods. MATERIAL AND METHODS: The 14 846 men (without disease) who were screened in the Oslo Health Study in 1972-73 have been followed for 33 years. Cox and logistic regression analyses were used to estimate associations between risk factors and mortality for the four time periods 0-12, 12-24, 24-33 and 0-33 years. The predictivity of Westlund's score was compared to risk score functions based on three classical and some other risk factors. RESULTS: In a multivariate analysis the following there factors were the best predictors of total mortality in the period 0-12 years: total cholesterol, blood pressure and smoking. Triglycerides, glucose, body mass index, physical activity at work and little physical activity at leisure were more weakly, but consistently associated with mortality. With longer follow-up, predictivity decreased for total cholesterol and blood pressure in contrast to smoking (hazard ratio 1.41; 95% confidence interval 1.38-1.45), which also was the best discriminator between survival and death. Westlund's score performed worse than the 3-factor score. Use of a score based on eight factors did not result in a clinically significant increase in predictivity. INTERPRETATION: The classical risk factors predicted mortality over all follow-up periods. Smoking was the most important discriminator between survival and death. The 3- factor score resulted in adequate predictivity in comparison with the 8-factor score.