Cardiovascular risk factors, premature heart disease, and all-cause mortality in a cohort of northern California women.
Large prospective studies and intervention trials have identified major risk factors for premature heart disease in men, while the Framingham Heart Disease Study has provided the leading evidence of predictors of cardiovascular disease in women. We evaluated the role of these risk factors in a 13-year follow-up study of 8935 premenopausal and 2716 postmenopausal women in the Walnut Creek Contraceptive Drug Study cohort in Northern California. Elevated cholesterol levels, high blood pressure, smoking, obesity, family history of heart disease, and diabetes were investigated for their contribution to premature death due to all causes and due to cardiovascular disease. In addition, risk factor profiles were developed separately for users and nonusers of Premarin (conjugated estrogen) in the postmenopausal cohort. The results show that the strongest predictors of cardiovascular mortality among premenopausal women were smoking, high blood pressure, and diabetes, with relative risks of 2.8, 10.5, and 11.6, respectively. A disparity between high cardiovascular risk factor prevalence and low rates of premature heart disease indicates that the high relative risks will not be accompanied by large attributable risks. Nevertheless, the study reconfirms the need for screening women for heart disease risk because life-style changes can improve cardiovascular risk factors and can potentially reduce the chance of premature death even further.
Perlman
J A
JA
Contraceptive Evaluation Branch, National Institute of Child Health and Human Development, Bethesda, MD 20892.
Wolf
P H
PH
Ray
R
R
Lieberknecht
G
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002140:California; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000235:genetics / Q000401:mortality*; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D008593:Menopause / Q000097:blood; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D003278:Contraceptives, Oral, Hormonal; D002784:Cholesterol