Metabolic risk factors for cardiovascular disease in a working population: a retrospective cohort study.
Risk factors for cardiovascular disease (CVD) appear to cluster in individuals, possibly because of a single, underlying metabolic disorder. We describe the prevalence of metabolic risk factors for CVD in a young working population and the tendency for individuals with some risk factors to acquire additional factors. This was a retrospective three-year follow-up study of baseline CVD risk factors assessing (1) incidence of risk factors and (2) fatal CVD. The study group consisted of 9,747 Eastman Kodak employees, who participated in a worksite-based cardiovascular screening program in Rochester, New York, which included a medical history, physical examination, and laboratory evaluation. Abnormal metabolic risk factors were defined as (1) an abnormal glucose value (fasting blood sugar greater than 115 mg/dl); (2) abnormal lipids (high-density lipoprotein cholesterol under 35 mg/dl in men or under 45 mg/dl in women; or low-density lipoproteins of 160 or greater; or triglycerides greater than 250 mg/dl), and (3) hypertension (blood pressure systolic above 160 mmHg; or diastolic above 90 mmHg). Subjects were classified as having none, one, two, or all three risk factors. Prevalence of single risk factors were: hypertension 9.8%, abnormal lipids 22.6%, and abnormal glucose 1.5%. Combinations of two risk factors were greater than expected by chance (p < 0.01). Individuals who started with one or more abnormal values tended to have an increased risk of developing others. The highest relative risk (RR) was for those with hypertension and a later diagnosis of abnormal glucose (RR 2.0; 95% CI = 0.87, 4.58). Seven employees of 4,263 with at least one risk factor died of CVD, compared with one of 5,484 employees with no factors (RR 9.0, 95% CI = 1.1, 73.2). In conclusion, this study suggests that young working individuals with CVD risk factors may continue to acquire additional factors. This clustering could be an indication of an underlying metabolic disorder and identify individuals at risk for negative CVD sequelae.
Gumbiner
B
B
University of Rochester, NY 14620, USA.
Andresen
E M
EM
Hearne
F T
FT
Michaelson
T E
TE
Bryson
M
M
Lednar
W M
WM
Cass
R
R
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
D001786:Blood Glucose; D008055:Lipids