Incidence of cardiovascular disease in older Americans: the cardiovascular health study.
OBJECTIVE
To estimate incidence rates of major cardiovascular disease (CVD) in older Americans.


METHODS
Longitudinal cohort study using prospectively collected data on cardiovascular events.


METHODS
Four U.S. communities in the Cardiovascular Health Study (CHS).


METHODS
Five thousand eight hundred eighty-eight participants in CHS, aged 65 or older at enrollment, including 3,393 women (581 African American) and 2,495 men (343 African American).


METHODS
At semiannual contacts, participants reported any occurrence of clinical CVD. Medical records were obtained and adjudicated to confirm diagnosis of CVD.


RESULTS
During 10 years of follow-up, incidence of coronary heart disease (CHD) per 1,000 person-years was 39.6 (95% confidence interval (CI)=36.4-43.1) in men and 22.3 (95% CI=20.4-24.2) in women. Cumulative event rates for CHD and myocardial infarction for women aged 75 and older at baseline were similar to those for men aged 65 to 74. The overall incidence of stroke was similar for men and women (14.7 (95% CI=13.0-16.6) and 13.7 (95% CI=12.4-15.1) per 1,000 person-years, respectively), but the risk of stroke increased with age more rapidly in women, resulting in a greater cumulative event rate for stroke in women than in men aged 75 and older. The incidence of congestive heart failure increased 9% with each year of age over 65 and was greater than 6% per year in Caucasian men and women aged 85 and older at baseline. Rates were similar in African Americans and Caucasians.


CONCLUSIONS
The occurrence of new CVD in older Americans is high, indicating that preventive efforts need to be maintained into older ages.
Arnold
Alice M
AM
Department of Biostatistics, University of Washington, Seattle, USA. arnolda@u.washington.edu <arnolda@u.washington.edu>
Psaty
Bruce M
BM
Kuller
Lewis H
LH
Burke
Gregory L
GL
Manolio
Teri A
TA
Fried
Linda P
LP
Robbins
John A
JA
Kronmal
Richard A
RA
D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000208:ethnology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D017678:Sex Distribution; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*