Age and follow-up time affect the prognostic value of the ECG and conventional cardiovascular risk factors for stroke in adult men.
OBJECTIVE
To explore whether the predictive power of mid-life ECG abnormalities and conventional cardiovascular risk factors for future stroke change over a 30-year follow-up period, and whether a repeated examination improves their predictive power.


METHODS
Longitudinal population-based study.


METHODS
2,322 men aged 50 years, with a follow-up period of 30 years. 1,221 subjects were re-examined at age 70 years


METHODS
Risk for fatal and non-fatal stroke during three decades of follow-up. Investigations included resting ECG and traditional cardiovascular risk factors.


RESULTS
When measured at age 50 years, ST segment depression and T wave abnormalities, together with ECG-left ventricular hypertrophy, were of importance only during the first 20 years, but regained importance when re-measured at age 70 years. Blood pressure was a significant predictor for stroke over all three decades of follow-up. In elderly people only, there is evidence that apolipoprotein A1 may protect from future stroke.


CONCLUSIONS
Mid-life values for blood pressure and ECG abnormalities retain their predictive value over long follow-up periods even though they improved in predictive power when re-measured in elderly people. Despite lower prevalence, ECG abnormalities had greater impact at age 50 years than at age 70 years. By contrast, apolipoprotein A1 was protective for future stroke only at age 70 years.
Möller
Christina Ström
CS
Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala Science Park, SE-751 85 Uppsala, Sweden. christina.strom_moller@pubcare.uu.se
Häggström
Jonas
J
Zethelius
Björn
B
Wiberg
Bernice
B
Sundström
Johan
J
Lind
Lars
L
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D013548:Sweden / Q000453:epidemiology
D001786:Blood Glucose; D007328:Insulin