Arthritis as a risk factor for incident coronary heart disease in elderly Japanese-American males - the Honolulu Heart Program.
BACKGROUND
Arthritis is the most common chronic disease in the elderly. Studies show that rheumatoid arthritis is a risk factor for cardiovascular morbidity and mortality, and osteoarthritis is associated with an unfavorable cardiovascular risk factor profile.


METHODS
At the Honolulu Heart Program's fourth examination in 1991 to 1993, arthritis status was assessed among a cohort of 3741 Japanese-American males, ages 71 to 93 years. Arthritis was determined by self-report of physician diagnosis, and subjects were divided into two groups: current arthritis and no current arthritis. Eight years of follow-up data are available for incident coronary heart disease (CHD) in 2777 subjects free of CHD at baseline. Age-adjusted rates of incident CHD and means of cardiovascular risk factors were compared in each group. Cox proportional hazards models were used to calculate relative risks, adjusting for common cardiovascular risk factors, alcohol, and use of aspirin or NSAIDs, or both.


RESULTS
There were 279 cases of incident CHD in the cohort over 8 years; in those with arthritis, 11.7% developed incident CHD, compared to 9.8% in those without arthritis (p = 0.24). Age-adjusted rates of incident CHD in those with and without arthritis were 20.5 and 18.0 per 1000 person-years, respectively (p = 0.25). Arthritis was not significantly associated with CHD risk factors. Arthritis was not a significant independent predictor of incident CHD (relative risk, 1.06; 95% CI, 0.74 to 1.51).


CONCLUSIONS
Arthritis, and most probably osteoarthritis, may not be associated with most CHD risk factors or 8-year incident CHD in elderly Japanese-American males.
Kishimoto
Mitsumasa
M
Division of Rheumatology, NYU School of Medicine, New York, NY, USA. kishimotomitsumasa@yahoo.co.jp
Greenberg
Jeffrey
J
Lee
Ryan
R
Masaki
Kamal H
KH
Chen
Randi
R
Rodriguez
Beatriz L
BL
Blanchette
Patricia
P
Pillinger
Michael
M
David Curb
J
J
D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000150:complications* / Q000208:ethnology; D001213:Asian / Q000706:statistics & numerical data*; D003327:Coronary Disease / Q000208:ethnology / Q000209:etiology*; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors