Objectives: We attempted to determine whether elevated levels of the classic coronary heart disease risk factors are associated with increased coronary risk and all-cause mortality among elderly men with and without coronary heart disease at baseline.
Background: The strength of any association between the classic coronary risk factors and survival among elderly men with and without coronary heart disease has not been established.
Methods: The classic coronary risk factor levels and risk of coronary events and total mortality during a 5-year follow-up interval were studied among men aged 65 to 84 years. Coronary events were fatal myocardial infarction (n = 71), any myocardial infarction (n = 96) and, among the men without disease, other nonfatal coronary heart disease events (n = 80).
Results: Among the 171 men with prevalent coronary heart disease, significant (p < 0.05) risk factors for fatal myocardial infarction (n = 42) in multivariate analyses were low high density lipoprotein cholesterol (odds ratio [OR] 0.2, 95% confidence interval [CI] 0.1 to 0.8 for 1-mmol/liter increase), high ratio of total to high density lipoprotein cholesterol (OR 1.4, 95% CI 1.1 to 1.7 for 1-U increase), and smoking more than nine cigarettes daily (OR 6.0, 95% CI 1.5 to 24.9 vs. values in men who had never smoked). Among the 476 men without prevalent coronary heart disease, only high serum total cholesterol was a risk factor for fatal myocardial infarction (n = 29) (OR 1.4, 95% CI 1.0 to 2.0 for 1-mmol/liter increase). Among men with prevalent coronary heart disease, the only significant (p < 0.05) risk factor for total mortality was smoking more than nine cigarettes daily (OR 3.9, 95% CI 1.1 to 13.4 vs. values among men who had never smoked). Among men without prevalent coronary heart disease, only the use of antihypertensive medication (OR 2.0, 95% CI 1.2 to 3.3 between men with and without such medication) was a risk factor for total mortality.
Conclusions: The classic risk factors for coronary heart disease appear to be of importance even in old age, especially among men with prevalent coronary heart disease.