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ARTICLE

Risk Factors for Coronary Heart Disease in Men 18 to 39 Years of Age

Elena L. Navas-Nacher, MS; Laura Colangelo, MS; Craig Beam, PhD; and Philip Greenland, MD

20 March 2001 | Volume 134 Issue 6 | Pages 433-439

Background: Few studies have evaluated the long-term predictive capacity of risk factors for death from coronary heart disease in men younger than 40 years of age.

Objective: To assess the predictive capacity and discriminatory ability of major coronary risk factors in predicting death from coronary heart disease in young men.

Design: Prospective cohort study with 20 years of follow-up.

Setting: 84 companies in the Chicago area that participated in the Chicago Heart Association Detection Project in Industry (1967–1973).

Participants: 11 016 men 18 to 39 years of age (mean age, 29.7 years) at baseline were the primary focus of this report; 8955 men 40 to 59 years of age at baseline served as a reference group.

Measurements: The main end point was death from coronary heart disease.

Results: All major risk factors—age, serum cholesterol level, systolic blood pressure, and cigarette smoking—were significantly associated with death from coronary heart disease over 20 years in young men. Relative risks for the major risk factors were of generally similar magnitude in young and middle-aged men. Receiver-operating characteristic curves for the best predictive model yielded an area under the curve of 0.82, indicating that standard risk factors were highly predictive of long-term outcome in young men.

Conclusions: Major coronary disease risk factors, many of which are modifiable, are strong contributors to prediction of future risk, even in young men. These data may help in formulating appropriate strategies to identify young men at heightened risk for death from coronary heart disease in later adulthood.

Author and Article Information

From Northwestern University Medical School, Chicago, Illinois; and Medical College of Wisconsin, Milwaukee, Wisconsin.

Acknowledgments: The authors thank the staff and volunteers at the Chicago Heart Association who assisted with this project and Sheila Kessler for bibliographic assistance and librarian support. A list of colleagues who contributed to this endeavor has been published elsewhere (14).

Grant Support: By grant HL21010 22 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.

Requests for Single Reprints: Philip Greenland, MD, Department of Preventive Medicine, Northwestern University Medical School, 680 North Lake Shore Drive, Suite 1102, Chicago, IL 60611.

Current Author Addresses: Ms. Navas-Nacher: 452 West Aldine Avenue, No. 408, Chicago, IL 60657.

Ms. Colangelo and Dr. Greenland: Department of Preventive Medicine, Northwestern University Medical School, 680 North Lake Shore Drive, Suite 1102, Chicago, IL 60611.

Dr. Beam: Department of Radiology, Cancer Center of the Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226.

Author Contributions: Conception and design: E.L. Navas-Nacher, L. Colangelo, C. Beam, P. Greenland.

Analysis and interpretation of the data: E.L. Navas-Nacher, L. Colangelo, C. Beam, P. Greenland.

Drafting of the article: E.L. Navas-Nacher.

Critical revision of the article for important intellectual content: E.L. Navas-Nacher, L. Colangelo, C. Beam, P. Greenland.

Final approval of the article: E.L. Navas-Nacher, L. Colangelo, C. Beam, P. Greenland.

Statistical expertise: E.L. Navas-Nacher, L. Colangelo, C. Beam.

Obtaining of funding: E.L. Navas-Nacher, P. Greenland.

Related articles in Annals:

Summaries for Patients
Risk Factors for Coronary Heart Disease in Young Men

Annals 2001 134: S88. [Full Text]  

Letters
Correction: Risk Factors for Coronary Heart Disease in Men 18 to 39 Years of Age

Annals 2001 135: 71. [Full Text]  

Letters
Long-Term Prediction of Coronary Heart Disease in Young Men
Apoor S. Gami, Victor M. Montori, AND Steven A. Smith

Annals 2002 136: 631. [Full Text]  

Letters
Long-Term Prediction of Coronary Heart Disease in Young Men
Philip Greenland AND Laura Colangelo

Annals 2002 136: 631-632. [Full Text]  

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