Risk Factors for Coronary Heart Disease in Young Men

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The summary below is from the full report titled "Risk Factors for Coronary Heart Disease in Men 18 to 39 Years of Age." It is in the 20 March 2001 issue of Annals of Internal Medicine (volume 134, pages 433-439). The authors are EL Navas-Nacher, L Colangelo, C Beam, and P Greenland.

What is the problem and what is known about it so far?

Coronary heart disease (CHD) still causes more deaths in the United States than any other condition. Several things, such as high cholesterol level, high blood pressure, diabetes, smoking, and physical inactivity, may lead to CHD. We commonly call such things risk factors for CHD. We know that middle-aged people who have these risk factors are more likely to have CHD later in life than are middle-aged people who do not have these risk factors. Whether having the risk factors during young adulthood predicts later CHD has been less clear.

Why did the researchers do this particular study?

To see whether risk factors in young men predict later death from CHD.

Who was studied?

The study included 11,016 younger men (18 to 39 years of age) and 8955 middle-aged men (40 to 59 years of age). All were employees of companies located in the Chicago, Illinois, area. None of the men had diabetes.

How was the study done?

The men answered standard questions about their smoking and medical history. They were examined in a standard way: heart tracings (electrocardiograms) were obtained, weight and blood pressure were measured, and blood was taken for measurement of cholesterol, uric acid, and glucose. The researchers followed the men for 20 years. Local and national records were reviewed routinely to see how many of the men died and whether they died from CHD or some other cause. The researchers then looked at how closely the risk factors were related to death from CHD in younger and middle-aged men.

What did the researchers find?

Increasing age, higher cholesterol levels and blood pressure, and smoking were positively related to CHD deaths in both the younger and the middle-aged men. In general, the size or strength of the relationships appeared similar in both age groups. Abnormal electrocardiograms in middle-aged men were related to CHD deaths; this relationship was not clear in younger men.

What were the limitations of the study?

Some risk factors for CHD, such as diabetes and physical inactivity, were not examined. Women were not studied, and changes in risk factors over time were not evaluated. Finding positive associations between risk factors and death does not necessarily mean that changing or treating the risk factors will decrease deaths.

What are the implications of the study?

The presence of CHD risk factors in young adult men predicts subsequent CHD deaths.