Background-The objective of this study was to examine the association of Joint National Committee (JNC-V) blood pressure and National Cholesterol Education Program (NCEP) cholesterol categories with coronary heart disease (CHD) risk, to incorporate them into coronary prediction algorithms, and to compare the discrimination properties of this approach with other noncategorical prediction functions. Methods and Results-This work was designed as a prospective, single-center study in the setting of a community-based cohort. The patients were 2489 men and 2856 women 30 to 74 years old at baseline with 12 years of follow-up. During the 12 years of follow-up, a total of 383 men and 227 women developed CHD, which was significantly associated with categories of blood pressure, total cholesterol, LDL cholesterol, and HDL cholesterol (all PϽ.001). Sex-specific prediction equations were formulated to predict CHD risk according to age, diabetes, smoking, JNC-V blood pressure categories, and NCEP total cholesterol and LDL cholesterol categories. The accuracy of this categorical approach was found to be comparable to CHD prediction when the continuous variables themselves were used. After adjustment for other factors, Ϸ28% of CHD events in men and 29% in women were attributable to blood pressure levels that exceeded high normal (Ն130/85). The corresponding multivariable-adjusted attributable risk percent associated with elevated total cholesterol (Ն200 mg/dL) was 27% in men and 34% in women. Conclusions-Recommended guidelines of blood pressure, total cholesterol, and LDL cholesterol effectively predict CHD risk in a middle-aged white population sample. A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD.

No abstract

An increased plasma homocysteine level is a strong, independent risk factor for the development of dementia and Alzheimer's disease.

Background-Cardiovascular disease (CVD) is the leading cause of death in the United States and is responsible for 17%of national health expenditures. As the population ages, these costs are expected to increase substantially. Methods and Results-To prepare for future cardiovascular care needs, the American Heart Association developed methodology to project future costs of care for hypertension, coronary heart disease, heart failure, stroke, and all other

No abstract