The impact of cardiovascular risk factors on the age-related excess risk of coronary heart disease

Asia Pacific Cohort Studies Collaboration (2006) The impact of cardiovascular risk factors on the age-related excess risk of coronary heart disease. Int J Epidemiol 35:1025-1033

PURPOSE: Differences in cardiovascular risk factor levels have been suggested to contribute to the age-related excess risk of coronary heart disease (CHD). The aim of this study was to reliably quantify these contributions using a large prospective dataset. METHODS: We carried out an individual participant data meta-analysis of 41 cohort studies (n = 582,134) from Asia, and Australia and New Zealand. Cox models were used to estimate hazard ratios for coronary death, comparing individuals aged 55-64, 65-74, and >or=5 yrs with those aged <55 yrs.="" adjustments="" were="" made="" for="" coronary="" risk="" factors="" to="" quantify="" their="" contributions="" to="" the="" age="" differential.="" results:="" during="" 4.1="" million="" person-years="" of="" follow-up,="" there="" were="" 2,915="" deaths="" from="" chd.="" the="" risk="" of="" chd="" increased="" substantially="" with="" age="" in="" all="" groups,="" especially="" in="" women.="" differences="" in="" cardiovascular="" risk="" factors="" explained="" between="" one-quarter="" to="" one-third="" of="" the="" age-related="" excess="" of="" chd="" in="" men="" and="" one-half="" of="" that="" in="" women.="" systolic="" blood="" pressure="" was="" the="" chief="" contributor="" to="" the="" excess="" risk="" in="" all="" groups.="" conclusions:="" systolic="" blood="" pressure="" was="" the="" most="" important="" modifiable="" risk="" factor="" contributing="" to="" the="" excess="" chd="" risk="" that="" occurs="" with="" aging="" in="" men="" and="" women,="" but="" in="" comparison="" with="" the="" effects="" of="" age="" itself,="" the="" effects="" of="" blood="" pressure="" are="">