Circulation, Vol 86, 406-413, Copyright © 1992 by American Heart Association
GE Fraser, TM Strahan, J Sabate, WL Beeson and D Kissinger
BACKGROUND. California Seventh-Day Adventists have lower mortality rates
from coronary heart disease (CHD) than other Californians. Associations
between traditional risk factor and CHD events have not been reported
previously for Adventists. METHODS AND RESULTS. A cohort study allowed 6
years of follow-up of 27,658 male and female California Seventh-Day
Adventists. Data collected included age, sex, physician- diagnosed
hypertension and diabetes mellitus, body height, weight, previous and
current cigarette smoking habits, and current exercise habits. Incident
cases of definite myocardial infarction (MI) and definite fatal CHD were
diagnosed according to recognized criteria. Both stratified and
proportional hazards analyses demonstrated that in this low-risk
population, the above traditional coronary risk factors exhibit their usual
associations with risk of CHD events. It was noted that exercise had a
strong negative association with fatal CHD events (relative risks [RR],
1.0, 0.66, and 0.50 with increasing exercise) but no association with risk
of MI (either nonfatal or all cases). Conversely, obesity was much more
clearly associated with MI (RR, 1.0, 1.18, and 1.83 with increasing
tertiles of obesity) than with fatal events. The importance of the risk
factors was similar in both sexes, except that the effect of cigarette
smoking seemed more pronounced in women. CONCLUSIONS. The epidemiology of
coronary heart disease in this low-risk California population appears to be
at least qualitatively similar to that seen in other groups. There was
evidence that the effects of exercise and obesity may differ depending on
whether fatal CHD and MI (either all MI or nonfatal alone) is the end
point.
ARTICLES
Effects of traditional coronary risk factors on rates of incident coronary events in a low-risk population. The Adventist Health Study
Center for Health Research, Loma Linda University School of Public Health, CA 92350.
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