Epidemiological Studies of Cardiovascular Disease in a Total Community—Tecumseh, Michigan

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Abstract
The prevalence of the various forms of cardiovascular disease was determined in 8,641 persons of all ages (90% of the community). The prevalence of "probable" coronary heart disease, expressed as cases per 1,000, depending on the diagnostic criteria used, was from 30 to 49 for males and 19 to 33 for females. Prevalence, for men and women, respectively, was 7 and 9 for hypertensive, 4 and 6 for rheumatic and 0.1 and 2 for congenital heart disease. Congestive heart failure showed a prevalence of 6/1,000 in men and 9/1000 in women. The effect of levels of serum cholesterol, blood pressure and blood glucose (after a standard load) on the prevalence of coronary heart disease was assessed singly and in combination. Each of these 3 variables exerted an effect independent of the other; when all 3 variables were in the upper range, i.e. above the 80th per-centile, the prevalence (expressed as "relative prevalance") was 5.5 times higher in men and 6.2 times higher in women, as compared with the situation where all 3 variables fell below the upper quintile. The association between blood glucose levels and coronary heart disease, even in the absence of clinical diabetes, was especailly noteworthy. Blood pressure and relative weight were both associated with coronary heart disease; with blood pressure range held constant, persons with higher weight showed a greater prevalence of coronary heart disease. In this study, cigarette smoking showed no association with coronary heart disease but this finding must be interpreted with caution, pending follow-up studies in this population to yield incidence rather than prevalence rates. Such data are now being collected.