Proportional Hazards Analysis of Risk Factors for Coronary Heart Disease in Individuals Aged 65 or Older

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Abstract
Risk factors for coronary heart disease were examined in 2,501 individuals in the Framingham Heart Study who survived to the age of 65 without evidence of coronary artery disease. We used a proportional hazards (Cox) analysis that examined risk factors over time and included events through the 16th biennial examination. The independently significant mlutivariate correlates of the development of coronary heart disease after the age of 65 were sex (incidence rate ratio [RR] for males of 1.7 (95% confidence interval of 1.4, 2.0]), left ventricular hypertrophy (RR = 2.4 [1.7, 3.5]), systolic blood pressure (RR = 2.2 [1.4, 3.3] for systolic blood pressureof 160 mmHg or higher as compared with less than 120 mmHg), causal blood glucose (RR = 2.2 [1.5, 3.4] for 175 mg/dL or more as compared with less than 90 mg/dL), Metropolitan relative weight from examination 1 (RR = 1.3 [1.0, 1.6] for those 130% or more of ideal weight compared with those less than 110% of ideal), and total serum cholesterol (RR = 1.8 [1.3, 2,5] for cholesterol in the 90th percentile or higher compared with less than 200 mg/dL). Controlling for all these risk factors, those smoking 20 cigarettes a day or more were at slightly increased risk of coronary heart disease (RR = 1.2 [.9, 1.6]) compared with nonsmokers. These analyses suggests that older persons share the same risk factors for coronary artery disease that are significant in younger populations.