TABLE 1:Characteristics of respondents overall and by familial coronary heart disease risk categories (HealthStyles 2003 Survey of Health-related Attitudes and Behaviors
Among the U.S. Adult Population)a
Sex |
|
|
|
|
|
Female |
2427 (60.1) |
784 (61.6) |
274 (58.2) |
1369 (59.8) |
|
Male |
1608 (39.9) |
489 (38.4) |
197 (41.8) |
922 (40.2) |
Age groupb |
|
|
|
|
|
18–34 y |
700 (17.3) |
122 (9.6)d |
39 (8.3)d |
539 (23.5) |
|
35–44 y |
1104 (27.4) |
293 (23.0) |
130 (27.6) |
681 (29.7) |
|
45–54 y |
1010 (25.0) |
353 (27.7) |
143 (30.4) |
514 (22.4) |
|
55–64 y |
558 (13.8) |
234 (18.4)d |
69 (14.6) |
255 (11.1) |
|
65+ y |
663 (16.4) |
271 (21.3)d |
90 (19.1) |
302 (13.2) |
Race/ethnicity |
|
|
|
|
|
White |
2901 (71.9) |
979 (76.9)d |
368 (78.1)d |
1554 (67.8)d |
|
African American |
493 (12.2) |
124 (9.7) |
38 (8.1) |
331 (14.4) |
|
Hispanic |
449 (11.1) |
115 (9.0) |
45 (9.6) |
289 (12.6) |
|
Asian |
139 (3.4) |
35 (2.7) |
13 (2.8) |
91 (4.0) |
|
Other |
53 (1.3) |
20 (1.6) |
7 (1.5) |
26 (1.1) |
Educationc |
|
|
|
|
|
≤High school graduate |
1317 (32.6) |
457 (35.9) |
120 (25.5) |
740 (32.3) |
|
Some college |
1318 (32.7) |
398 (31.3) |
165 (35.0) |
755 (33.0) |
|
≥College graduate |
1128 (28.0) |
346 (27.2) |
156 (33.1) |
626 (27.3) |
Income |
|
|
|
|
|
≥$35,000 |
2290 (56.8) |
703 (55.2) |
303 (64.3) |
1284 (56.0) |
|
<$35,000 |
1745 (43.2) |
570 (44.8) |
168 (35.7) |
1007 (44.0) |
Marital status |
|
|
|
|
|
Ever married or cohabitating |
3508 (86.9) |
1142 (89.7) |
427 (90.7) |
1939 (84.6) |
|
Never married |
527 (13.1) |
131 (10.3) |
44 (9.3) |
352 (15.4) |
Early-onset CHD |
178 (4.4) |
122 (9.6)d |
16 (3.4) |
40 (1.7)d |
Late-onset CHD |
79 (2.0) |
43 (3.4) |
13 (2.8) |
23 (1.0) |
Early-onset stroke |
121 (3.0) |
65 (5.1)d |
18 (3.8) |
38 (1.7) |
Late-onset stroke |
50 (1.2) |
28 (2.2) |
2 (0.4) |
20 (0.9) |
Diabetes |
495 (12.3) |
213 (16.7)d |
50 (10.6) |
232 (10.1) |
Obesity |
700 (17.3) |
274 (21.5)d |
82 (17.4) |
344 (15.0) |
Hypertension |
1336 (33.1) |
539 (42.3)d |
158 (33.5) |
639 (27.9)d |
Hypercholesterolemia |
1376 (34.1) |
548 (43.0)d |
193 (41.0) |
635 (27.7)d |
CHD, coronary heart disease.
a Early-onset CHD, disease at or before age 60 years; late-onset CHD, disease after age 60 years.
b Mean age (standard deviation) for total population, 48.4 years (14.4); for strong familial risk, 52.2 years (13.7), P<.0001; moderate familial risk, 51.0 years (13.6),
P < .0001; and weak familial risk, 45.7 (14.5), P < .0001. P values compared mean values with the mean age (48.4 years) among all respondents.
c Educational status missing for 272 respondents.
d Significant (<.05) P values corrected for 81 comparisons of frequencies of characteristics with frequencies among all respondents.
TABLE 2: Associations between familial coronary heart disease risk categories and early-onset coronary heart disease
Strong (n = 1273) |
4.9 (3.3–7.2) |
4.6 (3.1–6.8) |
4.3 (2.9–6.5) |
4.0 (2.7–6.0) |
Moderate (n = 471) |
2.0 (1.1–3.6) |
1.9 (1.0–3.5) |
1.8 (1.0–3.3) |
1.7 (0.9–3.2) |
Weak (n = 2291) |
1.0 |
1.0 |
1.0 |
1.0 |
CHD, coronary heart disease; early-onset CHD, disease at or before age 60 years; late-onset CHD, disease after age 60 years; OR, odds ratio; CI, confidence interval.
aAdjusted for age, sex, ethnicity, marital status, education, and income.
bAdjusted for age, sex, ethnicity, marital status, education, income, and personal history of stroke at any age of onset.
cAdjusted for age, sex, ethnicity, marital status, education, income, and personal history of obesity, hypertension, hypercholesterolemia, and diabetes.
dAdjusted for age, sex, ethnicity, marital status, education, income, and personal history of stroke, obesity, hypertension, hypercholesterolemia, and diabetes.
TABLE 3: Associations between familial coronary heart disease risk categories and the related conditions of obesity, hypertension, hypercholesterolemia, and diabetes
Strong (n = 1273) |
1.5 (1.3–1.8)a |
1.5 (1.3–1.8)a |
1.4 (1.6–1.9)a |
1.6 (1.3–2.0)a |
|
1.4 (1.2–1.7)b |
1.4 (1.2–1.6)b |
1.4 (1.2–1.7)b |
1.4 (1.1–1.7)b |
Moderate (n = 471) |
1.2 (0.9–1.6)a |
1.2 (0.9–1.5)a |
1.5 (1.2–1.9)a |
1.0 (0.7–1.4)a |
|
1.2 (0.9–1.6)b |
1.1 (0.9–1.4)b |
1.5 (1.2–1.9)b |
1.0 (0.6–1.3)b |
Weak (n = 2291) |
1.0 |
1.0 |
1.0 |
1.0 |
CHD, coronary heart disease; OR, odds ratio; CI, confidence interval.
aAdjusted for age, sex, ethnicity, marital status, education, and income.
bAdjusted for age, sex, ethnicity, marital status, education, income, and personal history of CHD at any age of onset and stroke at any age of onset.
TABLE 4: Early-onset coronary heart disease associated with weak, moderate, and
strong familial coronary heart disease risk
and increasing number of related conditions including obesity,
hypertension, hypercholesterolemia, and diabetes
0 (n = 1716 |
1.0 (referent) |
3.6 (0.6–21.9) |
4.3 (1.1–17.6) |
1 (n = 1203) |
3.7 (1.0–13.9) |
2.1 (0.21–20.0) |
17.9 (5.3–61.0) |
2 (n = 740) |
12.6 (3.6–44.4) |
27.8 (7.2–106.8) |
48.6 (14.8–160.0) |
≥3 (n = 376) |
16.5 (4.4–61.2) |
24.9 (5.2–119.7) |
62.2 (18.5–209.1) |
CHD, coronary heart disease; early-onset CHD, disease at or before age 60
years; OR, odds ratio; CI, confidence interval. Related conditions indicate
obesity, hypertension, hypercholesterolemia, and diabetes.
aAdjusted for age, sex, ethnicity, marital status, education, and income.
TABLE 5: Ability of different coronary heart disease risk assessment models to identify
people with early-onset coronary heart disease
1. Familial risk + demographics + related conditions |
87.2 |
2. Familial risk + related conditions |
84.6 |
3. Demographics + related conditions |
84.6 |
4. Familial risk + demographics |
82.3 |
5. Related conditions only |
80.1 |
6. Demographics only |
76.7 |
7. Familial risk only |
70.9 |
CHD, coronary heart disease; early-onset CHD, disease at or before age 60
years; AUC, area under the curve.
Demographics include age, sex, ethnicity, marital status, education, and income.
Related conditions include diabetes, hypercholesterolemia, hypertension,
and obesity. AUC statistics were calculated for each risk assessment
model using multivariate logistic regression with personal history of earlyonset
CHD as the outcome of interest. AUC values greater than 70% suggest
good discriminatory ability. Model 1 includes familial risk assessment for
CHD, demographic factors, and related conditions. Model 2 includes familial
risk assessment and related conditions. Model 3 includes demographics and
related conditions. Model 4 includes familial risk assessment and demographics.
Model 5 includes only related conditions. Model 6 includes only demographic
factors. Model 7 includes only familial risk assessment.
|