Cardiovascular Disease Mortality in Men

Cardiosource: "Revised Adult Treatment Panel III Guidelines and Cardiovascular Disease Mortality in Men Attending a Preventive Medical Clinic
Topic: Prevention/Vascular
Date Posted: 11/5/2005
Author(s): Ardern CI, Katzmarzyk PT, Janssen I, Church TS, Blair SN.
Citation: Circulation. 2005;112:1478-1485.

Study Question: What is the relative contribution of cardiovascular fitness (CardFit) and the metabolic syndrome on cardiovascular disease (CVD) mortality within each intervention window, as defined by the revised Adult Treatment Panel (ATP) III guidelines (ATP III-R)?
Methods: Risk factor and CardFit data from 19,125 men (aged 20-79 years) who attended a preventive medical clinic between 1979 and 1995 were used. Mortality follow-up was completed until December 31, 1996. Five classic risk factors were considered: age =45 years, family history, current smoker, hypertension, and low high-density lipoprotein cholesterol (HDL-C). Participants were assigned to one of four ATP III-R groups (high risk as coronary heart disease [CHD] or CHD risk equivalent, moderate risk as 2+ risk factors or 10-year Framingham risk of 10-20%, moderate risk 10-year risk <10%, and low risk 0-1 risk factor). The ATP III-R group was then used to assign one of the groups: LDL-C at goal, therapeutic lifestyle change (TLC) initiation, and drug consideration. Unfit was defined as in the lowest age-adjusted lowest quintile. The risk of CVD mortality was assessed by Cox proportional hazards regression.
Results: Mean age was 45 years; 58% were classified as being at the LDL goal, whereas 18% were eligible for TLC initiation and 24% for drug treatment. There were 179 CVD deaths over an average 10.2 years of follow-up. Compared with those with LDL-"