16-year incidence of ischemic heart disease in the NHLBI twin study. A classification of subjects into high- and low-risk groups.

Abstract:

:Prospective data from the National Heart, Lung, and Blood Institute (NHLBI) Twin Study were used to investigate the relationship of risk factors measured in 1970 to 1971 to 16-year incidence of ischemic heart disease (IHD) in 905 males born between 1917 and 1927. A newly developed methodology, tree-structured survival analysis (TSSA), was used to classify subjects into discrete subgroups that differed significantly in profiles of risk factors and incidence of IHD. On the basis of five characteristics--systolic blood pressure (SBP), high-density-lipoprotein cholesterol (HDL-C), 1-hour postload glucose levels, forced expiratory volume in 1 second (FEV1), and a family history score for heart disease--the TSSA algorithm partitioned the cohort into six discrete subgroups that formed three clusters of individuals with distinct IHD experience. Highest IHD incidence rates were experienced by a subgroup of 56 men with baseline SBP above 134 mm Hg and HDL-C levels lower than 33 mg/dL. No IHD events were observed in a subgroup of 117 men who had low SBP, high FEV1, and a negative family history of heart disease. Relationships to the twinning condition showed that for both zygosities, cotwin-pair members were in the same risk subgroup more often than expected; however, the overall difference between the frequency of monozygotic (MZ) and dizygotic (DZ) cotwins was relatively small. The highest MZ/DZ ratios of observed to expected cotwin-pair membership occurred in subgroups with the highest and lowest incidences of IHD, suggesting that these extremes of incidence are most likely to be genetically determined.

journal_name

Ann Epidemiol

journal_title

Annals of epidemiology

authors

Carmelli D,Selby JV,Quiroga J,Reed T,Fabsitz RR,Christian JC

doi

10.1016/1047-2797(94)90097-3

subject

Has Abstract

pub_date

1994-05-01 00:00:00

pages

198-204

issue

3

eissn

1047-2797

issn

1873-2585

pii

1047-2797(94)90097-3

journal_volume

4

pub_type

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