Cardiovascular risk and all-cause mortality; A 12 year follow-up study in The Netherlands

Hoes, Arno W.; Grobbee, Diederick E.; Valkenburg, H. A.; Lubsen, J; Hofman, Albert

doi:10.1007/bf00146265

Cited by 43 publications

(23 citation statements)

References 29 publications

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“…In addition, we performed an indirect validation by comparing the risk scores prospectively developed in the Framingham Heart cohort 31 and in a follow-up study conducted in the Netherlands. 32 These 2 risk scores were obtained from relatively healthy cohorts and may not be directly applicable to the relatively high-risk SMART cohort. The Framingham risk score was based on subjects free of cardiovascular disease at baseline and used coronary heart disease as the end point.…”

Section: Discussionmentioning

confidence: 99%

“…32 In that study, a Cox proportional-hazards model was used to identify the most relevant cardiovascular risk factors for all-cause mortality. Individual risk scores are based on sex-specific contributions of the following characteristics: age, body mass index, systolic blood pressure, pulse rate, cigarette use, antihypertensive drug use, diabetes mellitus, and myocardial infarction.…”

Section: Risk Scoresmentioning

confidence: 99%

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Common Carotid Intima-Media Thickness and Arterial Stiffness

et al. 1999

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for the SMART Study GroupBackground-Common carotid intima-media thickness (IMT) and distensibility are markers of structural and functional vessel wall properties. Both parameters have been found in population-based studies to be associated with cardiovascular risk factors and prevalent cardiovascular disease. We investigated cross-sectionally whether IMT and distensibility are associated with cardiovascular risk in patients who already have vascular disease or atherosclerotic risk factors and evaluated the diagnostic ability of IMT and distensibility to discriminate between low-and high-risk patients. Methods and Results-IMT and distensibility (change of diameter) of the left and right common carotid arteries were measured in the first 570 patients (537 for distensibility) enrolled in the Second Manifestations of ARTerial disease (SMART) study, a cohort study among patients with a manifestation of vascular disease or cardiovascular risk factors. Three risk scores were used to classify each patient's vascular risk. Areas under the curve (AUCs) of receiver-operating characteristic curves were calculated for IMT and distensibility after the patients were dichotomized on the median of the risk scores as the outcome. Risk scores increased nearly linearly with increasing IMT and decreasing distensibility. The AUCs for IMT predicting high-risk patients were 0.77, 0.73, and 0.77 based on the 3 risk scores. The AUCs for distensibility were 0.65, 0.62, and 0.66. Conclusions-Common carotid IMT and distensibility are clear markers of cardiovascular risk in patients who already have vascular disease or atherosclerotic risk factors. IMT appears to discriminate between low-and high-risk patients better than distensibility. (Circulation. 1999;100:951-957.)

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Section: Discussionmentioning

confidence: 99%

Section: Risk Scoresmentioning

confidence: 99%

Common Carotid Intima-Media Thickness and Arterial Stiffness

et al. 1999

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“…For this purpose we used the files of a large epidemiological cardiovascular study in a healthy population in Zoetermeer, set up in 1975 [12, 13]. For the present study we selected from these files all individuals who were in 1975 between 4 and 18 years of age and had a height below the 3rd percentile and no disease which could explain their short stature.…”

Section: Methodsmentioning

confidence: 99%

Quality of Life in Short Adults

et al. 1997

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The use of (costly) growth hormone (GH) treatment in short children is often justified by the assumption that short stature considerably reduces quality of life in adults. We tested this assumption in 5 groups of short adults: 25 patients with isolated GH deficiency; 17 male patients with childhood onset renal failure; 25 women with Turner syndrome and 26 patients who were presented as a child to a paediatrician for idiopathic short stature. A group of 44 short individuals with presumably idiopathic short stature, who had not been presented to a paediatrician for short stature, was sampled from the general population (‘normal shorts’). We measured quality of life in terms of socio-economic variables, the Nottingham Health Profile and time trade-off. The mean height of most groups was close to the 3rd percentile. The chance of having a partner was low for all groups, except for the normal shorts. Problems with job application were only reported in Turner syndrome. The scores on the Nottingham Health Profile were all within the normal range, but GH-deficient adults had a higher score on the domain energy than normal shorts. Women with Turner syndrome, individuals with renal failure, and those with idiopathic short stature had a wish to be taller, with an estimated reduction in quality of life of 2–4% (time trade-off). As the normal shorts did not show any sign of a reduced quality of life, we falsify the assumption of a direct relation between short stature and quality of life. The complaints of patients with idiopathic short stature around the 3rd percentile seem to be the result of unsuccessful coping strategies.

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“…Accordingly with the hypothesis that cardiovascular risk factors are also major risk factors for all-cause mortality, a previous European cohort [20] originally intended and designed to analyse risk factors for cardiovascular but also other chronic diseases pointed out that age, smoking, diabetes and high blood pressure are also independent determinants of all-cause mortality in middle-aged subjects.…”

Section: Discussionmentioning

confidence: 99%