Clinical myocardial infarction over a five-year period - III. A multivariate analysis of incidence, the Israel Ischemic Heart Disease Study

Uri Goldbourt*, Jack H. Medalie, Henry N. Neufeld

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Analysis of 5-yr incidence of clinically recognized myocardial infarction is presented. Multivariate techniques identify serum cholesterol, systolic or diastolic blood pressure, cigarette smoking and presence of diabetes and angina pectoris, in addition to age increments, as the main risk factors. M.I. incidence appears directly related to continuous levels of these factors rather than to threshold values. This seems to hold for each variable at all levels of other variables. When incidence of M.I. among non-A.P. subjects is considered alone, the remaining risk factors continue to play the major role. Age gradients of the risk associated with cigarette smoking and serum cholesterol were identified, as well as increased contribution of smoking in the multivariate context. Implications for prevention reemphasize weight control and abstinence or reduction of smoking, as 'primary' methods, combined with early detection and control of high levels of cholesterol, blood pressure and clinical or preclinical diabetes. With knowledge lacking regarding reversibility of the risk induced by them, and since atherosclerosis is present in age much younger than covered by this study (and others), the degree of success such prevention will achieve cannot be assessed without actual intervention trials. It was not possible to completely account for incidence difference between ethnic groups. This further enhances the need in understanding which additional differences exists between them, which are not (or not fully) reflected in the levels of the main risk factors associated with incidence.

Original languageEnglish
Pages (from-to)217-237
Number of pages21
JournalJournal of Chronic Diseases
Volume28
Issue number4
DOIs
StatePublished - Apr 1975

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