Abstract
Epidemiological studies have identified a number of risk factors for chronic circulatory disease. Though these risk factors (e.g., serum cholesterol, systolic and diastolic blood pressure, smoking) have significant associations with heart and other chronic disease risks in multiple longitudinal studies, there is little evaluation of the lifetime effect of controlling those factors. When these risk factors have been evaluated in forecasts, the effect on population risks was often less than in longitudinal studies because the models employed were not biologically realistic (e.g., risk factors were assumed to operate independently and cohort dynamics were not represented; e.g., Weinstein et al., 1987). The results in this chapter are based on a multivariate model (presented in Chapter 4) of the effect of risk factors on (1) the risk of disease at specific ages; (2) the interaction of causes of death (i.e., the effect of dependent competing risks); and (3) the effect of selective mortality on the age-specific, relative survival of at-risk populations. Estimates of the effect of intervening in risk factors produced from these models should be more realistic because “diffusion” is represented; that is, “uncertainty” about individual risk factor values measured at any single time is described (Strachan and Rose, 1991).
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References
Dowd, J.E., and Manton, K.G. 1991. Forecasting chronic disease risks in developing countries. International Journal of Epidemiology 19 (4): 1018–1036.
Epstein, F.H. 1992. Low serum cholesterol, cancer and other noncardiovascular disorders. Atherosclerosis 94: 1–12.
Frank, J.W., Reed, D.M., Grove, J.S., and Benfante, R. 1992. Will lowering population levels of serum cholesterol affect total mortality? Expectations from the Honolulu heart program. Journal of Clinical Epidemiology 45 (4): 333–346.
Fries, J.F. 1989. The compression of morbidity: Near or far? Milbank Quarterly 67 (2): 208–232.
Gordon, T., and Kannel, W.B. 1970. The Framingham, Massachusetts, Study twenty years later. In The Community as an Epidemiologic Laboratory ( Kessler, I.I., and Levin, M.L., Eds.). Baltimore: Johns Hopkins Press, pp. 123–146.
Kannel, W.B., and Gordon, T. 1980. Cardiovascular risk factors in the aged. The Framingham Study. In Epidemiology of Aging (Haynes S.G., Feinleib M., Eds.). USDHHS Pub. No. 80–969, Washington, DC: USGPO, pp. 65–90.
Manton, K.G., and Stallard, E. 1988. Chronic Disease Modelling: Measurement and Evaluation of the Risks of Chronic Disease Processes. London: Charles Griffith.
Manton, K.G., and Woodbury, M.A. 1985. A continuous-time multivariate Gaussian stochastic model of change in discrete and continuous state variables. Sociological Methodology 1985 (Tuma N., Ed.). San Francisco: Jossey-Bass, pp. 277–315.
Multiple Risk Factor Intervention Trial Research Group. 1990. Mortality rates after 10.5 years for participants in the multiple risk factor intervention trial. Journal of the American Medical Association 263: 1795–1801.
Pekkanen, J., Manton, K.G., Stallard, E., Nissinen, A., and Karvonen, M. 1992. Risk factor dynamics, mortality and life expectancy differences between eastern and western Finland: the Finnish cohorts of the Seven Countries Study. International Journal of Epidemiology 21 (2): 406–419.
SHEP Cooperative Research Group. 1991. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Journal of the American Medical Association 265: 3255–3264.
Strachan, D., and Rose, G. 1991. Strategies of prevention revisited: effects of imprecise measurement of risk factors on the evaluation of “high-risk” and “population-based” approaches to prevention of cardiovascular disease Journal of Clinical Epidemiology 44 (11): 1187–1196.
Weinstein, M.C., Coxson, P.G., Williams, L.W., Pass, T.M., Stason, W.B., and Goldman, L. 1987. Forecasting coronary heart disease incidence, mortality and cost: The coronary heart disease policy model. American Journal of Public Health 77: 1417–1426.
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© 1993 Springer-Verlag New York, Inc.
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Manton, K.G., Dowd, J.E., Stallard, E. (1993). The Effects of Risk Factors on Male and Female Cardiovascular Risks in Middle and Late Age. In: Manton, K.G., Singer, B.H., Suzman, R.M. (eds) Forecasting the Health of Elderly Populations. Springer Series in Statistics. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-9332-0_6
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DOI: https://doi.org/10.1007/978-1-4613-9332-0_6
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