Copyright © 2002 by the European Society of Cardiology.
A cardiovascular life history
a Department of Public Health, Erasmus University Rotterdam, The Netherlands
b Population Research Centre, University of Groningen, The Netherlands
revised June 19, 2001; accepted June 20, 2001
Abstract
Aims The objective of this paper is to measure the potential burden of cardiovascular disease within the original Framingham Heart Study cohort by transforming its well-described epidemiological measures into time-based health policy measures, such as life years lost to or lived with the disease.
Methods and Results We constructed multi-state life tables of the Framingham Heart Study cohort to calculate dwelling times with a history of cardiovascular disease. Age-specific probabilities determined transitions from healthy through disease to death. For this synthetic cohort, from age 50 men (women) live on average 26 (32) years; 20 (26) free of cardiovascular disease. Allowing occupancy of more than one disease state, 50-year-old males (females) live 2·9 (1·2) years with a history of myocardial infarction, 0·93 (1·2) with a history of stroke, and 0·67 (0·93) with congestive heart failure. Having ever suffered acute myocardial infarction, stroke or congestive heart failure, life expectancy is reduced by 9 (13), 12 (15) or 16 (16) years, respectively in 60-year-old men (women).
Conclusions Transforming occurrence probabilities into time-based health measures, the prevalence of cardiovascular disease is remarkable: from age 50, 20% of remaining life expectancy is lived with the disease. Such measures are integral to appropriate health planning and assessment of the potential population health value of various treatment and prevention strategies.
Key Words: Cardiovascular diseases, morbidity, mortality, population, prevention
f1 Correspondence: Anna Peeters, Department of Public Health, Faculty of Medicine and Health Sciences, Dr. Molewaterplein 50, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
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