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A cardiovascular life history

A Peeters, A.A Mamun, F Willekens, L Bonneux
DOI: http://dx.doi.org/10.1053/euhj.2001.2838 458-466 First published online: 2 March 2002


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.

  • Cardiovascular diseases, morbidity, mortality, population, prevention