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Risk Factors for Coronary Heart Disease in Men 18 to 39 Years of Age

Elena L. Navas-Nacher, MS; Laura Colangelo, MS; Craig Beam, PhD; and Philip Greenland, MD
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From Northwestern University Medical School, Chicago, Illinois; and Medical College of Wisconsin, Milwaukee, Wisconsin.

Acknowledgments: The authors thank the staff and volunteers at the Chicago Heart Association who assisted with this project and Sheila Kessler for bibliographic assistance and librarian support. A list of colleagues who contributed to this endeavor has been published elsewhere (14).

Grant Support: By grant HL21010 22 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.

Requests for Single Reprints: Philip Greenland, MD, Department of Preventive Medicine, Northwestern University Medical School, 680 North Lake Shore Drive, Suite 1102, Chicago, IL 60611.

Current Author Addresses: Ms. Navas-Nacher: 452 West Aldine Avenue, No. 408, Chicago, IL 60657.

Ms. Colangelo and Dr. Greenland: Department of Preventive Medicine, Northwestern University Medical School, 680 North Lake Shore Drive, Suite 1102, Chicago, IL 60611.

Dr. Beam: Department of Radiology, Cancer Center of the Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226.

Author Contributions: Conception and design: E.L. Navas-Nacher, L. Colangelo, C. Beam, P. Greenland.

Analysis and interpretation of the data: E.L. Navas-Nacher, L. Colangelo, C. Beam, P. Greenland.

Drafting of the article: E.L. Navas-Nacher.

Critical revision of the article for important intellectual content: E.L. Navas-Nacher, L. Colangelo, C. Beam, P. Greenland.

Final approval of the article: E.L. Navas-Nacher, L. Colangelo, C. Beam, P. Greenland.

Statistical expertise: E.L. Navas-Nacher, L. Colangelo, C. Beam.

Obtaining of funding: E.L. Navas-Nacher, P. Greenland.

Ann Intern Med. 2001;134(6):433-439. doi:10.7326/0003-4819-134-6-200103200-00007
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Coronary heart disease remains the leading cause of death in the United States (1). Autopsy studies (25) show that coronary atherosclerosis begins as early as 20 years of age, and a recent study found severely stenotic coronary arteries (narrowing ≥ 40%) in 19% of men in their early thirties (6). On the basis of these observations, the National Cholesterol Education Program recommended cholesterol screening in all adults 20 years of age or older (7). Similarly, the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends screening for hypertension in all persons 18 years of age or older (8). However, guidelines on prevention of coronary heart disease in young adults have not been uniformly accepted, in part because data on risk prediction and coronary disease prevention in adults younger than 40 years of age are limited (912).

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Receiver-operating characteristic curves for prediction of fatal coronary heart disease in young men over 20 years.SBPBMIECGP

Separate plots are shown for five different models that included various combinations of age, serum cholesterol level, systolic blood pressure ( ), cigarette smoking, body mass index ( ), education level, black ethnicity, and minor electrocardiographic abnormalities ( ). *  < 0.001 for comparison with the model including age and serum cholesterol. AUC = area under the receiving-operating characteristic curve.

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Summary for Patients

Risk Factors for Coronary Heart Disease in Young Men

The summary below is from the full report titled “Risk Factors for Coronary Heart Disease in Men 18 to 39 Years of Age.” It is in the 20 March 2001 issue of Annals of Internal Medicine (volume 134, pages 433-439). The authors are EL Navas-Nacher, L Colangelo, C Beam, and P Greenland.


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