Albany Cardiovascular Health Center Study

Background/questions

Initiated by Herman Hilleboe in 1953 under the auspices of the New York State Department of Health that he directed, this was one of the earlier cohort studies in which characteristics leading to cardiovascular disease (CVD) risk were sought among a healthy population (civil service workers).

Methods/design

The cohort was 2202 civil employees, men 39 to 55 years of age, mostly white and educated, who were followed until 1981 with biannual examinations for incidence of CVD. There was excellent participation, and extensive sharing of survey methods and some combined data analysis with the Framingham Heart Study.

Results

The average annual incidence rate of coronary heart disease (CHD) during the initial study years was 8.5 per 1000. Approximately half of the new cases of CHD over the first 44 months of follow-up were due to acute infarction (AMI), approximately one third were attributed to angina pectoris, and the remainder to the findings of an abnormal exercise treadmill test and electrocardiogram.

The risk of sudden death increased with age up to 60 years with a fall off thereafter. At all ages, the incidence of sudden cardiac death was greater in persons with antecedent coronary risk factors including elevated serum cholesterol and blood pressure, cigarette smoking, ECG evidence of left ventricular hypertrophy, and higher relative body weight. The risk of sudden death increased with increasing deciles of multivariable-adjusted risk.

Discussion

Albany was one of the first epidemiological studies to report on the predictive power of a standardized exercise electrocardiogram, to pool data (with its “sister study” at Framingham), and to compare risk discrimination with the multiple logistic versus Cox proportional hazards models. (HB)