Elsevier

Annals of Epidemiology

Volume 5, Issue 4, July 1995, Pages 270-277
Annals of Epidemiology

Original report
Methods of assessing prevalent cardiovascular disease in the Cardiovascular Health Study

https://doi.org/10.1016/1047-2797(94)00092-8Get rights and content

Abstract

The objective of this article is to describe the methods of assessing cardiovascular conditions among older adults recruited to the Cardiovascular Health Study (CHS), a cohort study of risk factors for coronary disease and stroke. Medicare eligibility lists from four US communities were used to obtain a representative sample of 5201 community-dwelling elderly, who answered standardized questionnaires and underwent an extensive clinic examination at baseline. For each cardiovascular condition, self-reports were confirmed by components of the baseline examination or, if necessary, by a validation protocol that included either the review of medical records or surveys of treating physicians. Potential underreporting of a condition was detected either by the review of medical records at baseline for other self-reported conditions or, during prospective follow-up, by the investigation of potential incident events. For myocardial infarction, 75.5% of the self-reports in men and 60.6% in women were confirmed. Self-reported congestive heart failure was confirmed in 73.3% of men and 76.6% of women; stroke, in 59.6% of men and 53.8% of women; and transient ischemic attack, in 41.5% of men and 37.0% of women. Underreporting was also common. During prospective follow-up of an average of about 3 years per person, approximately 50% of men and 38% of women were hospitalized or investigated for at least one potential incident event; for each cardiovascular condition, about 1 to 4% of those investigated during prospective follow-up were found to have had the cardiovascular condition prior to entry into the cohort. While the proportions of false-negative self-reports were small, the underreported events nonetheless represented 10 to 35% of all subjects with a prevalent condition at baseline. Underreporting and overreporting of cardiovascular diseases were common among older adults. The CHS baseline disease classifications have served to define accurately the denominators for analyses of incident events.

References (22)

  • AR Assaf et al.

    Possible influence of the prospective payment system on the assignment of discharge diagnoses for coronary heart disease

    N Eng1 J Med

    (1993)
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    The research reported in this article was supported by contracts N01-HC-85079, N01-HC-85080, NO1-HC-85081, NO1-HC-85082, NO1-HC-85083, NO1-HC-85084, NO1-HC-85085, and NO1-HC-85086 and grant HL-43201 from the National Heart, Lung, and Blood Institute, and grant AG-09556 from the National Institute on Aging.

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    Dr. Psaty is a Merck/SER Clinical Epidemiology Fellow (sponsored by the Merck Co. Foundation, Rahway, NJ, and the Society for Epidemiologic Research, Baltimore, MD).

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