Traditional risk factors for incident cardiovascular events have limited importance in later life compared with the health in XXXX study cardiovascular risk score.

@entity1 @entity64 @entity1255
BACKGROUND AND PURPOSE: This study aimed to determine, among older @entity1 , the risk and independent significant baseline prognostic factors for first-ever @entity64 and MI. METHODS: We performed a prospective cohort study of 4382 community-dwelling older @entity1 (mean age, 75.4  4.2 years) with no history of @entity64 or MI. Baseline data comprised questionnaire responses, clinical measurements, and comorbidity. RESULTS: After a median of 6 years (interquartile range, 5.2-7.2) of follow-up, the overall rate of @entity64 /MI was 2.61 (95% CI, 2.42-2.81) per 100 @entity1 -years. Among major traditional risk prediction variables, only age and smoking were significantly associated with @entity64 /MI. In our final multivariate model, the independent significant predictors of @entity64 /MI were age (HR for age older than 85, 3.18; 95% CI, 2.05-4.93), diastolic blood pressure <70 mm Hg (Hazard ratio [HR], 1.45; 95% CI, 1.18-1.78), high-sensitivity C-reactive protein >3 mg/L (HR, 1.29; 95% CI, 1.05-1.59), @entity1255 >15 umol/L (HR, 1.35; 95% CI, 1.09-1.67), waist-to-hip ratio >1 (HR, 1.47; 95% CI, 1.20-1.18), and fair or poor self-reported health (HR, 1.52; 95% CI, 1.19-1.94). A new risk model incorporating these variables performed well compared with the Framingham risk equation (Harrell C of 0.660 versus C of 0.620; integrated discrimination improvement of 1.85%; z=4.95; P<0.001; net reclassification index of 0.08; z=2.0; P=0.023). The model was used to develop an 8- point clinical risk score comprising the independent predictors of @entity64 /MI among this population. CONCLUSIONS: Traditional vascular risk factors did not optimally predict @entity64 /MI among this cohort of community-dwelling older @entity1 . We have constructed a new risk score that requires validation in other data sets.
