Risk Factors for Cardiovascular Disease: One Down, Many More To Evaluate
Authors: Viola Vaccarino, Harlan M. Krumholz
Journal: Annals of Internal Medicine (1999)

Editorials6 July 1999Risk Factors for Cardiovascular Disease: One Down, Many More To EvaluateViola Vaccarino, MD, PhD and Harlan M. Krumholz, MDViola Vaccarino, MD, PhDYale University School of Medicine; New Haven, CT 06520 (Vaccarino)Yale University School of Medicine; New Haven, CT 06520 (Krumholz) and Harlan M. Krumholz, MDYale University School of Medicine; New Haven, CT 06520 (Vaccarino)Yale University School of Medicine; New Haven, CT 06520 (Krumholz)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-1-199907060-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Almost 50 years ago, investigators observed the association between uric acid and cardiovascular events. Subsequently, many epidemiologic studies have sought to clarify the role of this risk factor. In addition, laboratory studies have attempted to identify the mechanism by which an elevated uric acid level causes an increased risk for cardiovascular disease. Despite these efforts, the role of uric acid as a risk factor was never fully resolved.In this issue, investigators from the Framingham Heart Study resolve the long-standing controversy surrounding the role of uric acid as a risk factor for cardiovascular disease (1). Taking advantage of careful measures ...References1. Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med. 1999;131:7-13. LinkGoogle Scholar2. Braunwald E. Shattuck lecture—cardiovascular medicine at the turn of the millennium: triumphs, concerns, and opportunities. N Engl J Med. 1997;337:1360-9. CrossrefMedlineGoogle Scholar3. Hennekens CH. Increasing burden of cardiovascular disease: current knowledge and future directions for research on risk factors. Circulation. 1998;97:1095-102. CrossrefMedlineGoogle Scholar4. Javier Nieto F. Cardiovascular disease and risk factor epidemiology: a look back at the epidemic of the 20th century [Editorial]. Am J Public Health. 1999;89:292-4. CrossrefMedlineGoogle Scholar5. Krumholz HM, Seeman TE, Merrill SS, Mendes de Leon CF, Vaccarino V, Silverman DI, et al . Lack of association between cholesterol and coronary heart disease mortality and morbidity and all-cause mortality in persons older than 70 years. JAMA. 1994;272:1335-40. CrossrefMedlineGoogle Scholar6. Corti M, Guralnik JM, Salive ME, Harris T, Ferrucci L, Glynn RJ, et al . Clarifying the direct relation between total cholesterol levels and death from coronary heart disease in older persons. Ann Intern Med. 1997;126:753-60. LinkGoogle Scholar7. Kuller LH, Tracy RP, Shaten J, Meilahn EN. Relationship of C-reactive protein and coronary heart disease in the MRFIT nested case–control study. Multiple Risk Factor Intervention Trial. Am J Epidemiol. 1996;144:537-47. CrossrefMedlineGoogle Scholar8. Ridker PM, Buring JE, Shih J, Matias M, Hennekens CH. Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation. 1998;98:731-3. CrossrefMedlineGoogle Scholar9. Ridker PM, Cushman M, Stampfer MJ, Tracy R, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997;336:973-9. CrossrefMedlineGoogle Scholar10. Meade TW, Mellows S, Brozovic M, Miller GJ, Chakrabarti RR, North WR, et al . Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet. 1986;2:533-7. CrossrefMedlineGoogle Scholar11. Folsom AR, Wu KK, Shahar E, Davis CE. Association of hemostatic variables with prevalent cardiovascular disease and asymptomatic carotid artery atherosclerosis. The Atherosclerosis Risk in Communities (ARIC) Study Investigators. Arterioscler Thromb. 1993;13:1829-36. CrossrefMedlineGoogle Scholar12. Crouse JR. Gender, lipoproteins, diet, and cardiovascular risk. Sauce for the goose may not be sauce for the gander. Lancet. 1989;1:318-20. CrossrefMedlineGoogle Scholar13. Barrett-Connor E. Sex differences in coronary heart disease. Why are women so superior? The 1995 Ancel Keys Lecture. Circulation. 1997; 95:252-64. Google Scholar14. Kannel WB, Castelli WP, Gordon T, McNamara PM. Serum cholesterol, lipoproteins, and the risk of coronary heart disease. Ann Intern Med. 1971;74:1-12. LinkGoogle Scholar15. Kannel WB. Metabolic risk factors for coronary heart disease in women: perspective from the Framingham Study. Am Heart J. 1987;114:413-9. CrossrefMedlineGoogle Scholar16. Kannel WB, McGee DL. Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham Study. Diabetes Care. 1979;2:120-6. CrossrefMedlineGoogle Scholar17. Epstein FH. Cardiovascular disease epidemiology: a journey from the past into the future. Circulation. 1996;93:1755-64. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Yale University School of Medicine; New Haven, CT 06520 (Vaccarino)Yale University School of Medicine; New Haven, CT 06520 (Krumholz)Grant Support: Dr. Krumholz is a Paul Beeson Faculty Scholar.Corresponding Author: Harlan M. Krumholz, MD, Yale University School of Medicine, 333 Cedar Street, IE-61 SHM, New Haven, CT 06520.Current Author Addresses: Dr. Krumholz: Yale University School of Medicine, 333 Cedar Street, IE-61 SHM, New Haven, CT 06520.Dr. Vaccarino: Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, New Haven, CT 06520. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSerum Uric Acid and Risk for Cardiovascular Disease and Death: The Framingham Heart Study Bruce F. Culleton , Martin G. Larson , William B. 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Culleton, MD, Martin G. Larson, ScD, and Daniel Levy, MDMuch Ado About Nothing, or Much to Do About Something? The Continuing Controversy Over the Role of Uric Acid in Cardiovascular DiseaseThe Cohort Study – Watchful Waiting 6 July 1999Volume 131, Issue 1Page: 62-63KeywordsCardiovascular disease riskCardiovascular diseasesComputed axial tomographyCoronary heart diseaseEpidemiologyHypercholesterolemiaLongitudinal studiesMedical risk factorsResearch laboratoriesUric acid Issue Published: 6 July 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...