Revised Adult Treatment Panel III Guidelines and Cardiovascular Disease Mortality in Men Attending a Preventive Medical Clinic
Bibliographic record
Abstract
BACKGROUND: National Cholesterol Education Program Adult Treatment Panel III guidelines recommend therapeutic lifestyle changes (TLC) and drug therapy to reduce cardiovascular disease (CVD) risk. These guidelines have been revised recently (ATP III-R); however, the risk of CVD mortality within each intervention window and the effects of cardiorespiratory fitness (CRF) and metabolic syndrome on CVD mortality within the framework of the guidelines are unknown. METHODS AND RESULTS: Risk factor and CRF data from 19,125 men (aged 20 to 79 years) who attended a preventive medical clinic between 1979 and 1995 were used. Mortality follow-up was completed until December 31, 1996. Participants were assigned to ATP III-R groups (LDL-C goal, TLC initiation, and drug consideration), and risk of CVD mortality was assessed by Cox proportional hazards regression. There were 179 CVD deaths over an average 10.2 years of follow-up. Compared with the LDL-C goal group, men in the TLC initiation and drug consideration groups had an elevated risk of CVD mortality (TLC initiation: HR=2.65, 95% CI 1.67 to 4.19; drug consideration: HR=6.44, 95% CI 4.49 to 9.25). Compared with LDL-C goal/fit, CVD mortality risk was higher in the LDL-C goal/unfit (4.8, 2.5 to 9.1), TLC initiation/fit (3.0, 1.7 to 5.3), TLC initiation/unfit (7.5, 3.7 to 15.2), drug consideration/fit (7.2, 4.6 to 11.4), and drug consideration/unfit (14.9, 9.1 to 24.4) groups. A similar gradient was observed for metabolic syndrome across intervention windows. CONCLUSIONS: Men eligible for TLC or drug consideration under ATP III-R were at elevated risk of CVD mortality compared with men who met the LDL-C goal. Furthermore, men who were physically fit or who did not have the metabolic syndrome had a lower risk of CVD mortality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".