518 ABSTRACTS (ACE) AEP Vol. 12, No. 7 October 2002: 488–534 overweight subjects. Following adjustment for age and sex , the declines in mortality, incidence, and 28-day case fatality rate due to stroke were 18% (p = 0.386), 40% (p = 0.000), and 2% (p = 0.992), respectively, in normal weight subjects, and 55% (p = 0.025), 24% (p = 0.015), and 65% (p = 0.019), respectively, in overweight subjects. CONCLUSION: These findings suggest that the substantial de- cline in CVD mortality in the overweight group is mainly due to reduction in case fatality rate. PII S1047-2797(02)00363-0 #76 SYSTOLIC BLOOD PRESSURE GROWTH IN US CHILDREN AND ADOLESCENTS WM Hlaing , RJ Prineas, Y Zhu, Department of Public Health, Florida International University, North Miami, FL PURPOSE: Rapid height and weight changes occur from infancy throughout adolescence. The rate of weight and height changes contributes markedly to blood pressure change during children’s physical growth. Longitudinal assessment of systolic blood pressure (SBP), using growth modeling, has not been described in the U.S. This study evaluates the differences in SBP growth among four gender-ethnic groups: African American boys, African American girls, Caucasian boys, and Caucasian girls. METHODS: Subjects were 6 to 9 years old at entry, and were fol- lowed up for 12 years. A total of 19 semi-annual and annual SBP measurements were made. The population was restricted to sub- jects with a minimum of 5 timed measurements (n = 1,302). Re- peated SBP measures were analyzed using the Gompertz growth model. RESULTS: Two parameters of SBP growth were evaluated: (1) the initial SBP level at study entry, and (2) the asymptote level (e.g., the level at which SBP growth diminishes). The average age of children at entry was 7.72 (0.7) years. The mean and standard error of the initial SBP level (millimeters of mercury or mmHg) was highest in Caucasian boys (102.8  0.5), followed by African American boys (99.4  0.8), Caucasian girls (84.9  0.7), and African American girls (82.2  0.8). The asymptote level (mmHg) was highest among Caucasian boys (111.1  0.4), fol- lowed by African American boys (110.6  0.5), African Ameri- can girls (107.1  0.5), and Caucasian girls (105.3  0.4). CONCLUSION: These results suggest that longitudinal changes in SBP differ among children in the four gender-ethnic groups. PII S1047-2797(02)00364-2 #77 LONG-TERM OUTCOMES OF MEDICAL MANAGEMENT OF PATIENTS WITH CHRONIC CORONARY ARTERY DISEASE S Jabbour , B Lown, Faculties of Medicine and Health Sciences, American University of Beirut, Beirut, Lebanon PURPOSE: Insufficient data exist on the long-term outcomes of optimized medical therapy in patients with chronic stable coro- nary artery disease (CAD), compared with outcomes among those undergoing coronary revascularization. METHODS: We followed prospectively 693 subjects with proven CAD using a management strategy that emphasized maximally tolerated medical therapy and risk factor modification. Exclusion criteria were class III-IV congestive heart failure, severe valvular disease or prior revascularization. Referral to invasive coronary in- terventions followed stricter criteria than standard guidelines. Pri- mary outcomes were all-cause mortality or non-fatal myocardial infarction (MI). Secondary outcomes included cardiac death, un- stable angina or revascularization. RESULTS: Baseline characteristics were: mean age 67 years, 82% males, 42% with prior MI and 6% current smokers. Mean ejection fraction and total cholesterol were 59% and 204 mg/dl, respec- tively. During an average follow-up of 4.6 years, the annualized in- cidence of non-fatal MI, cardiac and total mortality was 2.2%, 0.8%, 1.4%, respectively. Coronary revascularization was per- formed in 24% of subjects; unstable or progressive anginal symp- toms were the most common reasons for revascularization. In multivariate analysis, the variables most predictive of adverse out- comes were: history of diabetes, RR 2.2 (1.4–3.4), prior MI, RR 1.5 (1.1–2.0), and age , RR 1.5 (1.2–1.9). Use of aspirin, beta blockers or lipid lowering agents was protective. CONCLUSION: In patients with chronic stable CAD, a man- agement strategy based on optimized medical therapy and modifi- cation of risk factors, is associated with excellent long-term outcome and represents a viable alternative to invasive proce- dures. Coronary interventions can be avoided or delayed until clinical instability ensues, without increased risk of MI or death. PII S1047-2797(02)00365-4 #78 BIRTH WEIGHT MODIFIES THE RELATIONSHIPS BETWEEN SYSTOLIC BLOODPRESSURE, PUBERTAL DEVELOPMENT, AND BODY MASS IN ADOLESCENTS C Li , ML Cruz, TT Huang, MI Goran, Department of Preventive Medicine, University of Southern California, Los Angeles, CA PURPOSE: Studies have shown that systolic blood pressure (SBP) is positively associated with body size and sexual matura- tion, but inversely associated with birth weight during childhood. The aim of the this longitudinal study was to examine the moder- ating effects of birth weight on the associations of SBP with puber- tal development and body mass in Caucasian and African American children. METHODS: One hundred and thirty nine children aged 4 to 12 years at the start of the study were followed up annually for 3 to 5 years with an average of 4 repeated measures for each subject (n = 560 observations) in Birmingham, Alabama. Characteristics mea- sured annually included blood pressure, Tanner stage, and body composition from dual energy x-ray absorptiometry. RESULTS: SBP was inversely correlated with birth weight (r = -0.10, p = 0.02), especially in Caucasian children (r = -0.16, p = 0.002). Larger BMI was significantly associated with higher