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Risk factors for cardiovascular disease across the spectrum of older age: the Cardiovascular Health Study.
Wednesday,2015-03-04 13:57 America/Los_Angeles — zdrager
| Title | Risk factors for cardiovascular disease across the spectrum of older age: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Odden, MC, Shlipak, MG, Whitson, HE, Katz, R, Kearney, PM, deFilippi, C, Shastri, S, Sarnak, MJ, Siscovick, DS, Cushman, M, Psaty, BM, Newman, AB |
| Journal | Atherosclerosis |
| Volume | 237 |
| Issue | 1 |
| Pagination | 336-42 |
| Date Published | 2014 Nov |
| ISSN | 1879-1484 |
| Keywords | Aged, Aged, 80 and over, Blood Pressure, C-Reactive Protein, Cardiovascular Diseases, Cholesterol, HDL, Cholesterol, LDL, Diabetes Complications, Diabetes Mellitus, Female, Humans, Inflammation, Kidney, Kidney Diseases, Lipids, Male, Natriuretic Peptide, Brain, Obesity, Peptide Fragments, Risk Factors |
| Abstract | <p><b>OBJECTIVE: </b>The associations of some risk factors with cardiovascular disease (CVD) are attenuated in older age; whereas others appear robust. The present study aimed to compare CVD risk factors across older age.</p><p><b>METHODS: </b>Participants (n = 4883) in the Cardiovascular Health Study free of prevalent CVD, were stratified into three age groups: 65-74, 75-84, 85+ years. Traditional risk factors included systolic blood pressure (BP), LDL-cholesterol, HDL-cholesterol, obesity, and diabetes. Novel risk factors included kidney function, C-reactive protein (CRP), and N-terminal pro-B-type natriuretic peptide (NT pro-BNP).</p><p><b>RESULTS: </b>There were 1498 composite CVD events (stroke, myocardial infarction, and cardiovascular death) over 5 years. The associations of high systolic BP and diabetes appeared strongest, though both were attenuated with age (p-values for interaction = 0.01 and 0.002, respectively). The demographic-adjusted hazard ratios (HR) for elevated systolic BP were 1.79 (95% confidence interval: 1.49, 2.15), 1.59 (1.37, 1.85) and 1.10 (0.86, 1.41) in participants aged 65-74, 75-84, 85+, and for diabetes, 2.36 (1.89, 2.95), 1.55 (1.27, 1.89), 1.51 (1.10, 2.09). The novel risk factors had consistent associations with the outcome across the age spectrum; low kidney function: 1.69 (1.31, 2.19), 1.61 (1.36, 1.90), and 1.57 (1.16, 2.14) for 65-74, 75-84, and 85+ years, respectively; elevated CRP: 1.54 (1.28, 1.87), 1.33 (1.13, 1.55), and 1.51 (1.15, 1.97); elevated NT pro-BNP: 2.67 (1.96, 3.64), 2.71 (2.25, 3.27), and 2.18 (1.43, 3.45).</p><p><b>CONCLUSIONS: </b>The associations of most traditional risk factors with CVD were minimal in the oldest old, whereas diabetes, eGFR, CRP, and NT pro-BNP were associated with CVD across older age.</p> |
| DOI | 10.1016/j.atherosclerosis.2014.09.012 |
| Alternate Journal | Atherosclerosis |
| PubMed ID | 25303772 |
| PubMed Central ID | PMC4254262 |
| Grant List | R01AG027002 / AG / NIA NIH HHS / United States N01HC85239 / HC / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States K01 AG039387 / AG / NIA NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States R01AG023629 / AG / NIA NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01 HC55222 / HC / NHLBI NIH HHS / United States |