TY - JOUR
T1 - Risk factors for cardiovascular disease across the spectrum of older age
T2 - The Cardiovascular Health Study
AU - Odden, Michelle C.
AU - Shlipak, Michael G.
AU - Whitson, Heather E.
AU - Katz, Ronit
AU - Kearney, Patricia M.
AU - Defilippi, Chris
AU - Shastri, Shani
AU - Sarnak, Mark J.
AU - Siscovick, David S.
AU - Cushman, Mary
AU - Psaty, Bruce M.
AU - Newman, Anne B.
N1 - Funding Information:
This research was supported by contracts HHSN268201200036C, N01HC85239, N01 HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grant HL080295 from the National Heart, Lung, and Blood Institute (NHLBI) , with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS) . Additional support was provided by R01AG023629 and R01AG027002 from the National Institute on Aging (NIA) . A full list of principal CHS investigators and institutions can be found at http://www.chs-nhlbi.org/PI.htm .
Funding Information:
Dr. Odden is supported by the American Heart Association Western States Affiliate ( 11CRP7210088 ) and the National Institute on Aging (K01AG039387). Dr. Whitson is supported by the National Institute on Aging K23AG032867 , P30AG028716 , and R01AG043438 .
Publisher Copyright:
© 2014 Elsevier Ireland Ltd.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objective: 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. Methods: 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). Results: 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). Conclusions: 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.
AB - Objective: 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. Methods: 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). Results: 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). Conclusions: 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.
KW - Aging
KW - Epidemiology
KW - Risk factors
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U2 - 10.1016/j.atherosclerosis.2014.09.012
DO - 10.1016/j.atherosclerosis.2014.09.012
M3 - Article
C2 - 25303772
AN - SCOPUS:84907853547
SN - 0021-9150
VL - 237
SP - 336
EP - 342
JO - Atherosclerosis
JF - Atherosclerosis
IS - 1
ER -