Risk factors for cardiovascular disease across the spectrum of older age: the Cardiovascular Health Study.

Published

Journal Article

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.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).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).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.

Full Text

Duke Authors

Cited 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

Published Date

  • November 2014

Published In

Volume / Issue

  • 237 / 1

Start / End Page

  • 336 - 342

PubMed ID

  • 25303772

Pubmed Central ID

  • 25303772

Electronic International Standard Serial Number (EISSN)

  • 1879-1484

International Standard Serial Number (ISSN)

  • 0021-9150

Digital Object Identifier (DOI)

  • 10.1016/j.atherosclerosis.2014.09.012

Language

  • eng