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Risk factors for cardiovascular disease across the spectrum of older age: The Cardiovascular Health Study Public Deposited

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  • 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.
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  • Odden, M. C., Shlipak, M. G., Whitson, H. E., Katz, R., Kearney, P. M., Defilippi, C., Shastri, S., ... & Newman, A. B. (2014). Risk factors for cardiovascular disease across the spectrum of older age: The Cardiovascular Health Study. Atherosclerosis, 237(1), 336-342. doi:10.1016/j.atherosclerosis.2014.09.012
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  • 237
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  • 1
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  • This research was supported by contractsHHSN268201200036C, 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 theNational Institute of Neurological Disorders and Stroke (NINDS).Additional support was provided by R01AG023629 andR01AG027002 from the National Institute on Aging (NIA).Dr. Odden is supported by the American Heart AssociationWestern States Affiliate (11CRP7210088) and the National Instituteon Aging (K01AG039387). Dr. Whitson is supported by the National Institute on Aging K23AG032867, P30AG028716, andR01AG043438.
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  • description.provenance : Submitted by Erin Clark (erin.clark@oregonstate.edu) on 2014-12-23T21:42:34Z No. of bitstreams: 2 OddenMichellePHHSRiskFactorsCardiovascular.pdf: 613685 bytes, checksum: 8dcc7f56d4e0fef491defbe04013e7a0 (MD5) OddenMichellePHHSRiskFactorsCardiovascular_SupplementaryData.zip: 387201 bytes, checksum: 7d7624453aaa48ec8ee17985dcb553ca (MD5)
  • description.provenance : Approved for entry into archive by Erin Clark(erin.clark@oregonstate.edu) on 2014-12-23T21:42:46Z (GMT) No. of bitstreams: 2 OddenMichellePHHSRiskFactorsCardiovascular.pdf: 613685 bytes, checksum: 8dcc7f56d4e0fef491defbe04013e7a0 (MD5) OddenMichellePHHSRiskFactorsCardiovascular_SupplementaryData.zip: 387201 bytes, checksum: 7d7624453aaa48ec8ee17985dcb553ca (MD5)
  • description.provenance : Made available in DSpace on 2014-12-23T21:42:46Z (GMT). No. of bitstreams: 2 OddenMichellePHHSRiskFactorsCardiovascular.pdf: 613685 bytes, checksum: 8dcc7f56d4e0fef491defbe04013e7a0 (MD5) OddenMichellePHHSRiskFactorsCardiovascular_SupplementaryData.zip: 387201 bytes, checksum: 7d7624453aaa48ec8ee17985dcb553ca (MD5) Previous issue date: 2014-11

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