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Subclinical Vascular Disease Burden and Longer Survival

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  • OBJECTIVES: Subclinical vascular disease (SVD) contributes to the aging process and may decrease life expectancy. We aimed to determine the contribution of gradations of SVD to the likelihood of achieving longer survival, and to determine what allows some individuals to achieve longer survival in the presence of high SVD. DESIGN: Cohort Study SETTING: Cardiovascular Health Study PARTICIPANTS: Adults who were born after June 30th, 1918 and before June 30th, 1921 (n=2,082); participants were age 70-75 years at baseline visit (1992-1993). MEASUREMENTS: A SVD index was scored as 0, 1, or 2 for no, mild, or severe abnormalities on ankle-arm index, electrocardiogram, and common carotid intima-media thickness measured at baseline. Survival groups were categorized as <80, 80-84, 85-89, and 90+ years. RESULTS: A one point lower SVD score was associated with a 1.22 (95% confidence interval: 1.14, 1.31) higher odds of achieving longer survival, independent of potential confounders. This association was unchanged after adjustment for intermediate incident cardiovascular events. There was suggestion of an interaction of kidney function, smoking, and CRP with SVD; the association of SVD and longer survival appeared modestly increased in persons with poor kidney function, inflammation, or a history of smoking. CONCLUSION: A lower burden of SVD is associated with longer survival, and this association was independent of intermediate cardiovascular events. Abstinence from smoking, better kidney function, and lower inflammation may attenuate the effects of higher SVD and further promote longer survival.
  • This is an author's peer-reviewed final manuscript, as accepted by the publisher. The article is copyrighted by the authors; the Journal compilation is copyrighted by the American Geriatrics Society and published by John Wiley & Sons, Inc. It can be found at: http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291532-5415
  • Keywords: kidney function, inflammation, smoking, survival, cardiovascular disease, subclinical disease
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  • Odden, M. C., Yee, L. M., Arnold, A. M., Sanders, J. L., Hirsch, C., deFilippi, C., ... & Newman, A. B. (2014). Subclinical Vascular Disease Burden and Longer Survival. Journal of the American Geriatrics Society, 62(9), 1692-1698. doi:10.1111/jgs.13018
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  • 62
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  • 9
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  • This research was supported by AG023629 from the National Institute on Aging (NIA). Support for the CHS was provided by Contracts HHSN268201200036C, HHSN268200800007C, N01 HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, and 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). A full list of principal CHS investigators and institutions can be found at http://www.chs-nhlbi.org/PI.htm. Dr. Odden is supported by the American Heart Association Western States Affiliate (11CRP7210088) and the NIA (K01AG039387). Dr. Newman is supported by the University of Pittsburgh Claude D. Pepper Older Americans Independence Center P30AG024827, and the CHS All Stars NIA R01 (AG023629).
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