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

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Title Risk factors for cardiovascular disease across the spectrum of older age: The Cardiovascular Health Study
Names Odden, Michelle C. (creator)
Shlipak, Michael G. (creator)
Whitson, Heather E. (creator)
et al. (creator)
Date Issued 2014-11 (iso8601)
Note To the best of our knowledge, one or more authors of this paper were federal employees when contributing to this work. This is the publisher’s final pdf. The published article is copyrighted by Elsevier and can be found at: http://www.journals.elsevier.com/atherosclerosis/.
Abstract 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.
Genre Article
Topic Aging
Identifier 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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