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Prognostic implications of microvascular and macrovascular abnormalities in older adults: cardiovascular health study.
Thursday,2014-05-29 13:44 America/Los_Angeles — poolea2
| Title | Prognostic implications of microvascular and macrovascular abnormalities in older adults: cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Kim, DHyun, Grodstein, F, Newman, AB, Chaves, PHM, Odden, MC, Klein, R, Sarnak, MJ, Patel, KV, Lipsitz, LA |
| Journal | J Gerontol A Biol Sci Med Sci |
| Volume | 69 |
| Issue | 12 |
| Pagination | 1495-502 |
| Date Published | 2014 Dec |
| ISSN | 1758-535X |
| Keywords | Aged, Aged, 80 and over, Aging, Ankle Brachial Index, Disability Evaluation, Electrocardiography, Female, Follow-Up Studies, Forecasting, Humans, Life Expectancy, Magnetic Resonance Imaging, Male, Microcirculation, Prognosis, Prospective Studies, Risk Factors, Vascular Malformations |
| Abstract | <p><b>BACKGROUND: </b>Microvascular and macrovascular abnormalities are frequently found on noninvasive tests performed in older adults. Their prognostic implications on disability and life expectancy have not been collectively assessed.</p><p><b>METHODS: </b>This prospective study included 2,452 adults (mean age: 79.5 years) with available measures of microvascular (brain, retina, kidney) and macrovascular abnormalities (brain, carotid, coronary, peripheral artery) in the Cardiovascular Health Study. The burden of microvascular and macrovascular abnormalities was examined in relation to total, activity-of-daily-living disability-free, and severe disability-free life expectancies in the next 10 years (1999-2009).</p><p><b>RESULTS: </b>At 75 years, individuals with low burden of both abnormalities lived, on average, 8.71 years (95% confidence interval: 8.29, 9.12) of which 7.67 years (7.16, 8.17) were without disability. In comparison, individuals with high burden of both abnormalities had shortest total life expectancy (6.95 years [6.52, 7.37]; p < .001) and disability-free life expectancy (5.60 years [5.10, 6.11]; p < .001). Although total life expectancy was similarly reduced for those with high burden of either type of abnormalities (microvascular: 7.96 years [7.50, 8.42] vs macrovascular: 8.25 years [7.80, 8.70]; p = .10), microvascular abnormalities seemed to have larger impact than macrovascular abnormalities on disability-free life expectancy (6.45 years [5.90, 6.99] vs 6.96 years [6.43, 7.48]; p = .016). These results were consistent for severe disability-free life expectancy and in individuals without clinical cardiovascular disease.</p><p><b>CONCLUSIONS: </b>Considering both microvascular and macrovascular abnormalities from multiple noninvasive tests may provide additional prognostic information on how older adults spend their remaining life. Optimal clinical use of this information remains to be determined.</p> |
| DOI | 10.1093/gerona/glu074 |
| Alternate Journal | J. Gerontol. A Biol. Sci. Med. Sci. |
| PubMed ID | 24864308 |
| PubMed Central ID | PMC4271022 |
| Grant List | N01HC55222 / HC / NHLBI NIH HHS / United States R01-AG-027002 / AG / NIA NIH HHS / United States P30 AG024827 / AG / NIA NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States R37-AG-25037 / AG / NIA NIH HHS / United States NHLBI-HC-97-06 / HC / NHLBI NIH HHS / United States K01 AG039387 / AG / NIA NIH HHS / United States P30-AG-024827 / AG / NIA NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States R21-HL-077166 / HL / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States HHSN268200800007C / / PHS HHS / United States R01 AG041785 / AG / NIA NIH HHS / United States R01-AG-023629 / AG / NIA NIH HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States P01-AG-004390 / AG / NIA NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States |