The effect of sarcopenic obesity on cardiovascular disease and all-cause mortality in older people

2015 ◽  
Vol 25 (2) ◽  
pp. 86-97 ◽  
Author(s):  
Janice L Atkins ◽  
S Goya Wannamethee
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Muscle Mass ◽  
Public Health Problem ◽  
Sarcopenic Obesity ◽  
Major Public Health Problem ◽  
Ageing Population ◽  
Obesity Prevalence ◽  
Cvd Risk ◽  
Cardiovascular Morbidity And Mortality

SummaryObesity is a major public health problem with increasing prevalence worldwide. It is well recognized as a risk factor for cardiovascular morbidity and mortality in adult populations. Obesity prevalence is also increasing with age, and this may be particularly important in an ageing population. Ageing is associated with an increase in visceral fat and a progressive loss of muscle mass. Sarcopenia has been defined as the age-associated loss of skeletal muscle mass and has been associated with metabolic impairment, cardiovascular disease (CVD) risk factors, physical disability and mortality. Sarcopenia is often associated with obesity. Sarcopenic obesity is a new category of obesity in older adults who have high adiposity coupled with low muscle mass. Thus sarcopenia with obesity may synergistically increase their effect on metabolic disorders, CVD and mortality. This review focuses on the effects of sarcopenic obesity on the risk of cardiovascular disease and mortality in older adults.

scholarly journals Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity

2015 ◽  
Vol 74 (4) ◽  
pp. 405-412 ◽  
Author(s):  
S. Goya Wannamethee ◽  
Janice L. Atkins
Keyword(s):  
Older Adults ◽  
Muscle Mass ◽  
Public Health Problem ◽  
Obesity Paradox ◽  
Overweight And Obesity ◽  
Sarcopenic Obesity ◽  
Major Public Health Problem ◽  
Health Implications ◽  
Cardiovascular Morbidity And Mortality ◽  
Increased Risk

This paper reviews the health implications of obesity, sarcopenia and sarcopenic obesity on CVD and mortality in older adults and discusses the obesity paradox seen in patients with CVD. Obesity is a major public health problem with increasing prevalence worldwide. It is an established risk factor for cardiovascular morbidity and mortality in adult populations. However, there is controversy surrounding the effects of obesity as measured by BMI in older people, and overweight and obesity (BMI ⩾ 25 kg/m2) are apparently associated with increased survival in those with CVD (obesity paradox). Ageing is associated with an increase in visceral fat and a progressive loss of muscle mass which have opposing effects on mortality. Thus BMI is not a good indicator of obesity in older adults. Sarcopenia, the age-associated loss of skeletal muscle mass, is a major concern in ageing populations and has been associated with metabolic impairment, CVD risk factors, physical disability and mortality. Sarcopenia often coexists with obesity. Sarcopenic obesity is a new category of obesity in older adults who have high adiposity coupled with low muscle mass. To fully understand the effect of obesity on mortality in the elderly it is important to take muscle mass into account. The evidence suggests that sarcopenia with obesity may be associated with higher levels of metabolic disorders and an increased risk of mortality than obesity or sarcopenia alone. Efforts to promote healthy ageing should focus on both preventing obesity and maintaining or increasing muscle mass.

scholarly journals Dietary Adherence of Saudi Males to the Saudi Dietary Guidelines and Its Relation to Cardiovascular Diseases: A Preliminary Cross-Sectional Study

2019 ◽  
Vol 6 (2) ◽  
pp. 17 ◽  
Author(s):  
Areej Alkhaldy ◽  
Reem Alamri ◽  
Rozana Magadmi ◽  
Nrvana Elshini ◽  
Rania Hussein ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Dietary Intake ◽  
Fasting Blood Glucose ◽  
Public Health Problem ◽  
Dietary Guidelines ◽  
Dietary Adherence ◽  
Major Public Health Problem ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Adherence Score

Cardiovascular disease (CVD) is a major public health problem in Saudi Arabia. Dietary intake plays a major role in CVD incidence; however, the dietary intake status in Saudi nationals with CVD is unknown. We aimed to investigate whether the dietary patterns of Saudi males, using the Saudi dietary guidelines adherence score, in parallel with the measurement of a selective number of cardiovascular disease-related biomarkers, are contributing factors to CVD risk. Demographics, dietary adherence score, and blood biomarker levels were collected for 40 CVD patients and forty non-CVD patients. Fasting blood glucose (p = 0.006) and high-density lipoprotein levels (p = 0.03) were significantly higher in CVD patients. The adherence score to the Saudi dietary guidelines was not significantly different between the CVD and non-CVD patients; however, the specific adherence scores of fruit (p = 0.02), olive oil (p = 0.01), and non-alcoholic beer (p = 0.02) were significantly higher in the non-CVD patients. The differences in CVD family history (p = 0.02) and adherence scores to specific groups/foods between the CVD and non-CVD patients may contribute to CVD risk in Saudi males. However, as the sample size of this study was small, further research is required to validate these findings.

OP116 Cost-Effectiveness Of Sacubitril/Valsartan In Heart Failure

2017 ◽  
Vol 33 (S1) ◽  
pp. 52-53
Author(s):  
Liang Lin ◽  
Mohamed Ismail Abdul Aziz ◽  
David Bin-Chia Wu ◽  
Kwong Ng
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
Public Health Problem ◽  
Cardiovascular Death ◽  
Sensitivity Analyses ◽  
Major Public Health Problem ◽  
Old Patients ◽  
Asian Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
The Cost

INTRODUCTION:Heart failure (HF) is a major public health problem worldwide and in Asia. Sacubitril/valsartan reduces cardiovascular death and hospitalizations for HF. However, decision makers need to determine whether its benefits are worth the additional costs, given the low-cost generic status of current standard of care.METHODS:Using a Markov model, we projected lifetime clinical and economic outcomes of sacubitril/valsartan versus enalapril for 66-year-old patients with HF in Singapore. Key health states included New York Heart Association (NYHA) classes; patients in each state incurred a monthly risk of hospitalization for HF and cardiovascular death. Probabilities of events were based on the PARADIGM-HF trial. The uncertain treatment effect of sacubtril/valsartan in Asian patients was modelled using a hazard ratio (HR) of 1 as upper limit in sensitivity analyses. Utilities were obtained from published literature. Local national epidemiological and cost data were applied. Analyses were conducted from the Singapore healthcare payer's perspective. Both one-way and Probabilistic Sensitivity Analyses (PSA) based on 10,000 Monte Carlo simulations were performed.RESULTS:Compared to enalapril, sacubitril/valsartan was associated with an incremental cost-effectiveness ratio (ICER) of SGD74k (USD52k) per quality-adjusted life year (QALY) gained. The cost-effectiveness of sacubitril/valsartan was highly dependent on its effectiveness in reducing the risk of cardiovascular death. However, this was uncertain, particularly in the Asian subgroup, where results were not statistically significant. In sensitivity analyses using results from Asian patients, the ICERs ranged from SGD41k (USD30k) to SGD1.3 million (USD 0.94 million) per QALY gained. PSA showed the probability of sacubitril/valsartan being cost-effective was below 1 percent, 12 percent and 71 percent at thresholds of SGD20k (USD14k), SGD50k (USD36k) and SGD100k (USD 72k) per QALY gained, respectively.CONCLUSIONS:Given the uncertain ICER, sacubtril/valsartan may not provide good value for money compared to enalapril in reducing cardiovascular morbidity and mortality in patients with HF at the current daily cost. Our study highlights the cost-benefit trade-off that healthcare professionals and patients face when considering HF therapy.

scholarly journals Factors associated with skeletal muscle mass, sarcopenia, and sarcopenic obesity in older adults: a multi-continent study

2015 ◽  
Vol 7 (3) ◽  
pp. 312-321 ◽  
Author(s):  
Stefanos Tyrovolas ◽  
Ai Koyanagi ◽  
Beatriz Olaya ◽  
Jose Luis Ayuso-Mateos ◽  
Marta Miret ◽  
...  
Keyword(s):  
Older Adults ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Sarcopenic Obesity ◽  
Factors Associated

scholarly journals Short-Term Exposure to Waterpipe/Hookah Smoke Triggers a Hyperactive Platelet Activation State and Increases the Risk of Thrombogenesis

2020 ◽  
Vol 40 (2) ◽  
pp. 335-349 ◽  
Author(s):  
Ahmed B. Alarabi ◽  
Zubair A. Karim ◽  
Jean E. Montes Ramirez ◽  
Keziah R. Hernandez ◽  
Patricia A. Lozano ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Tobacco Smoking ◽  
Public Awareness ◽  
Real Life ◽  
Public Health Problem ◽  
Whole Body ◽  
Major Public Health Problem ◽  
Short Term Exposure ◽  
Clean Air ◽  
Induced Aggregation

Objective: Cardiovascular disease is a major public health problem. Among cardiovascular disease’s risk factors, tobacco smoking is considered the single most preventable cause of death, with thrombosis being the main mechanism of cardiovascular disease mortality in smokers. While tobacco smoking has been on the decline, the use of waterpipes/hookah has been rising, mainly due to the perception that they are less harmful than regular cigarettes. Strikingly, there are few studies on the negative effects of waterpipes on the cardiovascular system, and none regarding their direct contribution to thrombus formation. Approach and Results: We used a waterpipe whole-body exposure protocol that mimics real-life human exposure scenarios and investigated its effects, relative to clean air, on platelet function, hemostasis, and thrombogenesis. We found that waterpipe smoke (WPS)–exposed mice exhibited both shortened thrombus occlusion and bleeding times. Further, our results show that platelets from WPS-exposed mice are hyperactive, with enhanced agonist-induced aggregation, dense and α-granule secretion, αIIbβ3 integrin activation, phosphatidylserine expression, and platelet spreading, when compared with clean air–exposed platelets. Finally, at the molecular level, it was found that Akt (protein kinase B) and ERK (extracellular signal-regulated kinases) phosphorylation are enhanced in the WPS and in nicotine-treated platelets. Conclusions: Our findings demonstrate that WPS exposure directly modulates hemostasis and increases the risk of thrombosis and that this is mediated, in part, via a state of platelet hyperactivity. The negative health impact of WPS/hookah, therefore, should not be underestimated. Moreover, this study should also help in raising public awareness of the toxic effects of waterpipe/hookah.

scholarly journals Skeletal muscle mass in relation to 10 year cardiovascular disease incidence among middle aged and older adults: the ATTICA study

2019 ◽  
Vol 74 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Stefanos Tyrovolas ◽  
Demosthenes Panagiotakos ◽  
Ekavi Georgousopoulou ◽  
Christina Chrysohoou ◽  
Dimitrios Tousoulis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Disease Incidence ◽  
Population Based ◽  
Cardiometabolic Health ◽  
Inverse Association ◽  
Cvd Risk ◽  
Appendicular Skeletal Muscle

BackgroundSkeletal muscle mass (SMM) is inversely associated with cardiometabolic health and the ageing process. The aim of the present work was to evaluate the relation between SMM and 10 year cardiovascular disease (CVD) incidence, among CVD-free adults 45+ years old.MethodsATTICA is a prospective, population-based study that recruited 3042 adults without pre-existing CVD from the Greek general population (Caucasians; age ≥18 years; 1514 men). The 10 year study follow-up (2011–2012) captured the fatal/non-fatal CVD incidence in 2020 participants (50% men). The working sample consisted of 1019 participants, 45+ years old (men: n=534; women: n=485). A skeletal muscle mass index (SMI) was created to reflect SMM, using appendicular skeletal muscle mass (ASM) standardised by body mass index (BMI). ASM and SMI were calculated with specific indirect population formulas.ResultsThe 10 year CVD incidence increased significantly across the baseline SMI tertiles (p<0.001). Baseline SMM showed a significant inverse association with the 10 year CVD incidence (HR 0.06, 95% CI 0.005 to 0.78), even after adjusting for various confounders. Additionally, participants in the highest SMM tertile had 81% (95% CI 0.04 to 0.85) lower risk for a CVD event as compared with those in the lowest SMM tertile.ConclusionsThe presented findings support the importance of SMM evaluation in the prediction of long-term CVD risk among adults 45+ years old without pre-existing CVD. Preservation of SMM may contribute to CVD health.

Cardiovascular disease (CVD) risk factors in older adults – Perception and reality

2015 ◽  
Vol 61 (1) ◽  
pp. 88-92 ◽  
Author(s):  
Josipa Mazalin Protulipac ◽  
Zdenko Sonicki ◽  
Željko Reiner
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Cvd Risk Factors ◽  
Cvd Risk

scholarly journals Use of a Single Wireless IMU for the Segmentation and Automatic Analysis of Activities Performed in the 3-m Timed Up & Go Test

Sensors ◽  
2019 ◽  
Vol 19 (7) ◽  
pp. 1647 ◽  
Author(s):  
Paulina Ortega-Bastidas ◽  
Pablo Aqueveque ◽  
Britam Gómez ◽  
Francisco Saavedra ◽  
Roberto Cano-de-la-Cuerda
Keyword(s):  
Older Adults ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Video Recording ◽  
Public Health Problem ◽  
Measurement Unit ◽  
Major Public Health Problem ◽  
Similar Data ◽  
Mean Error ◽  
Young Subjects

Falls represent a major public health problem in the elderly population. The Timed Up & Go test (TU & Go) is the most used tool to measure this risk of falling, which offers a unique parameter in seconds that represents the dynamic balance. However, it is not determined in which activity the subject presents greater difficulties. For this, a feature-based segmentation method using a single wireless Inertial Measurement Unit (IMU) is proposed in order to analyze data of the inertial sensors to provide a complete report on risks of falls. Twenty-five young subjects and 12 older adults were measured to validate the method proposed with an IMU in the back and with video recording. The measurement system showed similar data compared to the conventional test video recorded, with a Pearson correlation coefficient of 0.9884 and a mean error of 0.17 ± 0.13 s for young subjects, as well as a correlation coefficient of 0.9878 and a mean error of 0.2 ± 0.22 s for older adults. Our methodology allows for identifying all the TU & Go sub–tasks with a single IMU automatically providing information about variables such as: duration of sub–tasks, standing and sitting accelerations, rotation velocity of turning, number of steps during walking and turns, and the inclination degrees of the trunk during standing and sitting.

scholarly journals Prevalence and Determinants of Falls among Older Adults in Ecuador: An Analysis of the SABE I Survey

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Carlos H. Orces
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Coastal Region ◽  
Public Health Problem ◽  
Linear Increase ◽  
Andes Mountains ◽  
Major Public Health Problem ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Nationally Representative

The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and those being physically active during the previous year were variables found independently associated with increased risk of falling among older adults in Ecuador. Moreover, a gradual and linear increase in the prevalence of falls was seen as the number of risk factors increased. Falls represent a major public health problem among older adults in Ecuador. The present findings may assist public health authorities to implement programs of awareness and fall prevention among older adults at higher risk of falls.

scholarly journals Can we walk away from cardiovascular disease risk or do we have to ‘huff and puff’? A cross-sectional compositional accelerometer data analysis among adults and older adults in the Copenhagen City Heart Study

2020 ◽  
Author(s):  
Melker Staffan Johansson ◽  
Karen Søgaard ◽  
Eva Prescott ◽  
Jacob Louis Marott ◽  
Peter Schnohr ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Data Analysis ◽  
Sedentary Behaviour ◽  
Accelerometer Data ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Heart Study ◽  
Copenhagen City Heart Study

Abstract Background: It is unclear whether walking can decrease cardiovascular disease (CVD) risk or if high intensity physical activity (HIPA) is needed, and whether the association is modified by age. We investigated how sedentary behaviour, walking, and HIPA, were associated with systolic blood pressure (SBP), waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C) among adults and older adults in a general population sample using compositional data analysis. Specifically, the measure of association was quantified by reallocating time between sedentary behaviour and 1) walking, and 2) HIPA. Methods: Cross-sectional data from the fifth examination of the Copenhagen City Heart Study was used. Using the software Acti4, we estimated daily time spent in physical behaviours from accelerometer data worn 24 h/day for 7 days (i.e., right frontal thigh and iliac crest; median wear time: 6 days, 23.8 h/day). SBP, WC, and LDL-C were measured during a physical examination. Inclusion criteria were ≥5 days with ≥16 h of accelerometer recordings per day, and no use of antihypertensives, diuretics or cholesterol lowering medicine. The 24-hour physical behaviour composition consisted of sedentary behaviour, standing, moving, walking, HIPA (i.e., sum of climbing stairs, running, cycling and rowing), and time in bed. We used fitted values from linear regression models to predict the difference in outcome given the investigated time reallocations relative to the group-specific mean composition. Results: Among 1053 eligible participants, we found an interaction between the physical behaviour composition and age. Age-stratified analyses (i.e., </≥65 years; 773 adults, 280 older adults) indicated that less sedentary behaviour and more walking was associated with lower SBP among older adults only. For less sedentary behaviour and more HIPA, the results i) indicated an association with lower SBP irrespective of age, ii) showed an association with a smaller WC among adults, and iii) showed an association with a lower LDL-C in both age groups. Conclusions: Less sedentary behaviour and more walking seems to be associated with lower CVD risk among older adults, while HIPA types are associated with lower risk among adults. Therefore, to reduce CVD risk, the modifying effect of age should be considered in future physical activity-promoting initiatives.

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