scholarly journals Aspirin prescribing in cardiovascular disease in middle-aged and older adults in Ireland: findings from The Irish Longitudinal Study on Ageing

2020 ◽  
Author(s):  
Frank Moriarty ◽  
Alan Barry ◽  
Rose Anne Kenny ◽  
Tom Fahey
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Cardiovascular Risk ◽  
Longitudinal Study ◽  
Secondary Prevention ◽  
Cross Sectional Study ◽  
Adjusted Relative Risk ◽  
Primary And Secondary Prevention ◽  
Cross Sectional ◽  
Factors Associated

Background Aspirin use for cardiovascular indications is widespread despite evidence not supporting use in patients without cardiovascular disease (CVD). This study characterises aspirin prescribing among people aged ≥50 years in Ireland for primary and secondary prevention, and factors associated with prescription. Methods This cross-sectional study includes participants from wave 3 (2014-2015) of The Irish Longitudinal Study on Ageing. We identified participants reporting use of prescribed aspirin, other antiplatelets/anticoagulants, and doctor-diagnosed CVD (MI, angina, stroke, TIA) and other cardiovascular conditions. We examined factors associated with aspirin use for primary and secondary prevention in multivariate regression. For a subset, we also examined 10-year cardiovascular risk (using the Framingham general risk score) as a predictor of aspirin use. Results Among 6,618 participants, the mean age was 66.9 years (SD 9.4) and 55.6% (3,679) were female. Prescribed aspirin was reported by 1,432 participants (21.6%), and 77.6% of aspirin users had no previous CVD. Among participants with previous CVD, 17% were not prescribed aspirin/another antithrombotic. This equates to 201,000 older adults nationally using aspirin for primary prevention, and 16,000 with previous CVD not prescribed an antithrombotic. Among those without CVD, older age, male sex, free health care, and more GP visits were associated with aspirin prescribing. Cardiovascular risk was significantly associated with aspirin use (adjusted relative risk 1.15, 95%CI 1.08-1.23, per 1% increase in cardiovascular risk). Conclusion Almost four-fifths of people aged ≥50 years on aspirin have no previous CVD, equivalent to 201,000 adults nationally, however prescribing appears rational in targeting higher cardiovascular risk patients.

scholarly journals Use of Cardiovascular Drugs for Primary and Secondary Prevention of Cardiovascular Disease Among Rural-Dwelling Older Chinese Adults

2020 ◽  
Vol 11 ◽  
Author(s):  
Lin Cong ◽  
Yifei Ren ◽  
Tingting Hou ◽  
Xiaolei Han ◽  
Yi Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Cardiovascular Risk ◽  
Secondary Prevention ◽  
Cardiovascular Risk Factors ◽  
Lipid Lowering ◽  
Hypoglycemic Agents ◽  
Primary And Secondary Prevention ◽  
Lipid Lowering Agents

Cardiovascular risk factors and related disorders are common among older adults, and use of various classes of cardiovascular (CV) drugs could reduce the risk of cardiovascular disease (CVD). However, data are sparse with regard to the use of CV drugs among rural-dwelling older adults in China. Therefore, this population-based study aimed to describe use of CV drugs among older adults living in the rural communities in China, while taking into account the use of CV drugs for primary and secondary prevention of CVDs. This study included 5,246 participants (age ≥65 years; 57.17% women; 40.68% illiteracy) in the baseline examination of the MIND-China study. In March-September 2018, data on health-related factors, CVDs (ischemic heart disease, atrial fibrillation, heart failure, and stroke), and CV drug use were collected via face-to-face survey, clinical examination, and laboratory tests. We classified CV drugs according to the Anatomical Therapeutic Chemical classification system for western medications and specific cardiovascular effects for the products of traditional Chinese medicine (TCM). We conducted descriptive analysis. The overall prevalence of major cardiovascular risk factors ranged from 14.30% in diabetes and 23.81% in dyslipidemia to 66.70% in hypertension, and CVDs affected 35.07% of all participants (36.28% in women vs. 33.47% in men, p = 0.035). In the total sample, calcium channel blockers (C08) were most commonly used (10.39%), followed by TCM products (7.64%), hypoglycemic agents (A10, 4.73%), renin-angiotensin system (RAS)-acting agents (C09, 4.61%), and lipid-lowering agents (C10, 4.17%). The proportions of CV drugs for primary prevention (i.e., use of CV drugs among people without CVD) were 3.14% for antithrombotic agents (mainly aspirin), 1.38% for lipid-lowering agents, and 3.11% for RAS-acting agents; the corresponding figures for secondary prevention (i.e., use of CV drugs among people with CVD) were 13.97%, 9.35%, and 7.39%. In conclusion, despite highly prevalent cardiovascular risk factors and CVDs, a fairly low proportion of the rural-dwelling older adults take CV medications for primary and secondary prevention. Notably, TCM products are among the most commonly used CV drugs. These results call for additional efforts to promote implementation of the evidence-based recommendations for prevention of CVDs in the primary care settings.

Relative risk of cardiovascular disease is higher in women with type 2 diabetes, but not in those with prediabetes, as compared with men

2020 ◽  
Author(s):  
Elena Succurro ◽  
Teresa Vanessa Fiorentino ◽  
Sofia Miceli ◽  
Maria Perticone ◽  
Angela Sciacqua ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Longitudinal Study ◽  
Relative Risk ◽  
Hdl Cholesterol ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Normal Glucose

<b>Objective</b>: Most, but not all studies suggested that women with type 2 diabetes have higher relative risk (RR) for cardiovascular disease (CVD) than men. More uncertainty exists on whether the RR for CVD is higher in prediabetic women compared to men. <p><b>Research Design and Methods</b>: In a cross-sectional study, in 3540 normal glucose tolerant (NGT), prediabetic, and diabetic adults, we compared the RR for prevalent non-fatal CVD between men and women. In a longitudinal study including 1658 NGT, prediabetic, and diabetic adults, we compared the RR for incident major adverse outcomes, including all-cause death, coronary heart disease, and cerebrovascular disease events after 5.6 years follow-up. </p> <p><b>Results:</b> Women with prediabetes and diabetes exhibited greater relative differences in BMI, waist circumference, blood pressure, total, LDL and HDL cholesterol, triglycerides, fasting glucose, hsCRP, and white blood cell count than men with prediabetes and diabetes when compared with their NGT counterparts. We found a higher RR for prevalent CVD in diabetic women (RR 9.29; 95% CI 4.73-18.25; <i>P</i><0.0001) than in men (RR 4.56; 95% CI 3.07-6.77; <i>P</i><0.0001), but no difference in RR for CVD was observed comparing prediabetic women and men. In the longitudinal study, we found that diabetic, but not prediabetic women have higher RR (RR 5.25; 95% CI 3.22-8.56; <i>P</i><0.0001) of incident major adverse outcomes than their male counterparts (RR 2.72; 95% CI 1.81-4.08; <i>P</i><0.0001).</p> <p><b>Conclusions:</b> This study suggests that diabetic, but not prediabetic, women have higher RR for prevalent and incident major adverse outcomes than men. </p>

scholarly journals Reference values and factors associated with hand grip strength among older adults living in southeastern Poland

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Agnieszka Wiśniowska-Szurlej ◽  
Agnieszka Ćwirlej-Sozańska ◽  
Justyna Kilian ◽  
Natalia Wołoszyn ◽  
Bernard Sozański ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Reference Values ◽  
Handgrip Strength ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Normative Values ◽  
Dominant Hand ◽  
Cross Sectional ◽  
Factors Associated

AbstractHandgrip strength (HGS) is used as a biomarker for the state of health of older people, but the number of research publications containing the normative values of HGS in older adult populations is limited. The aim of the study was to define reference values and factors associated with HGS in older adults living in southeastern Poland. A cross-sectional study including 405 participants aged 65 and older was conducted. Handgrip strength for the dominant hand was assessed by the average of three trials using a JAMAR dynamometer. The sample was categorized into the following age groups: 65–69 years, 70–74 years, 75–79 years, 80–84 years, 85 and over. The average HGS was 19.98 kg (16.91 kg for women and 26.19 kg for men). There was a decrease in handgrip strength across the age range in both sexes. The average handgrip strength of the older people was 17.97 kg (14.47 kg for women and 25.66 kg for men) for those aged 80–85 and 16.68 kg (13.51 kg for women and 21.77 kg for men) in the group over 85 years old. In both sexes, marital status was an independent factor associated with reduced handgrip strength. In conclusion, this study described, for the first time, handgrip strength values for the southeastern Polish population aged ≥ 65 years according to age and gender.

scholarly journals Cross-sectional analysis of the prevalence and predictors of statin utilisation in Ireland with a focus on primary prevention of cardiovascular disease

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018524 ◽  
Author(s):  
Paula Byrne ◽  
John Cullinan ◽  
Catríona Murphy ◽  
Susan M Smith
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
Sociodemographic Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
History Of ◽  
Base Category ◽  
Sectional Analysis ◽  
Prevention Of Cardiovascular Disease

ObjectiveTo describe the prevalence of statin utilisation by people aged over 50 years in Ireland and the factors associated with the likelihood of using a statin, focusing particularly on those using statins for primary prevention of cardiovascular disease (CVD).MethodsThis is a cross-sectional analysis of cardiovascular risk and sociodemographic factors associated with statin utilisation from wave 1 of The Irish Longitudinal Study on Ageing. A hierarchy of indications for statin utilisation, consisting of eight mutually exclusive levels of CVD-related diagnoses, was created. Participants were assigned one level of indication. The prevalence of statin utilisation was calculated. The likelihood that an individual was using a statin was estimated using a multivariable logistic regression model, controlling for cardiovascular risk and sociodemographic factors.ResultsIn this nationally representative sample (n=5618) of community-dwelling participants aged 50 years and over, 1715 (30.5%) were taking statins. Of these, 65.0% (57.3% of men and 72.7% of women) were doing so for the primary prevention of CVD. Thus, almost two-thirds of those taking statins did so for primary prevention and there was a notable difference between women and men in this regard. We also found that statin utilisation was highest among those with a prior history of CVD and was significantly associated with age (compared with the base category 50–64 years; 65–74 years OR 1.38 (95% CI 1.16 to 1.65); 75+ OR 1.33 (95% CI 1.04 to 1.69)), living with a spouse or partner (compared with the base category living alone; OR 1.35 (95% CI 1.10 to 1.65)), polypharmacy (OR 1.74 (95% CI 1.39 to 2.19)) and frequency of general practitioner visits (compared with the base category 0 visits per year; 1–2 visits OR 2.46 (95% CI 1.80 to 3.35); 3–4 visits OR 3.24 (95% CI 2.34 to 4.47); 5–6 visits OR 2.98 (95% CI 2.08 to 4.26); 7+ visits OR 2.51 (95% CI 1.73 to 3.63)), even after controlling for clinical need. There was no association between using statins and gender, education, income, social class, health insurance status, location or Systematic Coronary Risk Evaluation (SCORE) risk in the multivariable analysis.ConclusionStatin utilisation among those with no history of CVD accounted for almost two-thirds of all statin use, in part reflecting the high proportion of the population with no history of CVD, although utilisation rates were highest among those with a history of CVD.

scholarly journals FACTORS ASSOCIATED TO SUBJECTIVE WELLBEING IN OLDER ADULTS

2017 ◽  
Vol 26 (2) ◽  
Author(s):  
Ximena Alvarado San Román ◽  
Maria Cecilia Toffoletto ◽  
Juan Carlos Oyanedel Sepúlveda ◽  
Salvador Vargas Salfate ◽  
Katiuska Lidice Reynaldos Grandón
Keyword(s):  
Older Adults ◽  
Life Satisfaction ◽  
Subjective Wellbeing ◽  
Social Indicators ◽  
Perceived Health ◽  
Cross Sectional Study ◽  
Perceived Health Status ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Social

ABSTRACT Objective: identify the factors associated with subjective wellbeing in older adults. Method: analytical, cross-sectional study developed in Chile. The sample consisted of 20,351 seniors, who answered a question on overall life satisfaction in the National Socio-Economic Survey, 2011. Subjective wellbeing was correlated with health, demographic and social indicators. Comparisons of averages, correlations and regressions were applied using the software Statistical Package for the Social Sciences 20. Results: life satisfaction was associated with increased age; being male; participation in social organizations; being married or living as a couple; having higher education level; higher income; good perceived health status and better health care. Conclusion: according to the age and income predictors, it can be concluded that, over the years, life satisfaction is reinforced, but in combination with adequate perceived health and income, which permit an excellent quality of life.

scholarly journals Cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people: a cross-sectional study

2016 ◽  
Vol 134 (5) ◽  
pp. 393-399 ◽  
Author(s):  
Darlene Mara dos Santos Tavares ◽  
Camila Gigante Colamego ◽  
Maycon Sousa Pegorari ◽  
Pollyana Cristina dos Santos Ferreira ◽  
Flávia Aparecida Dias ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Elderly People ◽  
Cross Sectional Study ◽  
Frailty Syndrome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Hospitalized Elderly

ABSTRACT CONTEXT AND OBJECTIVE: Identification of frailty syndrome and its relationship with cardiovascular risk factors among hospitalized elderly people is important, since this may contribute towards broadening of knowledge regarding this association within tertiary-level services. This study aimed to evaluate the cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people. DESIGN AND SETTING: Observational cross-sectional study in a public teaching hospital. METHODS: The participants were elderly patients admitted to clinical and surgical wards. The cardiovascular risk factors assessed were: body mass index (BMI), waist circumference, systemic arterial hypertension (SAH), blood glucose, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides. To identify frailty syndrome, the method proposed by Fried was used. The data were analyzed through descriptive statistics, chi-square test (P < 0.10) and multinomial logistic regression (P < 0.05). RESULTS: A total of 205 individuals were evaluated. It was found that 26.3% (n = 54) of the elderly people were frail, 51.7% (n = 106) were pre-frail and 22% (n = 45) were non-frail. The preliminary bivariate analysis (P < 0.10) for the regression model showed that frailty was associated with BMI (P = 0.016), LDL cholesterol (P = 0.028) and triglycerides (P = 0.093). However, in the final multivariate model, only overweight remained associated with the pre-frail condition (odds ratio, OR = 0.44; 95% confidence interval, CI = 0.20-0.98; P = 0.045). CONCLUSION: States of frailty were highly present in the hospital environment. The pre-frail condition was inversely associated with overweight.

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