scholarly journals Total Cardiovascular Risk in the Elderly Population of Spain: The Epicardian Risk Score

2020 ◽  
Author(s):  
Rafael Gabriel ◽  
Javier Muñiz ◽  
Saturio Vega ◽  
Irene Moral ◽  
Isidro Lopez ◽  
...  

Abstract Background: Cardiovascular risk estimation in people over 70 years is problematic. Most scores have been derived from cohorts of middle-aged people, with older persons under-represented. The predictive power of classical cardiovascular risk factors reduce with age. The aim is to develop a specific score for the elderly populationMethods: Population-based cohort established in 1995. Setting: Three geographical areas of Spain (Madrid, Ávila and Lugo). Participants: 3,729 people older than 64 years, free of any cardiovascular diseases (CVD), at baseline. Measurements: Suspected fatal and nonfatal CVD (both coronary heart disease and stroke) were yearly investigated and confirmed using the WHO-MONICA criteria. All participants were followed until the occurrence of the first CVD event, until death or until December 31th 2015 if alive.Results: Age was the strongest predictor of 10-year CVD both in men and women. In men, variables associated to CVD were high blood pressure treatment (HR: 1,35; 95% CI: 1,067 , 1,710), diabetes (HR: 1,359; 95% CI: 0,997 , 1,852) and smoking (HR:1,207; 95%CI: 0,945 , 1,541), and in women smoking (HR: 1,881 95%CI: 1,356 , 2,609) and diabetes (HR:1,285; 95%CI:0,967 , 1,707). Total-cholesterol did not increased the risk of CVD either in males or females. However, total-cholesterol level (>200mg/dl) were negatively associated both in men and women.Conclusions: In old Spanish men, 10-year total CVD is significantly increased by age, diabetes and antihypertensive treatment, and in old women by diabetes and smoking. Total-cholesterol levels did not increased the risk of CVD either in males or females.

Author(s):  
Pil‐Sung Yang ◽  
Eunsun Jang ◽  
Hee Tae Yu ◽  
Tae‐Hoon Kim ◽  
Hui‐Nam Pak ◽  
...  

Background This study examines changes in the ideal cardiovascular health (CVH) status and whether these changes are associated with incident cardiovascular disease (CVD) and mortality in the elderly Asian population. Methods and Results In the Korea National Health Insurance Service–Senior cohort aged ≥60 years, 208 673 participants without prior CVD, including 109 431 who showed changes in CVH status, were assessed. The association of the changes in cardiovascular risk factors with incident CVD was assessed from 2004 to 2014 in the elderly (aged 60–74 years) and very elderly (≥75 years) groups. During the follow‐up period (7.1 years for CVD and 7.2 years for mortality), 19 429 incident CVD events and 24 225 deaths occurred. In both the elderly and very elderly participants, higher CVH status resulted in a lower risk of CVD and mortality. In the very elderly participants, compared with consistently low CVH, consistently high CVH (subhazard ratio, 0.41; 95% CI, 0.23–0.73) was associated with a lower risk of CVD. This trend was consistently observed in the elderly population. In the very elderly participants, total cholesterol level was not informative enough for the prediction of CVD events. In both the elderly and very elderly groups, body mass index and total cholesterol were not informative enough for the prediction of all‐cause mortality. Conclusions In both the elderly and very elderly Asian populations without CVD, a consistent relationship was observed between the improvement of a composite metric of CVH and the reduced risk of CVD. Body mass index and total cholesterol were not informative enough for the prediction of all‐cause mortality in both the elderly and very elderly groups.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041755
Author(s):  
Srinivas Marmamula ◽  
Satya Brahmanandam Modepalli ◽  
Thirupathi Reddy Kumbham ◽  
Rajesh Challa ◽  
Jill E Keeffe

ObjectivesTo assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India.DesignPopulation-based cross-sectional study using a cluster random sampling method to select the study clusters.SettingElderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities.Participants1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education.Primary outcome measurePrevalence of disabilities and NCDs.ResultsOverall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were: seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2).ConclusionEvery fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.


2009 ◽  
Vol 32 (9) ◽  
pp. 780-785 ◽  
Author(s):  
Axel C Carlsson ◽  
Per E Wändell ◽  
Gunilla Journath ◽  
Ulf de Faire ◽  
Mai-Lis Hellénius

In modern day technology, among the elderly population, there is an increased cases of dementia. However, there is a delay in dementia diagnosis over the past years. So there is a primary requirement for improving diagnosis of dementia in every part of the nation across the world. However, Dementia screening remains controversial, although strong preference is given for screening dementia, mainly for hospital inpatients. Here the objective is to implement screening, to alert family members about the condition of patients. The entire screening process is achieved using Robotic Process Automation where automatic screening and validation of the mental state of the elderly people is recognized and shared with their respective family members


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Charlotte A Larsson ◽  
Bledar Daka ◽  
Margareta I Hellgren ◽  
Maria C Eriksson ◽  
Lennart Råstam ◽  
...  

Introduction: Clusters of metabolic variables and their effects on incidence of type 2 diabetes have been studied previously; however, little is known about the effects on diabetes from risk factor clusters including lifestyle and self-rated health. Hypothesis: We assessed the hypothesis that clusters of common cardiovascular risk factors, including lifestyle and self-rated health, can predict development of type 2 diabetes in men and women, respectively. Methods: In 2002-2005, 2816 men and women, 30-74 years, were randomly selected from two municipalities in southwestern Sweden and assessed with regard to cardiovascular/metabolic risk factors within the Skaraborg Project (76% participation). Participants performed an OGTT, had blood samples drawn, had anthropometric measurements and blood pressure taken, and answered validated questionnaires about e.g. leisure-time physical activity (with four answer alternatives from intensive to sedentary) and self-rated health (with five alternatives from excellent to very poor). Using the same protocol, 1332 participants from the baseline survey where re-examined in 2011-2014. After excluding those with diabetes at baseline, 1268 participants were included in this prospective population-based study. Results: Factor analysis (using varimax rotation) identified significant loadings (≥0.40) on the following three identical factors in men and women: the metabolic factor , comprising HOMA-ir, WHR, systolic blood pressure, and apolipoprotein B-to-A1 ratio; the vitality factor , comprising physical activity and self-rated health; and the addiction factor , comprising smoking and alcohol consumption. After a mean follow-up of 9.7±1.4 years, 76 cases of diabetes were identified; 46 in men and 30 in women. In a logistic regression analysis adjusted for all principal components, age, and educational level, the metabolic factor significantly predicted type 2 diabetes in both men (OR: 3.3, CI: 2.3-5.0) and women (OR: 3.5, CI: 2.2-5.6). Furthermore, a predictive effect of the vitality factor was also seen in women (OR: 1.8, CI: 1.2-2.9), but not in men (OR: 1.1, CI: 0.8-1.6), whereas the addiction factor had no effect in either men or women. Conclusions: This is to our knowledge the first time principle components of cardiovascular risk factors, including both metabolic and lifestyle variables, have been used to predict incidence of type 2 diabetes. The gender difference observed with regard to the combined impact of self-rated health and physical activity are novel and indicates a mechanism beside the metabolic syndrome that warrants further gender-specific exploration in future studies.


Author(s):  
Maria do Céu Mendes Pinto Marques ◽  
Ana Filipa Pereira Vaz ◽  
Ana Sofia Emídio Cardoso Leite ◽  
Cláudia Sofia Araújo ◽  
Cláudia Roque Condeço ◽  
...  

The objective of this chapter is to identify cardiovascular risk factors in the elderly and their prevalence in the elderly population of Alentejo. The research question was elaborated according to the PI[C]OD methodology. The prevalence studies included allow the authors to identify the risk factors with the greatest impact on cardiovascular diseases, with the analysis of at least one of the factors (hypertension, diabetes, smoking, obesity, hypercholesterolemia, alcoholism, and sedentary lifestyle) and their prevalence in the elderly from the region of Alentejo. The results present the prevalence of cardiovascular risk factors, mainly at the national level, compared to those at the regional level, with a small number of exclusive studies in the Alentejo region, while simultaneously disaggregating the results by age group. From the data obtained, it can be concluded that the prevalence of risk factors is generally increased in the elderly population and, consequently, in Alentejo, because it is a region in the interior of the country that is predominantly rural and very old.


2016 ◽  
Vol 26 (4) ◽  
pp. 25246
Author(s):  
Felipe Zancan Espanhol ◽  
Rita de Cássia S. M. De Oliveira ◽  
Gustavo Paes Silvano ◽  
André Luciano Manoel ◽  
Laise Rodrigues Silveira ◽  
...  

Aims: To evaluate the prevalence of hyperglycemia and associated factors in the elderly population of a municipality in southern Brazil.Methods: Cross-sectional population-based study, carried out with the elderly (≥60 years) living in the city of Tubarão, state of Santa Catarina, Brazil, from September 2010 to May 2011. Participants were selected by simple random sampling. The elderly were registered by the Community Health Agents of the Family's Health Strategy Program. Sociodemographic data (age, gender, skin color, marital status, employment status and education), behavioral data (physical activity, alcohol use and smoking) and clinical data (obesity, drug use and family history of diabetes) were recorded. After answering these questions the participants were scheduled to attend the clinic for blood collection and anthropometric measurements. The prevalence of hyperglycemia was assessed from fasting blood glucose tests, and individuals with values ≥126 mg/dL or use of hypoglycemic drugs were considered hyperglycemic. To assess the association between the variables of interest, the chi-square test was applied. The pre-determined confidence interval was of 95% and the error α of 5%.Results: Eight hundred thirty-three elderly patients were included, and 220 were considered hyperglycemic according to the methodology criteria (prevalence of 26.4%). Of the patients included in the hyperglycemia group, 190 were using oral hypoglycemic drugs, and of these, 112 had also fasting glucose ≥126 mg/dL, while in 78 fasting glucose was <126 mg/dL. Also in the hyperglycemia group, 30 patients had fasting glucose ≥126 mg/dL and were not on hypoglycemic treatment. Having parents diagnosed with diabetes and being obese were associated with the presence of hyperglycemia.Conclusions: This study suggests that a large portion of the elderly population have fasting hyperglycemia, requiring a wider evaluation for diabetes mellitus.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sidsel Graff-Iversen ◽  
Stephen Hewitt ◽  
Lisa Forsén ◽  
Liv Grøtvedt ◽  
Inger Ariansen

Abstract Background Studies indicate an effect of smoking toward abdominal obesity, but few assess hip and waist circumferences (HC and WC) independently. The present study aimed to assess the associations of smoking status and volume smoked with HC and WC and their ratio in a population with low prevalence of obesity together with high prevalence of smoking. Methods We used cross-sectional survey data from 11 of a total 19 Norwegian counties examined in 1997–99 including 65,875 men and women aged 39–44 years. Analysis of associations were adjusted for confounding by socioeconomic position, health indicators, and additionally for BMI. Results Compared with never-smokers, when adjusting for confounders and in addition for BMI, mean HC remained lower while mean WC and waist-hip-ratio (WHR) were higher in current smokers. The finding of a lower HC and higher WHR level among smokers was consistent by sex and in strata by levels of education and physical activity, while the finding of higher WC by smoking was less consistent. Among current smokers, BMI-adjusted mean HC decreased whereas WC and WHR increased by volume smoked. Compared with current smokers, former smokers had higher BMI-adjusted HC, lower WHR and among women WC was lower. Conclusions The main finding in this study was the consistent negative associations of smoking with HC. In line with the hypothesis that lower percentage gluteofemoral fat is linked with higher cardiovascular risk, our results suggest that smoking impacts cardiovascular risk through mechanisms that reduce the capacity of fat storage in the lower body region.


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