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C-reactive protein, cardiovascular risk factors, and mortality in a prospective study in the elderly
1Department of Medicine, University of Helsinki, Helsinki, Finland. timo.strandberg@hus.fi
Insights
Serum C-reactive protein (CRP) predicts mortality in older adults. Higher CRP levels are linked to increased cardiovascular and overall mortality, particularly in the youngest elderly cohort studied.
Area of Science:
- Gerontology
- Biomarkers
- Epidemiology
Background:
- Serum C-reactive protein (CRP) is a known inflammation marker and cardiovascular disease predictor in middle-aged populations.
- Its role and predictive value in elderly cohorts, considering various risk factors and mortality, require further investigation.
Purpose of the Study:
- To investigate the association between serum C-reactive protein (CRP) and cardiovascular risk factors.
- To examine the predictive value of CRP for 10-year total and cardiovascular mortality in elderly individuals.
- To assess these associations across different age groups within the elderly population.
Main Methods:
- Analysis of three elderly cohorts (aged 75, 80, 85) from the Helsinki Ageing Study (n=455).
- Baseline clinical and laboratory examinations, including sensitive CRP measurement.
- 10-year mortality data retrieval from national registers, with cause-specific mortality analysis.
Main Results:
- Serum CRP correlated with body mass index, plasma insulin, smoking, albumin, and cholesterol levels.
- Higher CRP was significantly associated with dementia.
- Baseline CRP significantly predicted 10-year total and cardiovascular mortality, with stronger predictive power in the 75-year-old cohort compared to older cohorts.
Conclusions:
- Serum CRP is associated with cardiovascular risk factors and dementia in the elderly.
- CRP is a significant predictor of overall and cardiovascular mortality in older adults, particularly those aged 75.
- The predictive value of CRP for mortality diminishes with increasing age in elderly populations.
Abstract:
Serum C-reactive protein (CRP) reflects inflammation and predicts cardiovascular disease in middle-aged individuals. We investigated CRP, risk factors, and 10-year mortality in 3 elderly cohorts (aged 75, 80, and 85 years; n=455) of the population-based Helsinki Ageing Study. Clinical and laboratory examinations were performed at baseline, and in 1998, CRP was measured by a sensitive method (sensitivity 0.3 mg/L) from frozen serum samples. Mortality data were retrieved from national registers. Serum CRP ranged from 0.18 to 170.0 mg/L (interquartile range 0.68 to 4.10 mg/L, median 1.60 mg/L). CRP correlated significantly with body mass index and plasma insulin and was associated with smoking at baseline. An inverse correlation was found with albumin and total and HDL cholesterol. CRP was not associated with diabetes or cardiovascular disease but was significantly (P=0.015) higher in persons with (n=70) than without (n=385) dementia. During the 10-year follow-up, 61% (n=278) of the cohort died; half of the deaths were due to cardiovascular diseases. Mean CRP in survivors and nonsurvivors was 3.16 and 5.22 mg/L (P=0.017), respectively. After controlling for age and sex, baseline CRP (per 10 mg/L) significantly predicted the 10-year total mortality (risk ratio 1.20, 95% CI 1.08 to 1.32) and cardiovascular mortality (risk ratio 1.22, 95% CI 1.10 to 1.35). Predictive value was found in the 75-year-old cohort, but it was clearly attenuated in the 80- and 85-year-old cohorts. The results indicate that CRP is associated with several cardiovascular risk factors in the elderly. CRP alone predicts overall and cardiovascular mortality, but the prediction was significant in only the 75-year-old cohort.