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The reverse metabolic syndrome in the elderly: Is it a "catabolic" syndrome?

Francesco Curcio1, Giuseppe Sasso1, Ilaria Liguori1

  • 1Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy.

Aging Clinical and Experimental Research
|August 11, 2017
PubMed

Insights

In older adults, higher body mass index (BMI), cholesterol, and blood pressure are linked to better survival, challenging traditional cardiovascular risk factors. This "reverse epidemiology" phenomenon requires further investigation for effective elderly patient management.

Area of Science:

  • Geriatric Medicine
  • Cardiovascular Health
  • Epidemiology

Background:

  • Traditional cardiovascular risk factors (BMI, cholesterol, blood pressure) show altered associations in the elderly.
  • Higher BMI, hypercholesterolemia, and hypertension are paradoxically linked to better survival in advanced age.
  • This
  • risk factor paradox
  • is observed in conditions like heart failure, where low values predict worse outcomes.

Purpose of the Study:

  • To explore the underlying factors contributing to the reverse epidemiology phenomenon in the geriatric population.
  • To analyze the implications of this paradox on cardiovascular therapy management for elderly patients.
  • To introduce and define a potential new phenotype:
  • catabolic syndrome
  • .

Main Methods:

  • Literature review synthesizing existing research on reverse epidemiology in cardiovascular disease and aging.
  • Analysis of hypothesized causes and controversies surrounding the elderly risk factor paradox.
  • Exploration of clinical management strategies in light of these findings.

Main Results:

  • The study confirms the inverse relationship between traditional cardiovascular risk factors and outcomes in the elderly.
  • Hypotheses for this phenomenon are presented, though underlying mechanisms remain poorly understood.
  • The concept of a
  • catabolic syndrome
  • is proposed as a potential explanation.

Conclusions:

  • The reverse epidemiology of cardiovascular risk factors in the elderly presents a significant challenge to conventional medical practice.
  • Understanding this paradox is crucial for optimizing cardiovascular treatment strategies in aging populations.
  • Further research is needed to elucidate the mechanisms behind this phenomenon and validate the
  • catabolic syndrome
  • phenotype.

Keywords:
Blood pressureBody mass indexCatabolic syndromeCholesterolReverse epidemiology

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