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Cardiovascular risk profiling of long-lived people shows peculiar associations with mortality compared with younger
Alberto Montesanto1, Daniela Pellegrino1, Silvana Geracitano1
1Department of Biology, Ecology and Earth Sciences, University of Calabria, Rende, Italy.
Insights
For individuals aged 90 and above, traditional cardiovascular risk factors like high cholesterol may not decrease survival. In fact, higher serum cholesterol levels were associated with increased survival chances in this oldest-old population.
Area of Science:
- Gerontology
- Cardiology
- Epidemiology
Background:
- Centenarians are a model for successful aging, often postponing age-related diseases.
- Cardiovascular diseases are a major concern in aging populations.
Purpose of the Study:
- To investigate if a favorable cardiovascular risk profile enhances survival in long-lived individuals (nonagenarians and centenarians).
Main Methods:
- 355 community-dwelling individuals aged 90+ in Southern Italy were studied.
- Participants were categorized by cardiovascular risk (low/high) based on cholesterol, diabetes, hypertension, and smoking.
- Cox regression and splines-based hazard ratios analyzed the association between risk factors and 10-year mortality.
Main Results:
- Low levels of traditional cardiovascular risk factors did not improve survival in the oldest-old.
- Serum cholesterol >200 mg/dL was linked to increased survival chances (HR 0.742, 95% CI 0.572-0.963) after adjusting for confounders.
- The prognostic significance of cardiovascular risk factors differs significantly in centenarians compared to younger adults.
Conclusions:
- Traditional cardiovascular risk factors have a different clinical and prognostic meaning in nonagenarians and centenarians.
- Further research is needed to validate these findings and inform clinical practice for the growing elderly population.
Aim:
Centenarians represent a biological model of successful aging because they escaped/postponed most invalidating age-related diseases, such as cardiovascular diseases. The aim of the present study was to clarify whether a favorable cardiovascular risk profile increases the survival chances in long-lived people.
Methods:
A total of 355 community-dwelling nonagenarians and centenarians living in Southern Italy were recruited in the study. Patients were classified as at low and high cardiovascular risk on the basis of serum cholesterol, diabetes, hypertension and smoking status. The relationship between cardiovascular risk factors and 10-year mortality was investigated by Cox regression analysis. Splines-based hazard ratio curves were also estimated for total cholesterol, low-density lipoprotein cholesterol, and systolic and diastolic blood pressure.
Results:
Low levels of selected cardiovascular risk factors usually associated with lower mortality in adults do not increase survival chances among oldest-old individuals. In particular, after adjusting for age, sex, and cognitive, functional and nutritional status, serum cholesterol >200 mg/dL increased the survival chances during the follow-up period (hazard ratio 0.742, 95% CI 0.572-0.963).
Conclusions:
The present results showed that in nonagenarians and centenarians, the clinical and prognostic meaning associated with traditional cardiovascular risk factors is very different from younger populations. Consequently, considering the increase of this population segment, further studies are required to confirm these results and to translate them into clinical practice/primary care. Geriatr Gerontol Int 2019; 19: 165-170.
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