Variability in Cardiometabolic Parameters and All-Cause and Cause-Specific Mortality in Older Adults: Evidence From 2
Jian-Yun Lu1, Rui Zhou2, Jie-Qiang Huang1
1Guangzhou Baiyun Center for Disease Control and Prevention, Guangzhou, China.
Insights
Increased variability in cardiometabolic markers like blood pressure and glucose is linked to higher mortality risk in older adults. Managing this variability may help extend life expectancy.
Area of Science:
- Gerontology
- Cardiovascular Health
- Metabolic Health
Background:
- Cardiometabolic risk factors are crucial in older populations.
- Variability in these parameters, beyond average levels, may impact health outcomes.
Purpose of the Study:
- To investigate the association between variability in multiple cardiometabolic parameters and mortality risk in Chinese elderly.
- To assess individual and joint effects of parameter variability on mortality.
Main Methods:
- 51,551 Chinese elderly participants (≥60 years) with multiple measurements of SBP, VAI, FBG, and LDL-C.
- Variability assessed using metrics including variability independent of the mean (VIM).
- Participants categorized by number of high-variability parameters; Cox regression and external validation performed.
Main Results:
- Higher variability in SBP, VAI, FBG, and LDL-C correlated with increased all-cause, cardiovascular, and other-cause mortality.
- Compared to no high-variability parameters, VIM showed hazard ratios for all-cause mortality of 1.30, 1.86, and 2.02 for 1, 2, and 3-4 parameters, respectively.
- Associations were consistent across mortality causes and validated externally.
Conclusions:
- Elevated cardiometabolic parameter variability is a significant risk factor for mortality in older Chinese adults.
- Targeting variability reduction may be a strategy to improve life expectancy in aging populations.
Introduction:
The aim of this study is to assess the individual and joint associations of variability in multiple cardiometabolic parameters with mortality risk across older populations.
Methods:
A total of 51,551 Chinese elderly participants (aged ≥60 years) with ≥3 measurements of systolic blood pressure, visceral adiposity index, fasting blood glucose, and low-density lipoprotein cholesterol during 2018-2022 were included. Variability metrics included SD, coefficient of variation, average real variability, and variability independent of the mean (used in primary analysis). Participants were classified on the basis of the number of high-variability (highest quartile of variability) parameters into 4 categories: with 0, 1, 2, and 3-4 high-variability cardiometabolic parameters. Cox regression analyses were performed in 2024. Findings were then externally validated using the Health and Retirement Study (Waves 8-15).
Results:
Higher systolic blood pressure, visceral adiposity index, fasting plasma glucose, and low-density lipoprotein cholesterol variability were associated with greater all-, cardiovascular-, and other-cause mortality risk. Compared with those of subjects with no high-variability parameters measured as the variability independent of the mean, the hazard ratios (95% CI) of all-cause mortality were 1.30 (1.16, 1.44) for 1 parameter, 1.86 (1.66, 2.09) for 2 parameters, and 2.02 (1.75, 2.32) for 3-4 parameters. Consistent results were noted for cardiovascular-, cancer-, and other-cause mortality using other variability indices and in various sensitivity and subgroup analyses. These associations were validated in the Health and Retirement Study (n=1,991).
Conclusions:
Increased variability in cardiometabolic parameters is associated with elevated risks of all-cause and cause-specific mortality among older adults in China. Reducing variability of these parameters could serve as a target to increase life expectancy in older populations.
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