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Physiological measures variability and risks of heart disease and stroke: evidence from three cohort studies
Wei Liu1,2,3, Lieyang Fan1,4, Da Shi5
1Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Insights
Long-term variability in physiological measures increases heart disease and stroke risks in older adults. This risk is partly due to reduced muscle strength, high blood sugar, and poor kidney function.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Biomarkers
Background:
- The impact of long-term physiological variability on cardiovascular health in older adults is not fully understood.
- Underlying mechanisms linking physiological variability to cardiovascular outcomes require elucidation.
Purpose of the Study:
- To investigate the association between long-term physiological variability and incident risks of heart disease and stroke in older adults.
- To explore the mediating roles of specific biomarkers in these associations.
Main Methods:
- A composite score of physiological variability (blood pressure, pulse rate, BMI) was created for older adults from three large cohorts (CHARLS, HRS, UK Biobank).
- Associations between the composite score and incident heart disease/stroke were analyzed.
- Mediation analyses were performed using biomarkers such as grip strength, C-reactive protein, HbA1c, and cystatin C.
Main Results:
- Higher composite scores correlated with increased risks of heart disease and stroke across cohorts.
- Each 1-point increase in the composite score was linked to a 19% higher risk of heart disease and a 23% higher risk of stroke.
- Reduced grip strength, elevated HbA1c, and elevated cystatin C significantly mediated these increased risks.
Conclusions:
- Long-term physiological variability is a significant risk factor for heart disease and stroke in older populations.
- Biomarkers of muscle strength, hyperglycemia, and kidney function partially explain the link between physiological variability and cardiovascular events.
Background:
The overall effect of long-term variability in physiological measures on cardiovascular health of older adults and the underlying mechanic pathway remain uncertain.
Methods:
We constructed a composite score (0 ~ 3) of variability in physiological measures, including blood pressure, pulse rate, and body mass index, in older adults from the China Health and Retirement Longitudinal Study (CHARLS) 2011 ~ 2015, the Health and Retirement Study (HRS) 2006/2008 ~ 2014/2016, and the UK Biobank 2006 ~ 2019. The associations of the composite score with incident risks of heart disease and stroke were assessed. The mediation roles of several biomarkers were explored.
Results:
A higher composite score was related to increased incident risk of heart disease in older adults from the US and the UK and increased incident risk of stroke in all three cohorts. Upon pooling the results, each 1-point increment in the composite score was associated with a 19% (hazard ratio: 1.19; 95% confidence interval: 1.14, 1.30) and a 23% (1.23; 1.12, 1.35) increments in incident risks of heart disease and stroke, respectively. The composite score also exhibited an inverse relationship with grip strength while displaying positive associations with C-reactive protein, glycosylated hemoglobin Alc (HbAlc), and cystatin C. Reduced grip strength, elevated HbAlc, and elevated cystatin C significantly mediated the composite score-associated elevated risks of heart disease and stroke.
Conclusions:
Long-term variability in physiological measures was associated with increased incident risks of heart disease and stroke, and the associations were partially mediated through deteriorated biomarkers of muscle strength, hyperglycemia, and kidney function.
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