TY - JOUR
T1 - Midlife determinants of healthy cardiovascular aging
T2 - The Atherosclerosis Risk in Communities (ARIC) study
AU - Jia, Xiaoming
AU - Sun, Caroline
AU - Nambi, Vijay
AU - Virani, Salim S.
AU - Taffet, George
AU - Boerwinkle, Eric
AU - Bressler, Jan
AU - Ndumele, Chiadi
AU - Windham, B. Gwen
AU - de Lemos, James A.
AU - Matsushita, Kunihiro
AU - McEvoy, John William
AU - Hoogeveen, Ron C.
AU - Selvin, Elizabeth
AU - Ballantyne, Christie M.
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/6
Y1 - 2022/6
N2 - BACKGROUND AND AIMS: Risk factor cutoffs are derived from associations with clinical cardiovascular disease (CVD), but how these risk factors associate with preserved cardiovascular health into old age is not well studied. We investigated midlife determinants of healthy versus nonhealthy cardiovascular aging in the Atherosclerosis Risk in Communities (ARIC) study.METHODS: ARIC participants were categorized by cardiovascular status in older age (mean age 75.8 ± 5.3 years, range 66-90): healthy, subclinical disease (assessed by biomarkers and left ventricular function), clinical CVD (coronary heart disease, stroke, or heart failure), or prior death. We examined associations of midlife (mean age 52.1 ± 5.1 years) systolic and diastolic blood pressure (SBP, DBP), low-density lipoprotein cholesterol (LDL-C), triglycerides, hemoglobin A1c (HbA1c), and body mass index (BMI) with cardiovascular status in older age using multinomial logistic regression analyses.RESULTS: Compared with healthy status, odds for subclinical disease (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.09-1.55) and clinical CVD (OR 1.87, 95% CI 1.53-2.29) at older age increased starting with midlife SBP 120-129 mmHg, whereas odds for death increased starting with SBP 110-119 mmHg (OR 1.29, 95% CI 1.10-1.52); findings were similar for DBP. Odds for subclinical disease increased for HbA1c ≥ 6.5% and BMI starting at 30-<35 kg/m
2; odds for clinical CVD or death increased starting at HbA1c 5.5-5.9%, LDL-C >160 mg/dL, and BMI 30-<35 kg/m
2.
CONCLUSIONS: More-stringent levels of modifiable risk factors in midlife beyond current clinical practice and guidelines were associated with preserved cardiovascular health in older age.
AB - BACKGROUND AND AIMS: Risk factor cutoffs are derived from associations with clinical cardiovascular disease (CVD), but how these risk factors associate with preserved cardiovascular health into old age is not well studied. We investigated midlife determinants of healthy versus nonhealthy cardiovascular aging in the Atherosclerosis Risk in Communities (ARIC) study.METHODS: ARIC participants were categorized by cardiovascular status in older age (mean age 75.8 ± 5.3 years, range 66-90): healthy, subclinical disease (assessed by biomarkers and left ventricular function), clinical CVD (coronary heart disease, stroke, or heart failure), or prior death. We examined associations of midlife (mean age 52.1 ± 5.1 years) systolic and diastolic blood pressure (SBP, DBP), low-density lipoprotein cholesterol (LDL-C), triglycerides, hemoglobin A1c (HbA1c), and body mass index (BMI) with cardiovascular status in older age using multinomial logistic regression analyses.RESULTS: Compared with healthy status, odds for subclinical disease (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.09-1.55) and clinical CVD (OR 1.87, 95% CI 1.53-2.29) at older age increased starting with midlife SBP 120-129 mmHg, whereas odds for death increased starting with SBP 110-119 mmHg (OR 1.29, 95% CI 1.10-1.52); findings were similar for DBP. Odds for subclinical disease increased for HbA1c ≥ 6.5% and BMI starting at 30-<35 kg/m
2; odds for clinical CVD or death increased starting at HbA1c 5.5-5.9%, LDL-C >160 mg/dL, and BMI 30-<35 kg/m
2.
CONCLUSIONS: More-stringent levels of modifiable risk factors in midlife beyond current clinical practice and guidelines were associated with preserved cardiovascular health in older age.
KW - Cardiovascular disease prevention
KW - Cardiovascular risk factors
KW - Healthy aging
KW - Blood Pressure
KW - Humans
KW - Middle Aged
KW - Risk Factors
KW - Cholesterol, LDL
KW - Glycated Hemoglobin
KW - Atherosclerosis/diagnosis
KW - Aged, 80 and over
KW - Aging
KW - Aged
KW - Cardiovascular Diseases/diagnosis
UR - http://www.scopus.com/inward/record.url?scp=85129713496&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85129713496&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2022.04.028
DO - 10.1016/j.atherosclerosis.2022.04.028
M3 - Article
C2 - 35550933
AN - SCOPUS:85129713496
SN - 0021-9150
VL - 350
SP - 82
EP - 89
JO - Atherosclerosis
JF - Atherosclerosis
ER -