Impact of Aging on the Strength of Cardiovascular Risk Factors: A Longitudinal Study Over 40 Years

Lind, Lars; Sundström, Johan; Ärnlöv, Johan; Lampa, Erik

doi:10.1161/jaha.117.007061

Cited by 97 publications

(75 citation statements)

References 34 publications

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“…The null findings in this study may possibly reflect that we studied a relatively healthy sample with overall well-controlled levels of BP and lipids. Our sample was also older (mean age 68 years); risk factor associations are generally attenuated in older compared to younger individuals [32]. Moreover, our results may also differ from prior studies due to technical differences between the current approach (i.e., cardiac MRI-based AoPWV) and the approach typically used in prior studies (i.e., applanation tonometry-based carotid-femoral PWV used in prior studies) [25, 27].…”

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea and Structural/Functional Properties of the Thoracic Ascending Aorta: The Multi-Ethnic Study of Atherosclerosis (MESA)

et al. 2019

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Background: Structural and functional properties of the proximal thoracic aorta have important implications in clinical and subclinical cardiovascular disease (CVD). We examined whether obstructive sleep apnea (OSA) is associated with proximal aortic size and aortic stiffness in a multi-ethnic community-based cohort. Methods: The sample included the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep Ancillary study participants without known CVD who underwent cardiac magnetic resonance imaging. The main exposure variable was OSA severity based on the polysomnography-derived apnea hypopnea index (AHI; normal, AHI <5/h; mild, 5≤ AHI <15/h; moderate to severe, AHI ≥15/h). The study outcomes were ascending aortic diameter (AoD, cm), aortic pulse wave velocity (AoPWV, m/s), and ascending aortic distensibility (AAD, %/mm Hg). Analyses were performed in the overall sample and in sex-specific strata, adjusted for multiple potential confounders. Results: The 708 participants were 55.9% female and on average 68 years old (54–93 years). There was a significant trend (p < 0.0001) of greater mean (SD) AoD across the three OSA groups: normal (n = 87), 3.13 cm (0.35); mild (n = 215), 3.25 (0.34); moderate to severe (n = 406), 3.37 (0.36). In adjusted analysis, participants with moderate to severe OSA had a greater mean AoD compared with the normal group: adjusted mean difference (95% CI), 0.12 cm (0.05, 0.20), p = 0.002. This AoD gradient was observed in women but not in men (p for interaction = 0.02). No differences were found in AoPWV or AAD among the OSA groups. Conclusion: In a diverse community-based cohort, moderate to severe OSA (vs. no OSA) was associated with a larger ascending AoD in women.

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Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea and Structural/Functional Properties of the Thoracic Ascending Aorta: The Multi-Ethnic Study of Atherosclerosis (MESA)

et al. 2019

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“…The observation that risk factors for a disease are weaker for older individuals is not unique for the study of SEP and AF, as the impact of CVD risk factors seems to decrease by age. This is partly explained by the survival effect, which means that those with many risk factors already have experienced an event or died before inclusion 33. Furthermore, low SEP is associated with higher mortality and a selection bias in the oldest age may explain the observed association.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic position and risk of atrial fibrillation: a nationwide Danish cohort study

Lunde

Joensen

Lundbye‐Christensen

et al. 2019

J Epidemiol Community Health

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AimTo examine the association between socioeconomic position and the risk of atrial fibrillation (AF) in different stages of life in a population of Danish citizens.MethodsRegister-based study. We followed all individuals turning 35, 50, 65 or 80 years from 1 January 1996 to 31 December 2005 until AF, death, emigration or the end of study period (31 December 2015). Exposure was education and income. We used Cox regression for the HRs (95% CI) and the pseudo-observation method for the adjusted risk difference (RD) (%).ResultsA total of 2 173 857 participants were enrolled and 151 340 incident cases of AF occurred over a median of 13.6 years of follow-up. Adjusted HR (95% CI) of incident AF for the youngest age group with the highest education (ref lowest) was 0.62 (0.50 to 0.77) (women) and 0.85 (0.76 to 0.96) (men). The associations attenuated with increasing age, that is, HRs for the oldest age group were 1.04 (0.97 to 1.10) and 0.98 (0.96 to 1.04), respectively. The corresponding adjusted RDs (%) were: −0.28 (−0.43 to −0.14), −0.18 (−0.36 to −0.01), 3.04 (−0.55 to 6.64) and −0.74 (−3.38 to 2.49), respectively. Similar but weaker associations were found for income.ConclusionHigher level of education and income was associated with a lower risk of being diagnosed with AF in young individuals but the association decreased with increasing age and was almost absent for the oldest age cohort. However, since AF is relatively rare in the youngest the RDs were low.

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“…However, all procedures conducted in both groups were identical, and they were treated separately only in analysis. The age of 40 was chosen in order to divide the study sample into younger and older ones, as in a number of studies of cardiovascular risk, the participants aged above 40 are treated as a separate group, as they may develop cardiovascular problems even if not diagnosed [ 12 , 13 ]. Similarly, for the Framingham Heart Study cohort, the age group of participants older than 40 was also analyzed [ 14 ] and some authors even recommend to conduct the formal cardiovascular disease risk assessment, in the case of no risk factors, only for patients at the age of 40 or more [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Intake of Saturated Fatty Acids Affects Atherogenic Blood Properties in Young, Caucasian, Overweight Women Even without Influencing Blood Cholesterol

Hamułka

Głąbska

Guzek

et al. 2018

IJERPH

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Despite a general relation between fat intake and cardiovascular risk factors, the association is often not observed in studies conducted in heterogenic populations, as for population groups, it may differ. The aim of the study was to analyze the associations between dietary fat intake and lipoprotein cholesterol fractions, as well as atherogenic blood properties, in young and middle-aged overweight Caucasian women. In a group of 138 overweight women, the three-day dietary records were assessed, under-reporters were excluded, and lipoprotein cholesterol fractions were analyzed. For the included 24 young (aged 20–40) and 42 middle-age women (aged 40–60), the intakes of fat, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), and cholesterol, as well as the PUFA/SFA ratio, were assessed. Afterwards, the analysis of associations with blood levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride, as well as the TC/HDL ratio, HDL/LDL, ratio and Atherogenic Index of Plasma (AIP), were conducted. It was stated that the influence of the dietary fat level on lipoprotein cholesterol fractions as well as atherogenic blood properties in overweight Caucasian women is age dependent. For young, overweight, Caucasian women, the influence of the dietary fat level on the lipoprotein cholesterol fractions was not observed; however, SFA intake influenced atherogenic blood properties. For middle-aged, overweight, Caucasian women, the PUFA intake had an especially important influence in increasing the HDL cholesterol level. For overweight Caucasian women, not only should lipoprotein cholesterol fractions be controlled, but also the AIP calculated—especially for younger women.

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Impact of Aging on the Strength of Cardiovascular Risk Factors: A Longitudinal Study Over 40 Years

Cited by 97 publications

References 34 publications

Obstructive Sleep Apnea and Structural/Functional Properties of the Thoracic Ascending Aorta: The Multi-Ethnic Study of Atherosclerosis (MESA)

Obstructive Sleep Apnea and Structural/Functional Properties of the Thoracic Ascending Aorta: The Multi-Ethnic Study of Atherosclerosis (MESA)

Socioeconomic position and risk of atrial fibrillation: a nationwide Danish cohort study

Intake of Saturated Fatty Acids Affects Atherogenic Blood Properties in Young, Caucasian, Overweight Women Even without Influencing Blood Cholesterol

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