Mortality in Relation to Minnesota Code Items in Elderly Subjects. Sex-Related Differences in a Cardiovascular Study in the Elderly.

Casíglia, Edoardo; Spolaore, Paolo; Ginocchio, Giuliana; Marchioro, M.; Mazza, Alberto; Menza, Giuseppe di; Maniati, Giorgia; Daskalakis, Cosmas; Colangeli, Giovanna; Ambrosio, Giovanni B.

doi:10.1536/ihj.34.567

Cited by 14 publications

(9 citation statements)

References 30 publications

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“…In most studies the analysis is purely descriptive and differences by sex, cardiovascular disease or functional capacity are not considered. Similarly, they do not discuss whether these findings are associated with a higher mortality in centenarians, as in a younger population [24]. …”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic abnormalities in centenarians: impact on survival

et al. 2012

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BackgroundThe centenarian population is gradually increasing, so it is becoming more common to see centenarians in clinical practice. Electrocardiogram abnormalities in the elderly have been reported, but several methodological biases have been detected that limit the validity of their results. The aim of this study is to analyse the ECG abnormalities in a prospective study of the centenarian population and to assess their impact on survival.MethodWe performed a domiciliary visit, where a medical history, an ECG and blood analysis were obtained. Barthel index (BI), cognitive mini-exam (CME) and Charlson index (ChI) were all determined. Patients were followed up by telephone up until their death.ResultsA total of 80 centenarians were studied, 26 men and 64 women, mean age 100.8 (SD 1.3). Of these, 81% had been admitted to the hospital at least once in the past, 81.3% were taking drugs (mean 3.3, rank 0–11). ChI was 1.21 (SD 1.19). Men had higher scores both for BI (70 -SD 34.4- vs. 50.4 -SD 36.6-, P = .005) and CME (16.5 -SD 9.1- vs. 9.1 –SD 11.6-, P = .008); 40.3% of the centenarians had anaemia, 67.5% renal failure, 13% hyperglycaemia, 22.1% hypoalbuminaemia and 10.7% dyslipidaemia, without statistically significant differences regarding sex. Only 7% had a normal ECG; 21 (26.3%) had atrial fibrillation (AF), 30 (37.5%) conduction defects and 31 (38.8%) abnormalities suggestive of ischemia, without sex-related differences. A history of heart disease was significantly associated with the presence of AF (P = .002, OR 5.2, CI 95% 1.8 to 15.2) and changes suggestive of ischemia (P = .019, OR 3.2, CI 95% 1.2-8.7). Mean survival was 628 days (SD 578.5), median 481 days. Mortality risk was independently associated with the presence of AF (RR 2.0, P = .011), hyperglycaemia (RR 2.2, P = .032), hypoalbuminaemia (RR 3.5, P < .001) and functional dependence assessed by BI (RR 1.8, P = .024).ConclusionAlthough ECG abnormalities are common in centenarians, they are not related to sex, functional capacity or cognitive impairment. The only abnormality that has an impact on survival is AF.

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Section: Discussionmentioning

confidence: 99%

Electrocardiographic abnormalities in centenarians: impact on survival

et al. 2012

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“…This issue was dealt with in 2254 elderly subjects from the CAS-TEL. 27 A logistic regression showed a predictive role for overall mortality of ECG signs of ischaemia, bundle branch block (BBB) and atrio-ventricular block in males, and of ischaemia, myocardial infarction, BBB and atrial fibrillation in females. Taking into consideration cardiovascular mortality, atrial fibrillation, left BBB and ischaemia were predictors in both sexes, right BBB, LVH and supraventricular tachycardia were predictors in men, and A-V block in females.…”

Section: Other Ecg Abnormalitiesmentioning

confidence: 99%

Cardiovascular risk factors in the elderly

Casíglia

Palatini

1998

J Hum Hypertens

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Although a number of risk factors for cardiovascular morbidity and mortality have been identified in young and middle-aged adults, their prevalence and importance are less known in the elderly. Elderly people have a risk profile different from that of younger subjects, but representative data on risk factors for cardiovascular disease in the elderly are difficult to find in the literature. Some typical 'major' risk factors, like blood pressure (BP), total cholesterol or left ventricular hypertrophy, do

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“…In elderly subjects with atrial fibrillation, the RR of stroke is increased. 32) Finally, we have previously demonstrated 24) that in the Italian general population conduction defects independently increase mortality by 40 to 49%. The high prevalence of historical chronic diseases among the Cimbrians also deserves comment.…”

Section: Discussionmentioning

confidence: 92%

“…Register's Office reports indicate that they have greater cardiovascular mortality, 6) and the results reported here confirmed that they actually do have an inferior risk pattern compared to SCP of the same age class. In fact, practically all the most important risk factors (arterial hypertension, and namely systolic and pulse hypertension, 17,21) dislipidemia, 22) left ventricular hypertrophy, 23) atrial fibrillation, 24,25) and cardiac conduction defects 24) ) were more prevalent in the Leogra valley than in the SCP, and the prevalences of chronic diseases such as CAD, respiratory disease, intermittent claudication, and stroke were greater as well.…”

Section: Discussionmentioning

confidence: 99%

“…The hypothesis that the direct association between hypercholesterolemia and the risk of CAD becomes less robust with increasing age 31) is under debate, but in the Italian general population -and particularly in the geographic area where the Leogra and the CASTEL studies were performed -cholesterol continues to play a role in predicting coronary mortality even after the age of 65, at least in men and specially in those who smoke. 22) Left ventricular hypertrophy, highly prevalent in the elderly, 32) is another independent risk factor, whose impact is possibly reduced 24) but not abolished by age. 28,29) When CAD is taken into consideration, the RR of hypertrophy is > 1.70 in elderly Italian people.…”

Section: Discussionmentioning

confidence: 99%

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German Origin Clusters for High Cardiovascular Risk in an Italian Enclave

Casíglia

Basso²,

Guglielmi

et al. 2005

Int. Heart J.

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SUMMARYMortality and morbidity appear to be higher in a Cimbrian population representing an enclave of people who migrated from medieval Germany to the secluded Leogra valley in Italy.A population-based study was organized, recruiting 881 elderly subjects of Cimbrian origin and comparing them with a standard control population (SCP, n = 3282) having comparable general characteristics and lifestyle. Serum lipids and glucose, blood pressure, heart rate, respiratory function, ECG abnormalities, and historical events were used as risk indicators.Age-adjusted systolic and pulse pressure were higher in the Cimbrians than in the SCP, while diastolic blood pressure was comparable. The prevalences of arterial hypertension, isolated systolic hypertension, and pulse hypertension were significantly more represented among Cimbrians than SCP. The prevalences of diabetes, hypercholesterolemia, and hypertriglyceridemia were higher among the former than the latter. The ratio between apolipoproteins B and A1 was also higher, while the HDL fraction was significantly lower in Cimbrians than in the SCP. In Cimbrians, the relative risk (RR) for ischemic heart disease was 1.92 (1.57-2.34) in women, 2.30 (1.54-3.43) in men and 1.03 (1.00-1.06) in women for stroke, 2.43 (1.54-3.83) in men and 1.45 (1.01-1.12) in women for atrial fibrillation, 3.85 (2.83-5.24) in men and 1.39 (1.20-1.60) in women for respiratory disease, 1.97 (1.32-2.94) in men and 6.81 (4.38-10.60) in women for intermittent claudication, and 3.31 (2.44-4.50) in men and 2.30 (1.76-3.01) in women for left ventricular hypertrophy.The subjects living in the secluded Leogra valley are at higher cardiovascular risk than the standard controls. Whether this depends on genetic factors, lifestyle, or both will need to be clarified by further analysis. (Int Heart J 2005; 46: 489-500)

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Mortality in Relation to Minnesota Code Items in Elderly Subjects. Sex-Related Differences in a Cardiovascular Study in the Elderly.

Cited by 14 publications

References 30 publications

Electrocardiographic abnormalities in centenarians: impact on survival

Electrocardiographic abnormalities in centenarians: impact on survival

Cardiovascular risk factors in the elderly

German Origin Clusters for High Cardiovascular Risk in an Italian Enclave

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