The burden of cardiovascular risk factors among seniors with congenital heart disease: A single tertiary center experience

Abstract

Background:The number of adults with congenital heart disease (ACHD) surviving to old age is increasing worldwide. Acquired cardiovascular comorbidities may complicate the course and treatment of the underlying congenital disease and worsen the prognosis. Aims:The study aimed to assess the burden of cardiovascular (CV) risk factors among elderly patients with ACHD. Methods:A retrospective analysis of data on all patients ≥60 years of age hospitalized in a tertiary clinic for ACHD was performed from July 2013 to March 2020. We collected information on smoking status, body mass index, and the presence of dyslipidemia, systemic hypertension, and diabetes. Results:The most common CV risk factors among 322 patients ≥60 years of age (median age 66 years; 34% men) were: being overweight/obesity (65.5%), dyslipidemia (64.9%), and arterial hypertension (60.6%). Over 21% of patients suffered from diabetes, and 25.8% were smokers. Over 54% of patients had two or 3 CV risk factors. Patients above 70 years of age were healthier in terms of being overweight/obesity, dyslipidemia, and smoking status. Patients with mild ACHD were more likely hypertensive compared to individuals with complex defects. The highest CV burden was noted in younger men with mild ACHD. Conclusions:We demonstrated a high burden of CV risk factors in seniors with ACHD. Special attention should be paid to the identification and control of classical CV risk factors in order to prevent acquired CV disease in this population.

Effectiveness and Safety of Transcatheter Atrial Septal Defect Closure in Adults with Systemic Essential Hypertension

“…The prevalence of HTN in patients with ACHD was found to be 30-60% [9][10][11]41]. Comorbidities such as HTN and vascular disease were mainly present in patients older than 40 years [9][10][11]28,41]. Previous studies of adults undergoing transcatheter ASDC reported the prevalence of HTN in 4-12% in patients aged <30 years [22,26,31], 12-25% in patients aged 40-60 years [28,29], and 25-61% in patients >60 years old [11,27,28,30].…”

“…Adults with secundum ASD, especially older, can present a higher morbidity and mortality associated with the late presentation of ASD and an increased prevalence of comorbidities with advancing age. The prevalence of HTN in patients with ACHD was found to be 30-60% [9][10][11]41]. Comorbidities such as HTN and vascular disease were mainly present in patients older than 40 years [9][10][11]28,41].…”

“…Due to the ageing population, a number of patients with adult congenital heart disease (ACHD) continue to increase, including patients at an advanced age and/or with cardiovascular (CV) risk factors and acquired comorbidities, such as other CV diseases (CVDs) [9][10][11]. Systemic essential hypertension (HTN) remains a major CV risk factor, almost doubling the risk of death, with a rising systolic and diastolic blood pressure (BP) of as much as 20 and 10 mmHg, respectively [12,13].…”

“…The overall prevalence of HTN in the adult population is ~30-45% globally and ~43% in the Polish population [12,14]. HTN becomes progressively more common with an advancing age, reaching >60% in people aged >60 years [11,12,15]. Acquired comorbidities, such as HTN, are common in adults with ACHD, and can significantly contribute to their outcome [9][10][11].…”

“…HTN becomes progressively more common with an advancing age, reaching >60% in people aged >60 years [11,12,15]. Acquired comorbidities, such as HTN, are common in adults with ACHD, and can significantly contribute to their outcome [9][10][11]. HTN can lead to left ventricular (LV) hypertrophy (LVH), an abnormal LV compliance, and LV dysfunction, which may interfere with the disturbed hemodynamics associated with ASD [9].…”