Subclinical vascular disease burden and risk for death and cardiovascular events in older community dwellers

Individual measures and previous composite measures of subclinical vascular disease defined high risk for cardiovascular events, but did not detect low and modest risk. A different approach might better describe the spectrum from low to high risk. Methods and Results. In the Cardiovascular Health St...

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Published in:The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 2011-09, Vol.66 (9), p.986-993
Main Authors: Inzitari, Marco, Arnold, Alice M, Patel, Kushang V, Mercer, Laina D, Karlamangla, Arun, Ding, Jingzhong, Psaty, Bruce M, Williamson, Jeff D, Kuller, Lewis H, Newman, Anne B
Format: Article
Language:English
Subjects:
African Americans
Aged
Aged, 80 and over
Cardiovascular disease
Cardiovascular Diseases - etiology
Cost of Illness
Female
Humans
Journal of Gerontology: MEDICAL SCIENCES
Male
Mortality
Older people
Risk
Risk factors
Vascular Diseases - complications
Vascular Diseases - mortality
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Summary:Individual measures and previous composite measures of subclinical vascular disease defined high risk for cardiovascular events, but did not detect low and modest risk. A different approach might better describe the spectrum from low to high risk. Methods and Results. In the Cardiovascular Health Study, 3,252 participants without history of clinical cardiovascular disease (M ± SD 74.3 years ± 5.1, 63% women, 17% African Americans) had noninvasive vascular assessments in 1992-1993. We assigned a score of 0, 1, or 2 (no, mild, or severe abnormalities) to ankle-arm index, electrocardiogram, and common carotid intima-media thickness, based on clinical cutoffs. A summary index (range 0-6, absent to severe disease) summed individual scores. Abdominal aortic ultrasound and brain magnetic resonance imaging were collected in a subsample. Mortality and incident cardiovascular events were identified through June 2008. Event and death rates increased across index grades. Comparing grades 1 to 5+ with absent disease, and adjusting for demographics, hazard ratios for cardiovascular events within 8 years ranged from 1.1 (95% confidence interval 0.8-1.6) to 4.7 (3.4-6.9) and, for mortality, from 1.5 (1.0-2.3) to 5.0 (3.3-7.7) (p for trend across grades
ISSN:1079-5006
1758-535X
DOI:10.1093/gerona/glr069