Impact traditional CVD risk factors reduces as patients get older
Impact of Aging on the Strength of Cardiovascular Risk Factors: A Longitudinal Study Over 40 YearsLiterature - Lind L, Sundström J, Ärnlöv J, et al. - J Am Heart Assoc. 2018;7:e007061
A significant interaction was noted between age and the set of all traditional risk factors regarding incident MI (P=0.0033), incident ischemic stroke (P=0.025), and incident HF (P=0.0007).
When the interactions between the individual risk factors and age were calculated, BMI and smoking showed P<0.05 (P=0.020 and P=0.026, respectively) regarding incident MI, SBP showed P<0.05 (P=0.0067) regarding stroke, and SBP and HDL-c showed P<0.05 (P=0.0045 and P=0.016, respectively) regarding HF.
The impact of all traditional CV risk factors declined with increasing age, with declining risk ratios (RR) at the respective time points. In older patients, some risks were no longer significantly elevated, for instance BMI was only related to incident MI at ages 50 and 60, and SBP and smoking only showed significant relations up to 77 years.
Some RRs were still statistically significant at old age, or even higher than at middle-age, including LDL-c for MI, and BMI and fasting glucose for HF:
- RR for LDL-c regarding MI at age 82 years: 1.67; 95%CI: 1.33-2.11; P<0.001 (vs. RR: 1.27, 95%CI: 1.01-1.61, P=0.044 at age 50 years).
- RR for BMI regarding HF at age of 82 years: 1.30; 95%CI: 1.07-1.57; P=0.008 (vs. RR: 1.58, 95%CI: 1.07-2.35, P=0.23 at age 50 years).
- RR for fasting glucose regarding HF at age 82 years: 1.11; 95%CI: 1.03-1.19; P=0.008 (vs. RR: 1.09, 95%CI: 0.94-1.26, P=0.259 at age 50 years).
In general, the impact of traditional CV risk factors on CVD declines with age, and some risk factors no longer show a significant relation with CVD. Some risk factor do show significant associations with CVD at 82 years of age, including LDL-c for MI, and fasting glucose for HF.