European Journal of Cardiovascular Prevention & Rehabilitation最新文献

{"title":"Resting heart rate, mortality and future coronary heart disease in the elderly: the 3C Study.","authors":"C Legeai,&nbsp;X Jouven,&nbsp;M Tafflet,&nbsp;J F Dartigues,&nbsp;C Helmer,&nbsp;K Ritchie,&nbsp;P Amouyel,&nbsp;C Tzourio,&nbsp;P Ducimetière,&nbsp;J P Empana","doi":"10.1177/1741826710389365","DOIUrl":"https://doi.org/10.1177/1741826710389365","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between resting heart rate (RHR) and mortality and incident coronary heart disease (CHD) in the elderly.</p><p><strong>Methods: </strong>Data derived from the Three-City Study, a French multicentre prospective study including 9294 community-dwelling elderly subjects aged ≥65 years at baseline examination between 1999 and 2001. The study population comprised 7147 participants (61% women) who were free of a pacemaker or any cardiac arrhythmias at baseline. RHR was measured twice at baseline in a seated position using an electronic tensiometer. Participants were then followed up bi-annually for vascular morbidity and mortality over 6 years. CHD events and cardiovascular death were adjudicated by an independent expert committee.</p><p><strong>Results: </strong>After 6 years of follow-up, 615 subjects died including 17.9% from cardiovascular causes. Subjects from the top quintile of RHR (>79 bpm) had respectively a 74% (95% CI, 1.3-2.3), a 87% (95% CI: 0.98-3.6, p = 0.06) and a 72% (95% CI, 1.3-2.3) increased risk of total, cardiovascular and non-cardiovascular mortality compared to those from the lowest quintile (<62 bpm), after adjustment for cardiovascular risk factors and beta-blocker (BB) use in a Cox regression analysis. Associations with total mortality were consistent according to age, gender, BB use, diabetes and hypertension status (all p values for interaction >0.10). Conversely, RHR was not predictive of incident CHD (n = 228 events; top vs lowest quintile: HR: 1.0; 95% CI: 0.6-1.5).</p><p><strong>Conclusions: </strong>RHR is an independent risk marker of mortality but not of incident CHD events in community-dwelling elderly. Its routine measurement may help identify those who are at increased risk of mortality in the short term.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular evaluation of middle-aged/ senior individuals engaged in leisure-time sport activities: position stand from the sections of exercise physiology and sports cardiology of the European Association of Cardiovascular Prevention and Rehabilitation.","authors":"Mats Borjesson,&nbsp;Alex Urhausen,&nbsp;Evangelia Kouidi,&nbsp;Dorian Dugmore,&nbsp;Sanjay Sharma,&nbsp;Martin Halle,&nbsp;Hein Heidbüchel,&nbsp;Hans Halvor Björnstad,&nbsp;Stephan Gielen,&nbsp;Alessandro Mezzani,&nbsp;Domenico Corrado,&nbsp;Antonio Pelliccia,&nbsp;Luc Vanhees","doi":"10.1097/HJR.0b013e32833bo969","DOIUrl":"https://doi.org/10.1097/HJR.0b013e32833bo969","url":null,"abstract":"<p><p>Regular aerobic exercise at moderate intensities and an increased physical fitness are associated with a reduced risk of fatal and nonfatal coronary events in middle-aged individuals. In contrast, moderate and vigorous physical exertion is associated with an increased risk for cardiac events, including sudden cardiac death in individuals harbouring cardiovascular disease. The risk-benefit ratio may differ in relation to the individual’s age, fitness level, and presence of cardiovascular disease; sedentary individuals with underlying coronary artery disease are at greatest risk. The intention of the present position stand of the European Association of Cardiovascular Prevention and Rehabilitation is to encourage individuals to participate in regular physical activity and derive the benefits of physical exercise while minimizing the risk of cardiovascular adverse events. Therefore, the aim is to establish the most practical method of cardiovascular evaluation in middle-age/senior individuals, who are contemplating exercise or who are already engaged in nonprofessional competitive or recreational leisure sporting activity. These recommendations rely on existing scientific evidence, and in the absence of such, on expert consensus. The methodology of how middle-aged and older individuals should be evaluated appropriately before engaging in regular physical activity is both complex and controversial. On practical grounds the consensus panel recommend that such evaluation should vary according to the individual’s cardiac risk profile and the intended level of physical activity. Self assessment of the habitual physical activity level and of the risk factors, are recommended for screening of large populations. Individuals deemed to be at risk require further evaluation by a qualified physician. In senior/adult individuals with an increased risk for coronary events, maximal exercise testing (and possibly further evaluations) is advocated. Hopefully, the recommendations in this paper provide a practical solution for facilitating safe exercise prescription in senior/adults.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HJR.0b013e32833bo969","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commotio cordis - under-recognized in Europe?: a case report and review.","authors":"Erik Ekker Solberg,&nbsp;Bernt Inge Embrå,&nbsp;Mats Börjesson,&nbsp;Johan Herlitz,&nbsp;Domenico Corrado","doi":"10.1177/1741826710389363","DOIUrl":"https://doi.org/10.1177/1741826710389363","url":null,"abstract":"<p><p>This case and the review illustrate the induction of a sudden collapse of a football player secondary to a blow to his chest (commotio cordis) [CC]. The article argues that CC probably is under recognized in Europe and cautions that the mounting intensity and speed inherent in modern sports possibly increase the likeliness of CC in the future. If CC occurs, immediate cardiopulmonary resuscitation and automatic external defibrillator should be used.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of early-stage left ventricular dysfunction in type 2 diabetes: results of DYDA study.","authors":"Carlo B Giorda,&nbsp;Giovanni Cioffi,&nbsp;Giovanni de Simone,&nbsp;Andrea Di Lenarda,&nbsp;Pompilio Faggiano,&nbsp;Roberto Latini,&nbsp;Donata Lucci,&nbsp;Aldo P Maggioni,&nbsp;Luigi Tarantini,&nbsp;Mario Velussi,&nbsp;Paolo Verdecchia,&nbsp;Marco Comaschi","doi":"10.1177/1741826710389402","DOIUrl":"https://doi.org/10.1177/1741826710389402","url":null,"abstract":"<p><strong>Background: </strong>Better knowledge of prevalence and early-stage determinants of subclinical left ventricular dysfunction (LVD) in type 2 diabetes would be useful to design prevention strategies. The objective of the LVD in Diabetes (DYDA) study was to assess these points in patients without established cardiac disease.</p><p><strong>Method: </strong>Baseline clinical, ECG, laboratory and echocardiographic data from 751 patients (61 ± 7 years, 59% hypertensive) recruited by 37 Italian diabetes clinics were analysed. Clinical history, life habits, laboratory data (NT-proBNP, HsCRP, HbA1c, serum glucose, lipids and creatinine, liver enzymes, microalbuminuria, glomerular filtrate) and data on microvascular complications and drug therapy were collected.</p><p><strong>Results: </strong>LVD was present in 59.9% of patients. Age (OR 1.05, 95% CI [1.02-1.07]), HbA1c (OR 1.27, 95% CI [1.09-1.49]), triglycerides (OR 1.003, 95% CI [1.001-1.006]), treatment with metformin (OR 1.62, 95% CI [1.09-2.40]) and doxazosine (OR 2.48, 95% CI [1.10-5.55]) were independent predictors of LVD. Glitazones were associated with reduced risk of diastolic dysfunction (OR 0.44, 95% CI [0.22-0.87]) whereas waist circumference and metformin were adversely associated with systolic dysfunction (OR 1.02, 95% CI [1.01-1.04] and 1.57, 95% CI [1.01-2.43], respectively).</p><p><strong>Conclusion: </strong>In asymptomatic and fairly controlled diabetic patients, age, worse HbA1c, traits of insulin resistance, such as visceral adiposity and triglycerides or treatment with metformin, and use of doxazosin indicate greater risk of LVD. Glitazones, at this stage, seem to be associated with better diastolic performance.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance and limits of pre-hospital electrocardiogram in patients with ST elevation myocardial infarction undergoing percutaneous coronary angioplasty.","authors":"Alessandro Martinoni,&nbsp;Stefano De Servi,&nbsp;Enrico Boschetti,&nbsp;Roberto Zanini,&nbsp;Tullio Palmerini,&nbsp;Alessandro Politi,&nbsp;Giuseppe Musumeci,&nbsp;Guido Belli,&nbsp;Marcella De Paolis,&nbsp;Federica Ettori,&nbsp;Emanuela Piccaluga,&nbsp;Diego Sangiorgi,&nbsp;Alessandra Repetto,&nbsp;Maurizio D'Urbano,&nbsp;Battistina Castiglioni,&nbsp;Franco Fabbiocchi,&nbsp;Marco Onofri,&nbsp;Nicoletta De Cesare,&nbsp;Giuseppe Sangiorgi,&nbsp;Corrado Lettieri,&nbsp;Fabrizio Poletti,&nbsp;Salvatore Pirelli,&nbsp;Silvio Klugmann","doi":"10.1177/1741826710389395","DOIUrl":"https://doi.org/10.1177/1741826710389395","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to present data on the effects of pre-hospital electrocardiogram (PH-ECG) on the outcome of ST elevation myocardial infarction (STEMI) patients treated with percutaneous coronary angioplasty (PCI) included in a registry undertaken in the Italian region of Lombardy. Pre-hospital 12-lead electrocardiogram is recommended by current guidelines in order to achieve faster times to reperfusion in patients with STEMI.</p><p><strong>Methods: </strong>The registry includes 3901 STEMI patients who underwent primary PCI over an 18-month period.</p><p><strong>Results: </strong>Mean age was 63 ± 12 years. Admission through the emergency medical system (EMS) occurred in 1603 patients (40%): they were older, more frequently had previous MI, TIMI flow = 0 at entry and were more frequently in Killip class >1 than patients who were not admitted through the EMS. Among the patients admitted through the EMS, PH-ECG was obtained in 475 patients (12%). These patients had less frequently an anterior MI, but more frequently had absence of TIMI flow at entry than patients whose ECG was not teletransmitted. Moreover, they had a significantly shorter first medical contact-to-balloon time and a trend toward a lower 30-day death rate (5.3% vs 7.9 %, p = 0.06). However, only patients in Killip class 2-3 had a significantly lower mortality when the diagnostic ECG was transmitted, whereas no difference was found in Killip class 1 or Killip class 4 patients.</p><p><strong>Conclusions: </strong>In this registry, PH-ECG significantly decreased first medical contact-to-balloon time. Attempts to achieve faster reperfusion times should be undertaken, as this may result in improved outcome, particularly in patients with mild to moderate symptoms of heart failure.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29779581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-blocker initiation and adherence after hospitalization for acute myocardial infarction.","authors":"Vittorio Maio,&nbsp;Massimiliano Marino,&nbsp;Mary Robeson,&nbsp;Joshua J Gagne","doi":"10.1177/1741826710389401","DOIUrl":"https://doi.org/10.1177/1741826710389401","url":null,"abstract":"<p><strong>Aims: </strong>We sought to: (1) estimate the proportion of patients who initiated beta-blocker therapy after acute myocardial infarction (AMI) in Regione Emilia-Romagna (RER); (2) examine predictors of post-AMI beta-blocker initiation; and (3) assess adherence to such therapy.</p><p><strong>Methods and results: </strong>Using healthcare claims data covering all of RER, we identified a cohort of 24,367 patients with a hospitalization for AMI between 2004 and 2007, who were discharged from the hospital alive and without contraindications to beta-blocker therapy. We estimated the proportion of eligible patients with at least one prescription for a beta-blocker following discharge and performed a multivariable logistic regression analysis to identify independent predictors of post-AMI beta-blocker initiation. We computed the proportion of days covered (PCD) as a measure of medication adherence at 6 and 12 months post-discharge. Following discharge, 16,383 (67%) cohort members initiated beta-blocker therapy. Independent predictors of beta-blocker initiation included age and receipt of invasive procedures during hospitalization, such as coronary artery bypass graft surgery (odds ratio [OR], 2.37; 95% confidence interval [CI], 2.00-2.81), percutaneous transluminal coronary angioplasty (OR, 1.42; 95% CI, 1.31-1.54), and cardiac catheterization (OR, 1.21; 95% CI, 1.11-1.32). Among initiators, adherence to beta-blocker treatment at 6 and 12 months was low and decreased in each study year.</p><p><strong>Conclusion: </strong>Overall, use of and adherence to post-AMI beta-blocker therapy was suboptimal in RER between 2004 and 2007. Older patients and those with indicators of frailty were less likely to initiate therapy. The proportion of patients adherent at 6 and 12 months decreased over time.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NT-proBNP and cardiac events in older diabetic patients.","authors":"Michael Resl,&nbsp;Stephanie Neuhold,&nbsp;Michaela Riedl,&nbsp;Heidemarie Abrahamian,&nbsp;Guido Strunk,&nbsp;Rudolf Prager,&nbsp;Martin Clodi,&nbsp;Martin Hülsmann,&nbsp;Anton Luger,&nbsp;Richard Pacher","doi":"10.1177/1741826710389362","DOIUrl":"https://doi.org/10.1177/1741826710389362","url":null,"abstract":"<p><p>NT-proBNP is an excellent predictor of adverse events in patients with diabetes mellitus. Due to an aging population it is of interest to determine whether NT-proBNP can predict cardiac events with equal precision in subgroups with different ages. 1395 outpatients with diabetes mellitus were recruited for this prospective observational study. NT-proBNP, renal function, lipid status and other demographic variables were measured at baseline. The cohort was divided into three groups: Group I (609 patients under 60 years of age), group II (634 patients ranging from 60-75) and group III (152 patients older than 75). Patients were followed during a mean observation period of 11 months, 75 patients reached the defined endpoint, which was unplanned hospitalization due to a cardiac event. Mean age was 60 ± 30 years, mean HbA(1c) was 7.6% and mean NT-proBNP was 242 ± 437 pg/ml. In a multiple Cox regression model, age (hazard ratio (HR) 11.18, p < 0.01) and the absence of a cardiac disease (HR 0.49, p < 0.01) were important variables for short-term prognosis. The addition of the logarithm of NT-proBNP provided independent prognostic information (HR 1.81 p < 0.01) and significantly increased the explained variance of the model (χ(2 )= 22.93; d.f. = 1; p < 0.01). More importantly, the predictive power of this model was similar in different age-groups. The prognostic information of NT-proBNP was not influenced by age and this biomarker remained a reliable predictor of short-term cardiac events in patients with diabetes mellitus aged 75 years or older.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29781517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of cardiovascular disease risk factors among UK commercial pilots.","authors":"Stephen Houston,&nbsp;Stuart Mitchell,&nbsp;Sally Evans","doi":"10.1177/1741826710389417","DOIUrl":"https://doi.org/10.1177/1741826710389417","url":null,"abstract":"<p><strong>Aim: </strong>This study is one of the largest ever completed to examine the prevalence of cardiovascular disease (CVD) risk factors among commercial aircrew.</p><p><strong>Method and results: </strong>A retrospective cross-sectional study comparing prevalence of CVD risk factors age, body mass index (BMI), overweight and obesity, current smoking status, hypertension, and diabetes among commercial aircrew and the UK general population. A total of 14,379 subject records were eligible for the study. The age-sex group mean BMI was significantly lower in almost all pilot age groups compared to the general population. Overweight age-sex group prevalence was significantly higher in the <25, 35-44, 45-54, 55-64 age groups for male pilots, and lower for female pilots in the 25-34 and 45-54 age groups. Male and female pilots had significantly lower age-sex-group prevalence of obesity and current smoking compared to the general population. For hypertension, the male <25 and 35-44 year age groups had significantly higher prevalence, and the 45-54 and 55-64 year age groups had significantly lower prevalence than the general population. Age-standardised mean BMI and prevalence of overweight and hypertension were not significantly different from the highest income quintile of the general population. Age-standardised obesity and current smoking prevalence were significantly lower in pilots compared to the highest socio-economic quintile of the general population.</p><p><strong>Conclusion: </strong>Even when comparisons were made with the highest income quintile of the general population to control for socio-economic status, pilots had a significantly lower prevalence of obesity and smoking. This finding is consistent with a strong 'healthy worker effect'.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389417","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiopulmonary exercise testing in small abdominal aortic aneurysm: profile, safety, and mortality estimates.","authors":"Jonathan Myers,&nbsp;Alyssa Powell,&nbsp;Kimberly Smith,&nbsp;Holly Fonda,&nbsp;Ronald L Dalman","doi":"10.1177/1741826710389384","DOIUrl":"https://doi.org/10.1177/1741826710389384","url":null,"abstract":"<p><strong>Aim: </strong>Few data are available regarding exercise testing in patients with abdominal aortic aneurysm (AAA) disease. The purpose of this study was to evaluate safety and to characterize the hemodynamic and cardiopulmonary (CPX) response to exercise in a large group of patients with AAA.</p><p><strong>Methods: </strong>Three hundred and six patients with AAA ≥3.0 to ≤5.0 cm (mean 72 ± 8 years) underwent CPX as part of a randomized trial of exercise training. CPX and hemodynamic responses, ischemic events, rhythm disturbances, and risk estimates based on treadmill scores were quantified and compared to an age-matched group of 2155 veterans referred for exercise testing for clinical reasons.</p><p><strong>Results: </strong>Peak VO(2) was similar between patients with AAA and the referral group (20.0 ± 6 ml/kg/min; 77 percent of age-predicted and 20.3 ± 7 ml/kg/min; 80 percent of age-predicted, respectively). The incidence of exercise-induced hypotension and hypertension was higher in AAA patients versus the referral group (2.9 and 3.6 percent vs <1.0 percent, p < 0.001), but there were no occurrences of ventricular tachycardia (≥3 beats) or other serious events in the AAA subjects. The Duke Treadmill Score and VA Treadmill Scores, which estimate annual cardiovascular events and all-cause mortality, respectively, were similar between groups.</p><p><strong>Conclusions: </strong>Patients with AAA have a slightly higher incidence of hyper- and hypotensive responses to exercise than age-matched referrals, but no serious events related to CPX occurred. AAA patients can undergo maximal CPX safely and have risk scores based on treadmill test results that are similar to age-matched referral subjects. These findings extend recent studies using sub-maximal evaluations to stratify risk in patients considered for surgery, and support the routine use of exercise testing for risk evaluation and the functional assessment of patients with AAA.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389384","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29779586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for cardiovascular disease in the very elderly: results of a cohort study in a city in southern Brazil.","authors":"Maria Helena Werle,&nbsp;Emílio Moriguchi,&nbsp;Sandra Costa Fuchs,&nbsp;Neide Maria Bruscato,&nbsp;Waldemar de Carli,&nbsp;Flávio Danni Fuchs","doi":"10.1177/1741826710389405","DOIUrl":"https://doi.org/10.1177/1741826710389405","url":null,"abstract":"<p><strong>Background: </strong>Risk factors for cardiovascular mortality have barely been investigated in very elderly persons and there may be differences compared with younger individuals.</p><p><strong>Methods: </strong>This is a cohort study of all inhabitants over 80 years of age in the city of Veranópolis, Brazil. The association of demographic, anthropometric, physical, and medical characteristics with mortality by any cause and by cardiovascular disease (CVD) was investigated by means of Cox regression models.</p><p><strong>Results: </strong>The mean age of the participants was 83.6 ± 3.3 years. Vital status and cause of death was ascertained in 96.9% of the participants after a mean follow-up of 8.7 ± 3.8 years. Systolic and diastolic blood pressure showed a U-shape relationship with cardiovascular and total mortality. Blood pressure lower than 140/90 mmHg was associated with a higher risk for cardiovascular mortality (HR 4.76, 95% CI 1.56-14.28, p = 0.006). Duration of sleep was inversely associated with the risk of cardiovascular death (HR 0.83, 95% CI 0.73-0.95, p = 0.007), while apoA-I was inversely associated only with the risk of all-cause mortality (HR 0.99, 95% CI 0.98-1.00, p = 0.041). Anthropometric indexes, smoking, cholesterol, LDL-cholesterol, HDL-cholesterol, and other traditional risk factors were not associated with cardiovascular mortality.</p><p><strong>Conclusion: </strong>Many traditional risk factors are not associated with cardiovascular mortality in the very elderly. Longer sleep duration is associated with lower cardiovascular mortality of very elderly individuals, while low blood pressure identifies very elderly individuals at higher risk of dying from cardiovascular causes.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}