{"title":"Cholesterol paradox in the community-living old adults: is higher better?","authors":"Sheng-Shu Wang, Shan-Shan Yang, Chun-Jiang Pan, Jian-Hua Wang, Hao-Wei Li, Shi-Min Chen, Jun-Kai Hao, Xue-Hang Li, Rong-Rong Li, Bo-Yan Li, Jun-Han Yang, Yue-Ting Shi, Huai-Hao Li, Ying-Hui Bao, Wen-Chang Wang, Sheng-Yan DU, Yao He, Chun-Lin Li, Miao Liu","doi":"10.26599/1671-5411.2023.12.003","DOIUrl":"10.26599/1671-5411.2023.12.003","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the associations of lipid indicators and mortality in Beijing Elderly Comprehensive Health Cohort Study.</p><p><strong>Methods: </strong>A prospective cohort was conducted based on Beijing Elderly Comprehensive Health Cohort Study with 4499 community older adults. After the baseline survey, the last follow-up was March 31, 2021 with an average 8.13 years of follow-up. Cox proportional hazard model was used to estimate the hazard ratios (HR) with 95% CI for cardiovascular disease (CVD) death and all-cause death in associations with baseline lipid indicators.</p><p><strong>Results: </strong>A total of 4499 participants were recruited, and the mean levels of uric acid, body mass index, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol (TC), triglyceride, and low-density lipoprotein cholesterol (LDL-C) showed an upward trend with the increasing remnant cholesterol (RC) quarters (<i>P</i><sub>trend</sub> < 0.05), while the downward trend was found in high-density lipoprotein cholesterol (HDL-C). During the total 36,596 person-years follow-up, the CVD mortality and all-cause mortality during an average 8.13 years of follow-up was 3.87% (95% CI: 3.30%-4.43%) and 14.83% (95% CI: 13.79%-15.86%) with 174 CVD death participants and 667 all-cause death participants. After adjusting for confounders, the higher level of TC (HR = 0.854, 95% CI: 0.730-0.997), LDL-C (HR = 0.817, 95% CI: 0.680-0.982) and HDL-C (HR = 0.443, 95% CI: 0.271-0.724) were associated with lower risk of CVD death, and the higher level of HDL-C (HR = 0.637, 95% CI: 0.501-0.810) were associated with lower risk of all-cause death. The higher level of RC (HR = 1.276, 95% CI: 1.010-1.613) increase the risk of CVD death. Compared with the normal lipid group, TC ≥ 6.20 mmol/L group and LDL-C ≥ 4.10 mmol/L group were no longer associated with lower risk of CVD death, while RC ≥ 0.80 mmol/L group was still associated with higher risk of CVD death. In normal lipid group, the higher levels of TC, LDL-C and HDL-C were related with lower CVD death.</p><p><strong>Conclusions: </strong>In community older adults, higher levels of TC and HDL-C were associated with lower CVD mortality in normal lipid reference range. Higher RC was associated with higher CVD mortality, which may be a better lipid indicator for estimating the CVD death risk in older adults.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10755211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prescription patterns of antidiabetic and cardiovascular preventive medications in community-dwelling older adults with type 2 diabetes mellitus: a cross-sectional study.","authors":"Bahia Chahine, Farah Al Souheil, Venise Hanna","doi":"10.26599/1671-5411.2023.12.002","DOIUrl":"10.26599/1671-5411.2023.12.002","url":null,"abstract":"<p><strong>Objective: </strong>To describe trends in antidiabetics drug prescription patterns in community-dwelling older adults with type 2 diabetes mellitus (T2DM) and to evaluate the use of cardiovascular preventive medications among those diagnosed with atherosclerotic cardiovascular disease (ASCVD).</p><p><strong>Methods: </strong>This cross-sectional, face-to-face interview study that comprised community-dwelling older adults (≥ 65 years) diagnosed with T2DM. The study questionnaire included the patients' demographics, clinical data, and current medication use. Patients with established ASCVD were further classified into low (i.e., not receiving evidence-based therapy or only one) and high (i.e., receiving at least two evidence-based therapies) composite score groups. Bivariate analysis followed by multivariable logistic regression analysis were performed to evaluate the demographic/clinical characteristics associated with the use of antidiabetic monotherapy/polytherapy and evidence-based pharmacotherapy.</p><p><strong>Results: </strong>A total of 500 older adults were enrolled. The mean age of included participants was 73 ± 7 years, 310 participants (62%) were males, and 385 participants (77.0%) had established ASCVD. Antidiabetic monotherapy was reported in 251 participants (50.2%), with metformin followed by sulfonylureas being the most commonly prescribed drugs as monotherapy. The results of the multivariable analysis showed that age [odds ratio (OR) = 0.89, 95% CI: 0.85-0.94, <i>P</i> < 0.001], obesity (OR = 4.18, 95% CI: 1.63-10.36, <i>P</i> = 0.003), hypertension (OR = 4.2, 95% CI: 1.22-7.66, <i>P</i> = 0.04), and dyslipidemia (OR = 4.1, 95% CI: 1.28-8.30, <i>P</i> = 0.01), were significantly associated with the prescription of cardiovascular preventive medications.</p><p><strong>Conclusions: </strong>Only one in twenty-one participant with T2DM and ASCVD collectively received three guideline-recommended therapies, indicating a deficiency of utilization of cardiovascular preventive drugs.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10755210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Discordance analysis for apolipoprotein and lipid measures for predicting myocardial infarction in statin-treated patients with coronary artery disease: a cohort study.","authors":"Tian-Yu Li, Pei Zhu, Ying Song, Xiao-Fang Tang, Zhan Gao, Run-Lin Gao, Jin-Qing Yuan","doi":"10.26599/1671-5411.2023.12.001","DOIUrl":"10.26599/1671-5411.2023.12.001","url":null,"abstract":"<p><strong>Background: </strong>The optimal apolipoprotein or lipid measures for identifying statin-treated patients with coronary artery disease (CAD) at residual cardiovascular risk remain controversial. This study aimed to compare the predictive powers of apolipoprotein B (apoB), non-high-density lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL-C), apoB/apolipoprotein A-1 (apoA-1) and non-HDL-C/HDL-C for myocardial infarction (MI) in CAD patients treated with statins in the setting of secondary prevention.</p><p><strong>Methods: </strong>The study included 9191 statin-treated CAD patients with a five-year median follow-up. All measures were analyzed as continuous variables and concordance/discordance groups by medians. The hazard ratio (HR) with 95% CI was estimated by Cox proportional hazards regression. Patients were classified by the clinical presentation of CAD for further analysis.</p><p><strong>Results: </strong>The high-apoB-low-LDL-C and the high-non-HDL-C-low-LDL-C categories yielded HR of 1.40 (95% CI: 1.04-1.88) and 1.51 (95% CI: 1.07-2.13) for MI, respectively, whereas discordant high LDL-C with low apoB or non-HDL-C was not associated with the risk of MI. No association of MI with discordant apoB versus non-HDL-C, apoB/apoA-1 versus apoB, non-HDL-C/HDL-C versus non-HDL-C, or apoB/apoA-1 versus non-HDL-C/HDL-C was observed. Similar patterns were found in patients with acute coronary syndrome. In contrast, no association was observed between any concordance/discordance category and the risk of MI in patients with chronic coronary syndrome.</p><p><strong>Conclusions: </strong>ApoB and non-HDL-C better predict MI in statin-treated CAD patients than LDL-C, especially in patients with acute coronary syndrome. ApoB/apoA-1 and non-HDL-C/HDL-C show no superiority to apoB and non-HDL-C for predicting MI.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10755212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fever induced Brugada electrocardiographic pattern converted to the early repolarization pattern after fever abatement in an elderly man.","authors":"Zhi-Qing Fu, Li Shuai, Yan Guo, Li Sheng","doi":"10.26599/1671-5411.2023.11.001","DOIUrl":"https://doi.org/10.26599/1671-5411.2023.11.001","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kwok M Ho, Anna Lee, William Wu, Matthew T V Chan, Lowell Ling, Jeffrey Lipman, Jason Roberts, Edward Litton, Gavin M Joynt, Martin Wong
{"title":"Flattening the biological age curve by improving metabolic health: to taurine or not to taurine, that' s the question.","authors":"Kwok M Ho, Anna Lee, William Wu, Matthew T V Chan, Lowell Ling, Jeffrey Lipman, Jason Roberts, Edward Litton, Gavin M Joynt, Martin Wong","doi":"10.26599/1671-5411.2023.11.004","DOIUrl":"https://doi.org/10.26599/1671-5411.2023.11.004","url":null,"abstract":"<p><p>The aging population is an important issue around the world especially in developed countries. Although medical advances have substantially extended life span, the same cannot be said for the duration of health span. We are seeing increasing numbers of elderly people who are frail and/or have multiple chronic conditions; all of these can affect the quality of life of the elderly population as well as increase the burden on the healthcare system. Aging is mechanistically related to common medical conditions such as diabetes mellitus, ischemic heart disease, cognitive decline, and frailty. A recently accepted concept termed 'Accelerated Biological Aging' can be diagnosed when a person's biological age-as measured by biomarkers of DNA methylation-is older than their corresponding chronological age. Taurine, a conditionally essential amino acid, has received much attention in the past few years. A substantial number of animal studies have provided a strong scientific foundation suggesting that this amino acid can improve cellular and metabolic health, including blood glucose control, so much that it has been labelled one of the 'longevity amino acids'. In this review article, we propose the rationale that an adequately powered randomized-controlled-trial (RCT) is needed to confirm whether taurine can meaningfully improve metabolic and microbiome health, and biological age. This trial should incorporate certain elements in order to provide the much-needed evidence to guide doctors, and also the community at large, to determine whether this promising and inexpensive amino acid is useful in improving human metabolic health.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Ali Tariq, Zoha Khalid, Minhail Khalid Malik
{"title":"Pre-existing frailty in the elderly and long-term mortality following percutaneous coronary intervention.","authors":"Muhammad Ali Tariq, Zoha Khalid, Minhail Khalid Malik","doi":"10.26599/1671-5411.2023.11.008","DOIUrl":"https://doi.org/10.26599/1671-5411.2023.11.008","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lifestyle improvement and the reduced risk of cardiovascular disease: the China-PAR project.","authors":"Ying-Ying Jiang, Fang-Chao Liu, Chong Shen, Jian-Xin Li, Ke-Yong Huang, Xue-Li Yang, Ji-Chun Chen, Xiao-Qing Liu, Jie Cao, Shu-Feng Chen, Ling Yu, Ying-Xin Zhao, Xian-Ping Wu, Lian-Cheng Zhao, Ying Li, Dong-Sheng Hu, Jian-Feng Huang, Xiang-Feng Lu, Dong-Feng Gu","doi":"10.26599/1671-5411.2023.11.005","DOIUrl":"https://doi.org/10.26599/1671-5411.2023.11.005","url":null,"abstract":"<p><strong>Background: </strong>The benefits of healthy lifestyles are well recognized. However, the extent to which improving unhealthy lifestyles reduces cardiovascular disease (CVD) risk needs to be discussed. We evaluated the impact of lifestyle improvement on CVD incidence using data from the China-PAR project (Prediction for Atherosclerotic Cardiovascular Disease Risk in China).</p><p><strong>Methods: </strong>A total of 12,588 participants free of CVD were followed up for three visits after the baseline examination. Changes in four lifestyle factors (LFs) (smoking, diet, physical activity, and alcohol consumption) were assessed through questionnaires from the baseline to the first follow-up visit. Cox proportional hazard models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). The risk advancement periods (RAPs: the age difference between exposed and unexposed participants reaching the same incident CVD risk) and population-attributable risk percentage (PAR%) were also calculated.</p><p><strong>Results: </strong>A total of 909 incident CVD cases occurred over a median follow-up of 11.14 years. Compared with maintaining 0-1 healthy LFs, maintaining 3-4 healthy LFs was associated with a 40% risk reduction of incident CVD (HR = 0.60, 95% CI: 0.45-0.79) and delayed CVD risk by 6.31 years (RAP: -6.31 [-9.92, -2.70] years). The PAR% of maintaining 3-4 unhealthy LFs was 22.0% compared to maintaining 0-1 unhealthy LFs. Besides, compared with maintaining two healthy LFs, improving healthy LFs from 2 to 3-4 was associated with a 23% lower risk of CVD (HR = 0.77, 95% CI: 0.60-0.98).</p><p><strong>Conclusions: </strong>Long-term sustenance of healthy lifestyles or improving unhealthy lifestyles can reduce and delay CVD risk.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}