Subclinical cardiovascular disease in healthy octogenarians : the brazilian study on healthy aging

Abstract

The world population is aging and a rapid increase is being seen in the very elderly (>80 years of age). To date there is scarce data on prevalence and correlates of subclinical cardiovascular disease (CVD) in this specific elderly population. In this study we evaluated presence and association of subclinical atherosclerosis and inflammation with traditional risk factorsin a selected group of consecutive octogenarians free of clinical evidence of CVD enrolled in the Brazilian Study of Healthy Aging. The study population consisted of 208 individuals (21% male) 80 and older (mean age 84±4, range 80-102) living in Brasilia, Brazil. Anthropometrics & biochemical parameterswere measuredby skinfold thickness measurement. Multidetector-row cardiac CT for coronary artery calcium score (CACS) and carotid sonography for intima-media thickness (IMT) were used to detect subclinical atherosclerosis. High reactive C reactive protein (hs-CRP) was measured to assess degree of underlying inflammation The prevalence of subclinical CVD defined by CACS >0, CACS >100, CIMT> 1mm & hsCRP>3 mg/L was 88%, 56%, 37.9%, 39%, and 33%, respectively. Male gender and low HDL were associated with presence and burden of CAC (p<0.05), whereas no such relationship was noted for LDL, age, hypertension, diabetes mellitus and obesity (p=NS). No significant association was noted for presence of CIMT>1 mm. On the other hand only elevated LDL and lower HDL was significantly associated with presence of subclinical vascular inflammation (hs-CRP>3 mg/dl). Our results suggest that subclinical CVD in octogenarians, particularly those with low HDL may help to identify asymptomatic patients at higher risk. Further studies are needed to explore the predictive value of these measures in predicting future cardiovascular events in octogenarians