PittsburghV1, Main, Exploration, bibRecord, 001937

Prognostic Implications of Microvascular and Macrovascular Abnormalities in Older Adults: Cardiovascular Health Study

Identifieur interne : 001937 ( Main/Exploration ); précédent : 001936; suivant : 001938

Prognostic Implications of Microvascular and Macrovascular Abnormalities in Older Adults: Cardiovascular Health Study

Auteurs : Dae Hyun Kim ; Francine Grodstein ; Anne B. Newman ; Paulo H. M. Chaves ; Michelle C. Odden ; Ronald Klein ; Mark J. Sarnak ; Kushang V. Patel ; Lewis A. Lipsitz

Source :

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences [ 1079-5006 ] ; 2014.

RBID : PMC:4271022

Descripteurs français

KwdFr :
- Anomalies vasculaires (diagnostic), Anomalies vasculaires (physiopathologie), Anomalies vasculaires (rééducation et réadaptation), Espérance de vie (tendances), Facteurs de risque, Femelle, Humains, Imagerie par résonance magnétique, Index de pression systolique cheville-bras, Microcirculation, Mâle, Pronostic, Prévision, Sujet âgé, Sujet âgé de 80 ans ou plus, Vieillissement, Électrocardiographie, Études de suivi, Études prospectives, Évaluation de l'incapacité.
MESH :
- diagnostic : Anomalies vasculaires.
- physiopathologie : Anomalies vasculaires.
- rééducation et réadaptation : Anomalies vasculaires.
- tendances : Espérance de vie.
- Facteurs de risque, Femelle, Humains, Imagerie par résonance magnétique, Index de pression systolique cheville-bras, Microcirculation, Mâle, Pronostic, Prévision, Sujet âgé, Sujet âgé de 80 ans ou plus, Vieillissement, Électrocardiographie, Études de suivi, Études prospectives, Évaluation de l'incapacité.

English descriptors

KwdEn :
- Aged, Aged, 80 and over, Aging, Ankle Brachial Index, Disability Evaluation, Electrocardiography, Female, Follow-Up Studies, Forecasting, Humans, Life Expectancy (trends), Magnetic Resonance Imaging, Male, Microcirculation, Prognosis, Prospective Studies, Risk Factors, Vascular Malformations (diagnosis), Vascular Malformations (physiopathology), Vascular Malformations (rehabilitation).
MESH :
- diagnosis : Vascular Malformations.
- physiopathology : Vascular Malformations.
- rehabilitation : Vascular Malformations.
- trends : Life Expectancy.
- Aged, Aged, 80 and over, Aging, Ankle Brachial Index, Disability Evaluation, Electrocardiography, Female, Follow-Up Studies, Forecasting, Humans, Magnetic Resonance Imaging, Male, Microcirculation, Prognosis, Prospective Studies, Risk Factors.

Abstract

Background.

Microvascular and macrovascular abnormalities are frequently found on noninvasive tests performed in older adults. Their prognostic implications on disability and life expectancy have not been collectively assessed.

Methods.

This prospective study included 2,452 adults (mean age: 79.5 years) with available measures of microvascular (brain, retina, kidney) and macrovascular abnormalities (brain, carotid, coronary, peripheral artery) in the Cardiovascular Health Study. The burden of microvascular and macrovascular abnormalities was examined in relation to total, activity-of-daily-living disability-free, and severe disability-free life expectancies in the next 10 years (1999–2009).

Results.

At 75 years, individuals with low burden of both abnormalities lived, on average, 8.71 years (95% confidence interval: 8.29, 9.12) of which 7.67 years (7.16, 8.17) were without disability. In comparison, individuals with high burden of both abnormalities had shortest total life expectancy (6.95 years [6.52, 7.37]; p < .001) and disability-free life expectancy (5.60 years [5.10, 6.11]; p < .001). Although total life expectancy was similarly reduced for those with high burden of either type of abnormalities (microvascular: 7.96 years [7.50, 8.42] vs macrovascular: 8.25 years [7.80, 8.70]; p = .10), microvascular abnormalities seemed to have larger impact than macrovascular abnormalities on disability-free life expectancy (6.45 years [5.90, 6.99] vs 6.96 years [6.43, 7.48]; p = .016). These results were consistent for severe disability-free life expectancy and in individuals without clinical cardiovascular disease.

Conclusions.

Considering both microvascular and macrovascular abnormalities from multiple noninvasive tests may provide additional prognostic information on how older adults spend their remaining life. Optimal clinical use of this information remains to be determined.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271022

DOI: 10.1093/gerona/glu074
PubMed: 24864308
PubMed Central: 4271022

Affiliations:

Le document en format XML

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<wicri:noCountry code="subfield">Massachusetts.</wicri:noCountry>
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</author>
<author><name sortKey="Odden, Michelle C" sort="Odden, Michelle C" uniqKey="Odden M" first="Michelle C." last="Odden">Michelle C. Odden</name>
<affiliation><nlm:aff id="AF0006"><institution>School of Biological and Population Health Sciences, Oregon State University</institution>
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</nlm:aff>
</affiliation>
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<author><name sortKey="Klein, Ronald" sort="Klein, Ronald" uniqKey="Klein R" first="Ronald" last="Klein">Ronald Klein</name>
<affiliation><nlm:aff id="AF0007"><institution>Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health</institution>
,<addr-line>Madison</addr-line>
.</nlm:aff>
</affiliation>
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<author><name sortKey="Sarnak, Mark J" sort="Sarnak, Mark J" uniqKey="Sarnak M" first="Mark J." last="Sarnak">Mark J. Sarnak</name>
<affiliation><nlm:aff id="AF0008"><institution>Division of Nephrology, Tufts Medical Center</institution>
,<addr-line>Boston, Massachusetts.</addr-line>
</nlm:aff>
<wicri:noCountry code="subfield">Massachusetts.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Patel, Kushang V" sort="Patel, Kushang V" uniqKey="Patel K" first="Kushang V." last="Patel">Kushang V. Patel</name>
<affiliation><nlm:aff id="AF0009"><institution>Department of Anesthesiology and Pain Medicine, University of Washington</institution>
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<author><name sortKey="Lipsitz, Lewis A" sort="Lipsitz, Lewis A" uniqKey="Lipsitz L" first="Lewis A." last="Lipsitz">Lewis A. Lipsitz</name>
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<series><title level="j">The Journals of Gerontology Series A: Biological Sciences and Medical Sciences</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Aging</term>
<term>Ankle Brachial Index</term>
<term>Disability Evaluation</term>
<term>Electrocardiography</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Forecasting</term>
<term>Humans</term>
<term>Life Expectancy (trends)</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Microcirculation</term>
<term>Prognosis</term>
<term>Prospective Studies</term>
<term>Risk Factors</term>
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<term>Vascular Malformations (rehabilitation)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Anomalies vasculaires (diagnostic)</term>
<term>Anomalies vasculaires (physiopathologie)</term>
<term>Anomalies vasculaires (rééducation et réadaptation)</term>
<term>Espérance de vie (tendances)</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Imagerie par résonance magnétique</term>
<term>Index de pression systolique cheville-bras</term>
<term>Microcirculation</term>
<term>Mâle</term>
<term>Pronostic</term>
<term>Prévision</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Vieillissement</term>
<term>Électrocardiographie</term>
<term>Études de suivi</term>
<term>Études prospectives</term>
<term>Évaluation de l'incapacité</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Vascular Malformations</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Anomalies vasculaires</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Anomalies vasculaires</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Vascular Malformations</term>
</keywords>
<keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en"><term>Vascular Malformations</term>
</keywords>
<keywords scheme="MESH" qualifier="rééducation et réadaptation" xml:lang="fr"><term>Anomalies vasculaires</term>
</keywords>
<keywords scheme="MESH" qualifier="tendances" xml:lang="fr"><term>Espérance de vie</term>
</keywords>
<keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Life Expectancy</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Aging</term>
<term>Ankle Brachial Index</term>
<term>Disability Evaluation</term>
<term>Electrocardiography</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Forecasting</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Microcirculation</term>
<term>Prognosis</term>
<term>Prospective Studies</term>
<term>Risk Factors</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Imagerie par résonance magnétique</term>
<term>Index de pression systolique cheville-bras</term>
<term>Microcirculation</term>
<term>Mâle</term>
<term>Pronostic</term>
<term>Prévision</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Vieillissement</term>
<term>Électrocardiographie</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background.</title>
<p>Microvascular and macrovascular abnormalities are frequently found on noninvasive tests performed in older adults. Their prognostic implications on disability and life expectancy have not been collectively assessed.</p>
</sec>
<sec><title>Methods.</title>
<p>This prospective study included 2,452 adults (mean age: 79.5 years) with available measures of microvascular (brain, retina, kidney) and macrovascular abnormalities (brain, carotid, coronary, peripheral artery) in the Cardiovascular Health Study. The burden of microvascular and macrovascular abnormalities was examined in relation to total, activity-of-daily-living disability-free, and severe disability-free life expectancies in the next 10 years (1999–2009).</p>
</sec>
<sec><title>Results.</title>
<p>At 75 years, individuals with low burden of both abnormalities lived, on average, 8.71 years (95% confidence interval: 8.29, 9.12) of which 7.67 years (7.16, 8.17) were without disability. In comparison, individuals with high burden of both abnormalities had shortest total life expectancy (6.95 years [6.52, 7.37]; <italic>p</italic>
 < .001) and disability-free life expectancy (5.60 years [5.10, 6.11]; <italic>p</italic>
 < .001). Although total life expectancy was similarly reduced for those with high burden of either type of abnormalities (microvascular: 7.96 years [7.50, 8.42] vs macrovascular: 8.25 years [7.80, 8.70]; <italic>p</italic>
 = .10), microvascular abnormalities seemed to have larger impact than macrovascular abnormalities on disability-free life expectancy (6.45 years [5.90, 6.99] vs 6.96 years [6.43, 7.48]; <italic>p</italic>
 = .016). These results were consistent for severe disability-free life expectancy and in individuals without clinical cardiovascular disease.</p>
</sec>
<sec><title>Conclusions.</title>
<p>Considering both microvascular and macrovascular abnormalities from multiple noninvasive tests may provide additional prognostic information on how older adults spend their remaining life. Optimal clinical use of this information remains to be determined.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list></list>
<tree><noCountry><name sortKey="Chaves, Paulo H M" sort="Chaves, Paulo H M" uniqKey="Chaves P" first="Paulo H. M." last="Chaves">Paulo H. M. Chaves</name>
<name sortKey="Grodstein, Francine" sort="Grodstein, Francine" uniqKey="Grodstein F" first="Francine" last="Grodstein">Francine Grodstein</name>
<name sortKey="Kim, Dae Hyun" sort="Kim, Dae Hyun" uniqKey="Kim D" first="Dae Hyun" last="Kim">Dae Hyun Kim</name>
<name sortKey="Klein, Ronald" sort="Klein, Ronald" uniqKey="Klein R" first="Ronald" last="Klein">Ronald Klein</name>
<name sortKey="Lipsitz, Lewis A" sort="Lipsitz, Lewis A" uniqKey="Lipsitz L" first="Lewis A." last="Lipsitz">Lewis A. Lipsitz</name>
<name sortKey="Newman, Anne B" sort="Newman, Anne B" uniqKey="Newman A" first="Anne B." last="Newman">Anne B. Newman</name>
<name sortKey="Odden, Michelle C" sort="Odden, Michelle C" uniqKey="Odden M" first="Michelle C." last="Odden">Michelle C. Odden</name>
<name sortKey="Patel, Kushang V" sort="Patel, Kushang V" uniqKey="Patel K" first="Kushang V." last="Patel">Kushang V. Patel</name>
<name sortKey="Sarnak, Mark J" sort="Sarnak, Mark J" uniqKey="Sarnak M" first="Mark J." last="Sarnak">Mark J. Sarnak</name>
</noCountry>
</tree>
</affiliations>
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Prognostic Implications of Microvascular and Macrovascular Abnormalities in Older Adults: Cardiovascular Health Study

Prognostic Implications of Microvascular and Macrovascular Abnormalities in Older Adults: Cardiovascular Health Study

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

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