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. 2020 Oct 15;75(11):2207-2214.
doi: 10.1093/gerona/glaa043.

Patterns of Cardiovascular Risk Factors in Old Age and Survival and Health Status at 90

Michelle C Odden  1   2 , Andreea M Rawlings  2   3 , Alice M Arnold  4 , Mary Cushman  5 , Mary L Biggs  4 , Bruce M Psaty  6   7 , Anne B Newman  8
Affiliations

Patterns of Cardiovascular Risk Factors in Old Age and Survival and Health Status at 90

Michelle C Odden et al. J Gerontol A Biol Sci Med Sci. .

Abstract

Background: The population age 90 years and older is the fastest growing segment of the U.S. population. Only recently is it possible to study the factors that portend survival to this age.

Methods: Among participants of the Cardiovascular Health Study, we studied the association of repeated measures of cardiovascular risk factors measured over 15-23 years of follow-up and not only survival to 90 years of age, but also healthy aging outcomes among the population who reached age 90. We included participants aged 67-75 years at baseline (n = 3,613/5,888) to control for birth cohort effects, and followed participants until death or age 90 (median follow-up = 14.7 years).

Results: Higher systolic blood pressure was associated with a lower likelihood of survival to age 90, although this association was attenuated at older ages (p-value for interaction <.001) and crossed the null for measurements taken in participants' 80's. Higher levels of high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and body mass index (BMI) were associated with greater longevity. Among the survivors to age 90, those with worse cardiovascular profile (high blood pressure, LDL cholesterol, glucose, and BMI; low HDL cholesterol) had lower likelihood of remaining free of cardiovascular disease, cognitive impairment, and disability.

Conclusion: In summary, we observed paradoxical associations between some cardiovascular risk factors and survival to old age; whereas, among those who survive to very old age, these risk factors were associated with higher risk of adverse health outcomes.

Keywords: Blood; Cardiovascular; Longevity; Nonagenarians; Successful aging.

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Figures

Figure 1.
Figure 1.
Age-adjusted association of risk factors and survival to 90. Associations with systolic blood pressure are stratified based on the age of blood pressure measurement < 85 and 85+ years. BMI = body mass index; BP = blood pressure; HDL = high-density lipoprotein; LDL = low-density lipoprotein.
Figure 2.
Figure 2.
Age-adjusted association of risk factors and being cardiovascular disease free at 90, among those surviving to 90. BMI = body mass index; BP = blood pressure; HDL = high-density lipoprotein; LDL = low-density lipoprotein.
Figure 3.
Figure 3.
Age-adjusted association of risk factors and being free of cognitive impairment at 90, among those surviving to 90. BMI = body mass index; BP = blood pressure; HDL = high-density lipoprotein; LDL = low-density lipoprotein.
Figure 4.
Figure 4.
Age-adjusted association of risk factors and being free of ADL impairment at 90, among those surviving to 90. ADL = activities of daily living; BMI = body mass index; BP = blood pressure; HDL = high-density lipoprotein; LDL = low-density lipoprotein.
See this image and copyright information in PMC

References

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