Cardiovascular Health in Individuals with Exceptional Longevity Residing in Arkansas

Abstract

Cardiovascular disease is a common comorbidity associated with an aging population. However, there is a unique group of individuals whose age-defying qualities are still being investigated. This retrospective chart review analyzed various cardiac and metabolic health parameters to characterize the prevalence of heart failure and metabolic derangements in individuals aged 90 years old or older in central Arkansas. Only 236 of the 291 patients in our study cohort had blood pressures recorded. Of these, 50% had systolic blood pressures ≥140 mmHg. Additionally, 77% had pulse pressures ≥50 mmHg. Of the 96 patients with BNP data, 44% had values ≥300 pg/mL. There was a slight positive correlation between aging and HDL cholesterol, while there was a negative correlation between aging and both total cholesterol and LDL cholesterol. A majority of our patients had both elevated systolic blood pressures and elevated pulse pressures. A majority also had high BNP values, indicative of some degree of heart failure. Additionally, atrial fibrillation was a common arrhythmia identified on EKG. However, these oldest of the old patients had fewer documented metabolic derangements. These findings lay important groundwork for further investigation into lifestyle and genetic components that allow them to live exceptionally long with such comorbidities.

Keywords: cardiovascular disease; heart disease risk factors; heart failure; longevity; oldest old.

Figure 1.

Scatterplot of systolic blood pressures (SBP) versus age; N = 236. SBP values ranged from 83 to 229 mmHg. Pearson’s correlation showed no significant association between SBP and age.

Figure 2.

Scatterplot of pulse pressures (PP) versus age; N = 237. PP values ranged from 21 to 180. The majority of patients in the study had elevated pulse pressures with values greater than or equal to 50, signifying less arterial compliance. Pearson’s correlation showed no significant association between PP and age.

Figure 3.

Scatterplot of ejection fraction versus age. Ejection fraction was available in only 25 patient charts for this study population. The majority of patients with this assessment in their chart had ejection fractions in the normal range between 50% and 60%. Pearson’s correlation showed no significant association between ejection fraction and age.

Figure 4.

B-type natriuretic peptide values vs. age. BNP values ranged from 21 to 4800 pg/mL: (a) scatterplot of BNP values 500 pg/mL and above (moderate to severe HF) versus age; N = 25 and (b) scatterplot of BNP values below 500 pg/mL (normal to mild HF) versus age; N = 71. Pearson’s correlation showed a significant negative association between BNP values under 500 pg/mL and aging, however, there was no association seen for BNP values 500 pg/mL and above.

Figure 5.

(a) Scatterplot of cholesterol levels versus. age; N = 91. Cholesterol levels ranged from 117 to 332 mg/dL. Pearson’s correlation showed a slight negative association between cholesterol and age, (b) scatterplot of high-density lipoprotein (HDL) versus age; N = 89. HDL levels ranged from 24 to 117 mg/dL and showed a slight positive correlation with age, (c) scatterplot of low-density lipoprotein (LDL) versus age; N = 90. LDL levels ranged from 45 to 215 mg/dL. This plot demonstrates a significant negative correlation between LDL and age, and (d) Scatterplot of total triglyceride versus age; N = 90. Triglyceride levels ranged from 36 to 526 mg/dL. There appeared to be no correlation between total triglyceride and age.