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Comment
. 2021 Sep 15:339:170-178.
doi: 10.1016/j.ijcard.2021.07.004. Epub 2021 Jul 7.

Health-related quality of life and incident cardiovascular disease events in community-dwelling older people: A prospective cohort study

Aung Zaw Zaw Phyo  1 , Joanne Ryan  1 , David A Gonzalez-Chica  2 , Nigel P Stocks  3 , Christopher M Reid  4 , Andrew M Tonkin  1 , Robyn L Woods  1 , Mark R Nelson  5 , Anne M Murray  6 , Danijela Gasevic  7 , Rosanne Freak-Poli  8 ; ASPREE Investigator Group
Affiliations
Comment

Health-related quality of life and incident cardiovascular disease events in community-dwelling older people: A prospective cohort study

Aung Zaw Zaw Phyo et al. Int J Cardiol. .

Abstract

Background: Lower health-related quality of life (HRQoL) has been shown to predict a higher risk of hospital readmission and mortality in patients with cardiovascular disease (CVD). Few studies have explored the associations between HRQoL and incident CVD. We explored the associations between baseline HRQoL and incident and fatal CVD in community-dwelling older people in Australia and the United States.

Methods: Longitudinal study using ASPirin in Reducing Events in the Elderly (ASPREE) trial data. This includes 19,106 individuals aged 65-98 years, initially free of CVD, dementia, or disability, and followed between March 2010 and June 2017. The physical (PCS) and mental component scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Incident major adverse CVD events included fatal CVD (death due to atherothrombotic CVD), hospitalizations for heart failure, myocardial infarction or stroke. Analyses were performed using Cox proportional-hazard regression.

Results: Over a median 4.7 follow-up years, there were 922 incident CVD events, 203 fatal CVD events, 171 hospitalizations for heart failure, 355 fatal or nonfatal myocardial infarction and 403 fatal or nonfatal strokes. After adjustment for sociodemographic, health-related behaviours and clinical measures, a 10-unit higher PCS, but not MCS, was associated with a 14% lower risk of incident CVD, 28% lower risk of hospitalization for heart failure and 15% lower risk of myocardial infarction. Neither PCS nor MCS was associated with fatal CVD events or stroke.

Conclusion: Physical HRQoL can be used in combination with clinical data to identify the incident CVD risk among older individuals.

Keywords: Aged; Cardiovascular diseases; Incidence; Quality of life; Risk factors.

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Conflict of interest statement

Declaration of Competing Interest

All authors: No conflict of interest to declare.

Figures

Fig. 1.
Fig. 1.
Cumulative incidence of cardiovascular disease, fatal cardiovascular disease, hospitalization for heart failure, fatal or nonfatal myocardial infarction, and fatal or nonfatal stroke according to the physical component score (PCS) in quartiles. PCS, physical component score; Q1, quartile 1; Q2, quartile 2; Q3, quartile 3; Q4, quartile 4. Quartile 1 = lowest, Quartile 4 = highest.
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