医学
内科学
风险因素
血压
老年学
糖尿病
人口
体质指数
疾病
优势比
肥胖
逻辑回归
冲程(发动机)
作者
Ivan Aprahamian,Marina Petrella,Everson de Cássio Robello,Hélder Jorge Andrade Gomes,Natália Almeida Lima,Isabela Cunha Fernandes,Fernanda Rezende Dias da Silva,Daniele Lima da Costa,Andréia Pain,Mateus de Oliveira Reis,Claudia K. Suemoto,Richard C. Oude Voshaar
标识
DOI:10.1016/j.exger.2021.111475
摘要
Background Frailty marks a process of increasing dysregulation of physiological systems which increases the risk of adverse health outcomes. This study examines the hypothesis that the association between multiple cardiovascular risk factors (CVRF) and cardiovascular diseases (CVD) becomes stronger with increasing frailty severity. Methods Cross-sectional analysis of 339 older adults (55.2% women; aged 75.2 ± 9.1 years) from an outpatient geriatric clinic from a middle-income country. The frailty index (FI) was calculated as the proportion of 30 possible health deficits. We assessed hypertension, diabetes, obesity, dyslipidemia, sedentarism and smoking as CVRF (determinants) and myocardial infarction, stroke, heart failure as CVD. Poisson regression models adjusted for age, sex, and education was applied to estimate the association between frailty as well as CVRF (independent variables) with CVD (dependent variable). Results Of the 339 patients, 18,3% were frail (FI ≥ 0.25) and 32.7% had at least one CVD. Both frailty and CVRF were significantly associated with CVD (PR = 1.03, 95% CI 1.01 to 1.05; p = 0.001, and PR = 1.46, 95% 1.24 to 1.71; p Conclusion Frailty and CVRF are both associated with CVD, but the impact of CVRF decreases in the presence of frailty. When confirmed in longitudinal studies, randomized controlled trials or causal inference methods like Mendelian randomization should be applied to assess whether a shift from traditional CVRF to frailty would improve cardiovascular outcome in the oldest old.
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