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Córdova C, Boullosa DA, Custódio MR, Quaglia LA, Santos SN, Freitas WM, Sposito AC, Nóbrega OT. Atheroprotective Properties of Serum IGF-1 in the Carotid and Coronary Territories and Beneficial Role on the Physical Fitness of the Oldest Old. J Gerontol A Biol Sci Med Sci 2015; 71:1281-8. [DOI: 10.1093/gerona/glv216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 11/09/2015] [Indexed: 12/21/2022] Open
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Chongsa W, Kanokwiroon K, Jansakul C. Effects of 6 weeks oral administration of Phyllanthus acidus leaf water extract on the vascular functions of middle-aged male rats. JOURNAL OF ETHNOPHARMACOLOGY 2015; 176:79-89. [PMID: 26498492 DOI: 10.1016/j.jep.2015.10.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 10/06/2015] [Accepted: 10/20/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Leaves of Phyllanthus acidus (PA) have been used in Thai traditional medicine for the treatment of hypertension. We have previously shown that chronic treatment of a PA water extract to middle-aged male rats caused a lowering of the body and serum lipids, two of the parameters that are implicated in cardiovascular disease. AIM OF THE STUDY To investigate if chronic treatment of middle-aged male rats with a PA water extract affected the perivascular (aortic) adipose tissue (PVAT) and/or their vascular functions MATERIALS AND METHODS Fresh leaves of PA were extracted with water and orally gavaged to the middle-aged male rats for 6 weeks. Vascular functions were studied in vitro using isolated thoracic aorta with and without PVAT, and mesenteric rings in Krebs Heinseleit solution with results recorded with a Polygraph or a Myograph system. The amount of blood vessel eNOS and CSE (cystathionine-γ-lyase) expression was measured by Western blotting. RESULTS PA treatment caused a lower maximal contractile response to phenylephrine (Phe) of the endothelium-intact aortic ring than that of the control group. This effect was abolished by N(G)-nitro-l-arginine (l-NA) or by denudation of the endothelium. dl-propargylglycine (PAG, H2S inhibitor) and TEA (Ca(2+)-activated K(+) channel blocker), but not glybenclamide (ATP-activated K(+) channel blocker), caused a similar increase in the baseline of the endothelium-intact aortic ring in the presence of l-NA in both the PA-treated and control aortic rings. This effect sequentially resulted in a greater contractile response of the aortic rings of both groups to Phe. Glybenclamide also caused a similar increase in the maximal contraction of the endothelium-intact blood vessels with l-NA to both groups. PAG, TEA or glybenclamide did not modify the phenylephrine C-R curves for either group of the PVAT-endothelium-intact aortic rings preincubated with l-NA. The CSE levels of the thoracic aorta and at the PVAT were not different between the PA-treated and the control group. Relaxation of the Phe-precontracted thoracic aortic ring to acetylcholine, but not to glyceryl trinitrate, was higher for the PA-treated than for the control aortic rings and this effect was abolished by l-NA. The mesenteric rings of the PA treated group showed a lower sensitivity on the contractile response to Phe than that of the control group, and this effect was abolished by l-NA. Vasodilatation to acetylcholine, but not to glyceryl trinitrate, of the PA treated-mesenteric ring was more sensitive than that of the control group and this effect was abolished by l-NA. The expression of eNOS by the PA treated thoracic aorta and the mesenteric arteries was higher than the control group. These results demonstrated that chronic treatment with a PA water extract to middle-aged rats affected their vascular functions by increasing the nitric oxide production from the endothelial cells and also modulated the responsiveness of the thoracic aortic- and mesenteric rings to phenylephrine and acetylcholine.
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Affiliation(s)
- Watchara Chongsa
- Department of Physiology, Faculty of Science, Prince of Songkla University, Hat-Yai, Thailand
| | - Kanyanatt Kanokwiroon
- Department of Biomedical Sciences, Faculty of medicine, Prince of Songkla University, Hat-Yai, Thailand; The Excellent Research Laboratory of Cancer Molecular Biology, Prince of Songkla University, Hat-Yai, Thailand
| | - Chaweewan Jansakul
- Faculty of Traditional Thai Medicine, Prince of Songkla University, Hat-Yai 90112, Thailand; Natural Research Center of Excellence, Prince of Songkla University, Hat-Yai, Thailand.
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Abstract
PURPOSE OF REVIEW For the past 40 years, apheresis, in particular, lipoprotein apheresis, has been the therapy of choice to lower LDL-C for familial hypercholesterolemia patients with uncontrolled dyslipidemia and cardiovascular disease. With the advent of recent and future lipid-modifying agents and their ability to lower LDL-C, the question arises on what will be the future of lipoprotein apheresis. RECENT FINDINGS Lipoprotein apheresis lowers not only plasma levels of apolipoprotein B lipoproteins but also markers of vascular inflammation and blood rheology. Other vascular diseases, not necessarily associated with familial hypercholesterolemia, such as nephrotic syndrome and peripheral arterial disease have profited from lipoprotein apheresis therapy. In 2013, the Food and Drug Administration approved lipoprotein apheresis therapy for patients with focal segmental glomerulosclerosis. Since 2010, the German healthcare ministry has approved lipoprotein apheresis therapy for patients with an elevated lipoprotein(a) and ongoing cardiovascular disease irrespective of LDL-C levels. SUMMARY Recent and future lipid-modifying therapies will most likely reduce the practice of lipoprotein apheresis therapy for familial hypercholesterolemia patients. Future implications for lipoprotein apheresis will involve vascular diseases that are at present lacking clinically effective therapy, whereas acute and chronic reductions of lipids, vascular inflammation, and/or rheology may improve the clinical outcome.
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Affiliation(s)
- Patrick M Moriarty
- Atherosclerosis and Lipoprotein Apheresis Center, University of Kansas Medical Center, Kansas City, Kansas
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354
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Guo T, Yin RX, Bin Y, Nie RJ, Chen X, Pan SL. Association of the SPT2 chromatin protein domain containing 1 gene rs17579600 polymorphism and serum lipid traits. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:12995-13010. [PMID: 26722495 PMCID: PMC4680440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 09/22/2015] [Indexed: 06/05/2023]
Abstract
SPT2 chromatin protein domain containing 1 gene (SPTY2D1) is a candidate gene for dyslipidemia. The single nucleotide polymorphism (SNP) of rs7934205 near SPTY2D1 locus was ethnic- and sex-specific associated with serum lipid levels in our previous study. Whether SPTY2D1 rs17579600 SNP and several environmental factors are associated with serum lipid profiles is unknown. A total of 712 participants of Han and 689 unrelated individuals of Mulao were included. The genotype and allele frequencies of SPTY2D1 rs17579600 SNP were different between the Han and Mulao populations (TT, 74.3% vs. 55.7%; TC, 17.6% vs. 31.2%, CC, 8.1% vs. 13.1%, P = 0.028; T, 83.1% vs. 71.3%; C, 16.9% vs. 28.7%, P = 0.044), and between males and females in the both ethnic groups. The levels of serum apolipoprotein (Apo) A1 in Han, triglyceride (TG) in Mulao, and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), ApoA1 and ApoB in Mulao males were difference among the genotypes. The C allele carriers had higher ApoA1 in Han, lower TG in Mulao, and lower TC, LDL-C and ApoB and higher ApoA1 in Mulao males than the C allele non-carriers. Serum lipid parameters were also associated with several environmental factors in both ethnic groups. The differences suggesting there may be a racial/ethnic- and/or sex-specific association between the SPTY2D1 rs17579600 SNP and serum lipid parameters in some ethnic groups.
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Affiliation(s)
- Tao Guo
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Rui-Xing Yin
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Yuan Bin
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Rong-Jun Nie
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Xia Chen
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical UniversityNanning 530021, Guangxi, China
| | - Shang-Ling Pan
- Department of Pathophysiology, School of Premedical Sciences, Guangxi Medical UniversityNanning 530021, Guangxi, People’s Republic of China
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355
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Beauchamp MR, Harden SM, Wolf SA, Rhodes RE, Liu Y, Dunlop WL, Schmader T, Sheel AW, Zumbo BD, Estabrooks PA. GrOup based physical Activity for oLder adults (GOAL) randomized controlled trial: study protocol. BMC Public Health 2015; 15:592. [PMID: 26116237 PMCID: PMC4483226 DOI: 10.1186/s12889-015-1909-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 06/04/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Physical activity has health benefits across the lifespan, yet only 13 % of Canadian older adults are sufficiently active. Results from a number of observational studies indicate that adults display positive preferences for exercising with others of a similar age and same gender, and that intra-group age- and gender-similarity are associated with elevated exercise adherence. However, research has yet to experimentally examine the extent to which intra-group age- and gender-related similarity affect exercise adherence behaviors. METHODS/DESIGN The GrOup-based physical Activity for oLder adults (GOAL) trial is a three-arm randomized control trial that will examine the efficacy of two different group-based exercise programs for older adults (informed by the tenets of self-categorization theory) in relation to a standard group-based exercise program. Within this manuscript we outline the design and proposed evaluation of the GOAL trial. The first arm is comprised of exercise groups made up of participants of a similar-age and of the same gender; the second arm consists of groups with similar-aged mixed gender participants; the control arm is comprised of mixed-aged mixed gender participants. We aim to compare the adherence rates of participants across conditions, as well as potential moderation effects and mediating mechanisms. DISCUSSION Results from this trial will inform intervention designs to improve the exercise adherence behaviors of older adult. At a systems-level, should support be derived for the efficacy of the interventions tested in this trial, changing group composition (i.e., age, gender) represents a feasible program adaptation for physical activity centers. TRIAL REGISTRATION ClinicalTrials.gov # NCT02023632 . Registered December 13, 2013.
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Affiliation(s)
- Mark R Beauchamp
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.
| | - Samantha M Harden
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, USA.
- Fralin Translational Obesity Research Center, Blacksburg, VA, USA.
| | - Svenja A Wolf
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.
| | - Ryan E Rhodes
- Behavioural Medicine Laboratory, School of Exercise Science, Health and Physical Education, University of Victoria, Victoria, BC, Canada.
| | - Yan Liu
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.
- Department of Cell Biology, Harvard Medical School, Harvard University, Boston, MA, USA.
| | - William L Dunlop
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.
- Department of Psychology, University of California-Riverside, Riverside, CA, USA.
| | - Toni Schmader
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada.
| | - Andrew W Sheel
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.
| | - Bruno D Zumbo
- Faculty of Education, University of British Columbia, Vancouver, BC, Canada.
| | - Paul A Estabrooks
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, USA.
- Fralin Translational Obesity Research Center, Blacksburg, VA, USA.
- Department of Family Medicine, Carilion Clinic, Roanoke, VA, USA.
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356
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Buford TW, Anton SD, Bavry AA, Carter CS, Daniels MJ, Pahor M. Multi-modal intervention to reduce cardiovascular risk among hypertensive older adults: Design of a randomized clinical trial. Contemp Clin Trials 2015; 43:237-42. [PMID: 26115878 DOI: 10.1016/j.cct.2015.06.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/16/2015] [Accepted: 06/20/2015] [Indexed: 01/13/2023]
Abstract
Persons aged over 65 years account for over 75% of healthcare expenditures and deaths attributable to cardiovascular disease (CVD). Accordingly, reducing CVD risk among older adults is an important public health priority. Functional status, determined by measures of physical performance, is an important predictor of cardiovascular outcomes in older adults and declines more rapidly in seniors with hypertension. To date, physical exercise is the primary strategy for attenuating declines in functional status. Yet despite the general benefits of training, exercise alone appears to be insufficient for preventing this decline. Thus, alternative or adjuvant strategies are needed to preserve functional status among seniors with hypertension. Prior data suggest that angiotensin converting enzyme inhibitors (ACEi) may be efficacious in enhancing exercise-derived improvements in functional status yet this hypothesis has not been tested in a randomized controlled trial. The objective of this randomized, double-masked pilot trial is to gather preliminary efficacy and safety data necessary for conducting a full-scale trial to test this hypothesis. Sedentary men and women ≥ 65 years of age with functional limitations and hypertension are being recruited into this 24 week intervention study. Participants are randomly assigned to one of three conditions: (1) ACEi plus exercise training, (2) thiazide diuretic plus exercise training, or (3) AT1 receptor antagonist plus exercise training. The primary outcome is change in walking speed and secondary outcomes consist of other indices of CV risk including exercise capacity, body composition, as well as circulating indices of metabolism, inflammation and oxidative stress.
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Affiliation(s)
- Thomas W Buford
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL, United States; Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, United States.
| | - Stephen D Anton
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL, United States; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Anthony A Bavry
- Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, United States; North Florida/South Georgia Veterans Health System, Gainesville, FL, United States
| | - Christy S Carter
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Michael J Daniels
- Department of Statistics & Data Sciences and Department of Integrative Biology, College of Natural Sciences, University of Texas, Austin, TX, United States
| | - Marco Pahor
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL, United States
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357
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Eichinger M, Titze S, Haditsch B, Dorner TE, Stronegger WJ. How are physical activity behaviors and cardiovascular risk factors associated with characteristics of the built and social residential environment? PLoS One 2015; 10:e0126010. [PMID: 26035294 PMCID: PMC4452766 DOI: 10.1371/journal.pone.0126010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 03/27/2015] [Indexed: 12/02/2022] Open
Abstract
Background The aim of our study was to identify perceptions of built and social residential characteristics and their association with behaviors such as physical activity (PA), nutrition and smoking and with cardiovascular risk factors (elevated BMI and fasting blood glucose). Methods Among participants of a preventive medical checkup at an Austrian District Health Insurance Fund (n=904, response rate = 82.2%, 42% women, 18-91 years) self-reported and measured data were collected. Results Total PA was positively associated with the presence of trees along the streets and high levels of pro-physical activity social modeling (SM) and it was negatively related to perceived safety from crime. More leisure-time PA was associated with higher levels of cycling/walking infrastructure and high levels of SM. PA for transportation was positively related to high levels of connectivity and high levels of SM. Better behavioral cardiovascular risk factor profiles (smoking and nutrition) were associated with high levels of SM and high levels of total PA. Lower BMI values were associated with high levels of infrastructure and high levels of SM. Conclusions Both built and social residential characteristics are important correlates of PA as well as of major cardiovascular risk factors besides PA.
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Affiliation(s)
- Michael Eichinger
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstrasse 6, 8010, Graz, Austria
- * E-mail:
| | - Sylvia Titze
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Bernd Haditsch
- Styrian District Health Insurance Fund, Friedrichgasse 18, 8010, Graz, Austria
| | - Thomas E. Dorner
- Institute of Social Medicine, Medical University of Vienna, Rooseveltplatz 3, 1090, Vienna, Austria
| | - Willibald J. Stronegger
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstrasse 6, 8010, Graz, Austria
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358
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Golpanian S, El-Khorazaty J, Mendizabal A, DiFede DL, Suncion VY, Karantalis V, Fishman JE, Ghersin E, Balkan W, Hare JM. Effect of aging on human mesenchymal stem cell therapy in ischemic cardiomyopathy patients. J Am Coll Cardiol 2015; 65:125-32. [PMID: 25593053 DOI: 10.1016/j.jacc.2014.10.040] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 09/21/2014] [Accepted: 10/14/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND The role of patient age in the efficacy of mesenchymal stem cell (MSC) therapy in ischemic cardiomyopathy (ICM) is controversial. OBJECTIVES This study sought to determine whether the therapeutic effect of culture-expanded MSCs persists, even in older subjects. METHODS Patients with ICM who received MSCs via transendocardial stem cell injection (TESI) as part of the TAC-HFT (Transendocardial Autologous Cells in Ischemic Heart Failure) (n = 19) and POSEIDON (Percutaneous Stem Cell Injection Delivery Effects on Neomyogenesis) (n = 30) clinical trials were divided into 2 age groups: younger than 60 and 60 years of age and older. Functional capacity was measured by 6-min walk distance (6MWD) and quality of life using the Minnesota Living With Heart Failure Questionnaire (MLHFQ) score, measured at baseline, 6 months, and 1 year post-TESI. Various cardiac imaging parameters, including absolute scar size, were compared at baseline and 1 year post-TESI. RESULTS The mean 6MWD was similar at baseline and increased at 1 year post-TESI in both groups: 48.5 ± 14.6 m (p = 0.001) for the younger and 35.9 ± 18.3 m (p = 0.038) for the older participants (p = NS between groups). The older group exhibited a significant reduction in MLHFQ score (-7.04 ± 3.54; p = 0.022), whereas the younger than 60 age group had a borderline significant reduction (-11.22 ± 5.24; p = 0.058) from baseline (p = NS between groups). Although there were significant reductions in absolute scar size from baseline to 1 year post-TESI, the effect did not differ by age. CONCLUSIONS MSC therapy with TESI in ICM patients improves 6MWD and MLHFQ score and reduces myocardial infarction size. Importantly, older individuals did not have an impaired response to MSC therapy.
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Affiliation(s)
- Samuel Golpanian
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida
| | | | | | - Darcy L DiFede
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Viky Y Suncion
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Vasileios Karantalis
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Joel E Fishman
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Eduard Ghersin
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Wayne Balkan
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Joshua M Hare
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida.
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359
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The global impact of non-communicable diseases on healthcare spending and national income: a systematic review. Eur J Epidemiol 2015; 30:251-77. [DOI: 10.1007/s10654-014-9984-2] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 12/23/2014] [Indexed: 12/11/2022]
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360
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Sicras Mainar A, Navarro Artieda R, Ibáñez Nolla J. Impacto económico de la insuficiencia cardiaca según la influencia de la insuficiencia renal. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.02.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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361
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Efficacy of female rat models in translational cardiovascular aging research. J Aging Res 2014; 2014:153127. [PMID: 25610649 PMCID: PMC4294461 DOI: 10.1155/2014/153127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 12/05/2014] [Accepted: 12/05/2014] [Indexed: 01/11/2023] Open
Abstract
Cardiovascular disease is the leading cause of death in women in the United States. Aging is a primary risk factor for the development of cardiovascular disease as well as cardiovascular-related morbidity and mortality. Aging is a universal process that all humans undergo; however, research in aging is limited by cost and time constraints. Therefore, most research in aging has been done in primates and rodents; however it is unknown how well the effects of aging in rat models translate into humans. To compound the complication of aging gender has also been indicated as a risk factor for various cardiovascular diseases. This review addresses the systemic pathophysiology of the cardiovascular system associated with aging and gender for aging research with regard to the applicability of rat derived data for translational application to human aging.
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362
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The ROVIGO study (risk of vascular complications: impact of genetics in old people): protocol, study design, and preliminary results of the initial survey : cardiovascular epidemiology in the elderly. High Blood Press Cardiovasc Prev 2014; 22:73-8. [PMID: 25339227 DOI: 10.1007/s40292-014-0072-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The epidemiology of cardiovascular risk (CV) in the elderly is far from being defined, and the reasons why some subjects retain a healthy body while growing old while others are affected by different diseases or die prematurely are still unknown. AIMS To compare the CV risk pattern in two elderly cohorts living in North-East Italy. MATERIALS AND METHODS The Risk Of Vascular complications: Impact of Genetics in Old people (ROVIGO) study is a population-based study including 580 unrelated elderly subjects representative of general population living in Rovigo in the Veneto region. They were compared to a cohort of 580 age-gender-matched unrelated subjects from the CArdiovascular STudy in the Elderly (CASTEL) living in the same region in Castelfranco Veneto and Chioggia. RESULTS Blood pressure (BP), heart rate (HR), low-density-lipoprotein cholesterol, and prevalence of coronary heart disease, heart failure and chronic pulmonary disease were lower in the ROVIGO than in the CASTEL cohort, while high-density-lipoprotein cholesterol and the prevalence of diabetes were higher in the former than in the latter. In the ROVIGO cohort, diabetes, left ventricular hypertrophy, coronary and cerebrovascular diseases were more represented in men. In the CASTEL cohort, systolic BP was higher in women. In both cohorts, the lipid pattern was less favourable and HR higher in women, chronic pulmonary disease more represented in men. CONCLUSIONS People living in Rovigo were at lower CV risk than those in Castelfranco Veneto and Chioggia, mainly due to lower BP values, better lipid pattern and lower prevalence of CV and pulmonary disease.
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363
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Sicras Mainar A, Navarro Artieda R, Ibáñez Nolla J. Economic impact of heart failure according to the effects of kidney failure. ACTA ACUST UNITED AC 2014; 68:39-46. [PMID: 25553938 DOI: 10.1016/j.rec.2014.02.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 02/07/2014] [Indexed: 01/10/2023]
Abstract
INTRODUCTION AND OBJECTIVES To evaluate the use of health care resources and their cost according to the effects of kidney failure in heart failure patients during 2-year follow-up in a population setting. METHODS Observational retrospective study based on a review of medical records. The study included patients ≥ 45 years treated for heart failure from 2008 to 2010. The patients were divided into 2 groups according to the presence/absence of KF. Main outcome variables were comorbidity, clinical status (functional class, etiology), metabolic syndrome, costs, and new cases of cardiovascular events and kidney failure. The cost model included direct and indirect health care costs. Statistical analysis included multiple regression models. RESULTS The study recruited 1600 patients (prevalence, 4.0%; mean age 72.4 years; women, 59.7%). Of these patients, 70.1% had hypertension, 47.1% had dyslipidemia, and 36.2% had diabetes mellitus. We analyzed 433 patients (27.1%) with kidney failure and 1167 (72.9%) without kidney failure. Patients with kidney failure were associated with functional class III-IV (54.1% vs 40.8%) and metabolic syndrome (65.3% vs 51.9%, P<.01). The average unit cost was €10,711.40. The corrected cost in the presence of kidney failure was €14,868.20 vs €9,364.50 (P=.001). During follow-up, 11.7% patients developed ischemic heart disease, 18.8% developed kidney failure, and 36.1% developed heart failure exacerbation. CONCLUSIONS Comorbidity associated with heart failure is high. The presence of kidney failure increases the use of health resources and leads to higher costs within the National Health System.
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Affiliation(s)
- Antoni Sicras Mainar
- Departamento de Planificación, Badalona Serveis Assistencials S.A., Badalona, Barcelona, Spain.
| | - Ruth Navarro Artieda
- Departamento de Documentación Médica, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Jordi Ibáñez Nolla
- Departamento Médico, Badalona Serveis Assistencials S.A., Badalona, Barcelona, Spain
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364
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Wu CY, Chou YC, Huang N, Chou YJ, Hu HY, Li CP. Association of body mass index with all-cause and cardiovascular disease mortality in the elderly. PLoS One 2014; 9:e102589. [PMID: 25014070 PMCID: PMC4094563 DOI: 10.1371/journal.pone.0102589] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 06/20/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the associations of body mass index (BMI) with all-cause, cardiovascular disease (CVD), and expanded CVD mortality in the elderly. DESIGN Observational cohort study. SETTING Annual physical examination program for the elderly from 2006 to 2010. PARTICIPANTS We included 77,541 Taipei residents aged ≥ 65 years (39,365 men and 38,176 women). MEASUREMENTS BMI was categorized as underweight (BMI<18.5), normal weight (18.5 ≤ BMI<25), overweight (25 ≤ BMI<30), grade 1 obesity (30 ≤ BMI<35), or grade 2-3 obesity (BMI ≥ 35). Mortality was ascertained by national death files. RESULTS Underweight (hazard ratios [HRs] of all-cause, CVD, and expanded CVD mortality: 1.92, 1.74, and 1.77, respectively), grade 2-3 obesity (HRs: 1.59, 2.36, and 2.22, respectively), older age, male sex, smoking, and high fasting blood sugar were significant predictors of mortality. Meanwhile, being married/cohabitating, higher education, alcohol consumption, more regular exercise, and high total cholesterol were inversely associated with mortality. Multivariate stratified subgroup analyses verified smokers (HRs of all-cause, CVD, and expanded CVD mortality: 3.25, 10.71, and 7.86, respectively, for grade 2-3 obesity), the high triglyceride group (HRs: 5.82, 10.99, and 14.22, respectively for underweight), and patients with 3-4 factors related to metabolic syndrome (HRs: 4.86, 12.72, and 11.42, respectively, for underweight) were associated with mortality. CONCLUSION The associations of BMI with all-cause, CVD, expanded CVD mortality in the elderly are represented by U-shaped curves, suggesting unilateral promotions or interventions in weight reduction in the elderly may be inappropriate. Heterogeneous effects of grades 1 and 2-3 obesity on mortality were observed and should be treated as different levels of obesity.
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Affiliation(s)
- Chen-Yi Wu
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan
- Department of Dermatology, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan
| | - Yi-Chang Chou
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Nicole Huang
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Yiing-Jenq Chou
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan
| | - Hsiao-Yun Hu
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- * E-mail: (HYH); (CPL)
| | - Chung-Pin Li
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University School of Medicine, Taipei, Taiwan
- * E-mail: (HYH); (CPL)
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365
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Changes in Functional Outcomes in Elderly Patients as a Result of Poststroke Rehabilitation Using the NDT-Bobath Method. TOPICS IN GERIATRIC REHABILITATION 2014. [DOI: 10.1097/tgr.0000000000000029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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366
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Abstract
Nuts are rich in many nutrients that can benefit multiple cardiometabolic functions, including arterial compliance, blood pressure, inflammation, glucoregulation and endothelial vasodilatation. Impaired vasodilatation may contribute to impaired cognitive performance due to poor cerebral perfusion. The present narrative review examines associations between nut consumption, vascular health and cognitive function. It includes a systematic search which identified seventy-one epidemiological or intervention studies in which effects of chronic nut consumption on blood pressure, glucoregulation, endothelial vasodilator function, arterial compliance, inflammatory biomarkers and cognitive performance were evaluated. Weighted mean changes were estimated where data were available; they indicate that nut consumption reduces blood pressure and improves glucoregulation, endothelial vasodilator function and inflammation, whilst a limited number of studies suggest that nut consumption may also improve cognitive performance. Further clinical trials are warranted to explore relationships between nut consumption, endothelial function and cognitive function.
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367
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Sicras-Mainar A, Navarro-Artieda R, Ibáñez-Nolla J. Clinical and economic characteristics associated with type 2 diabetes. Rev Clin Esp 2014. [DOI: 10.1016/j.rceng.2014.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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368
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Moura FA, Freitas WM, Sposito AC. Emergent cardiovascular risk factors in the very elderly. Expert Rev Cardiovasc Ther 2014. [DOI: 10.1586/erc.12.98] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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369
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Sicras-Mainar A, Rejas-Gutiérrez J, Navarro-Artieda R, Ibánez-Nolla J. Effect of smoking status on healthcare costs and resource utilization in patients with type 2 diabetes in routine clinical practice: a retrospective nested case-control economic study. Eur Addict Res 2014; 20:94-104. [PMID: 24192535 DOI: 10.1159/000355171] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 08/13/2013] [Indexed: 11/19/2022]
Abstract
AIM To compare healthcare resource utilization and costs according to smoking status in patients with type 2 diabetes in clinical practice. METHODS A retrospective cohort nested case-control study was designed. Cases were current smokers, while 2 types of controls (former smokers and never smokers) were matched (2 controls per case) for age, sex, duration of diabetes and burden of comorbidity using data from medical records. Noninstitutionalized diabetics of both genders, aged>18 years and seen consecutively over a 5-year period before the index date, were enrolled. Analysis compared healthcare resource utilization, loss of productivity due to sick leave and corresponding costs. RESULTS In total, 2,490 medical records were analyzed, i.e. 498 cases, 996 former smokers and 996 never smokers. Mean age was 63.4 years (64.9% male). Smokers had higher glycosylated hemoglobin levels (7.4 vs. 7.2 and 7.2%, respectively; p=0.013) and a lower degree of metabolic control (49.2 vs. 54.7 and 55.8%; p=0.036). Smokers had higher average annual costs (EUR 3,583) than former smokers (EUR 2,885; p<0.001) and never smokers (EUR 2,183; p<0.001). CONCLUSIONS Diabetic smoker patients had lower metabolic control, higher health resource utilization and more sick leave, resulting in higher healthcare costs and lost productivity compared with both former and never smoker diabetics.
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370
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Clinical and economic characteristics associated with type 2 diabetes. Rev Clin Esp 2013; 214:121-30. [PMID: 24359793 DOI: 10.1016/j.rce.2013.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 10/30/2013] [Accepted: 11/03/2013] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Type 2 diabetes mellitus (DM2) is usually accompanied by various comorbidities that can increase the cost of treatment. We are not aware of studies that have determined the costs associated with treating DM2 patients with co-morbidities such as overweight (OW), obesity (OBE) or arterial hypertension (AHT). The aim of the study was to examine the health-related costs and the incidence of cardiovascular disease (CVD) in these patients. PATIENTS AND METHODS Multicenter, observational retrospective design. We included patients 40-99 years of age who requested medical attention in 2010 in Badalona (Barcelona, Spain). There were two study groups: those with DM2 and without DM2 (reference group/control), and six subgroups: DM2-only, DM2-AHT, DM2-OW, DM2-OBE; DM2-AHT-OW and DM2-AHT-OBE. The main outcome measures were: co-morbidity, metabolic syndrome (MS), complications (hypoglycemia, CVD) and costs (health and non-health). Follow-up was carried out for two years. RESULTS A total of 26,845 patients were recruited. The prevalence of DM2 was 14.0%. Subjects with DM2 were older (67.8 vs. 59.7 years) and more were men (51.3 vs. 43.0%), P<.001. DM2 status was associated primarily with OBE (OR=2.8, CI=2.4-3.1), AHT (OR=2.4, CI=2.2-2.6) and OW (OR=1.9, CI=1.7-2.2). The distribution by subgroups was: 6.7% of patients had only DM2, 26.1% had DM2, AHT and OW, and 34.1% had DM2, AHT, and OBE. Some 75.4% had MS and 37.5% reported an episode of hypoglycemia. The total cost/patient with DM2 was €4,458. By subgroups the costs were as follows: DM2: €3,431; DM2-AHT: €4,075; DM2-OW: €4,057; DM2-OBE: €4,915; DM2-AHT-OW: €4,203 and DM2-AHT-OBE: €5,021, P<.001. The CVD rate among patients with DM2 was 4.7 vs. 1.7% in those without DM2 P<.001. CONCLUSIONS Obesity is a comorbidity associated with DM2 that leads to greater healthcare costs than AHT. The presence of these comorbidities causes increased rates of CVD.
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371
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Szabo AJ, Alosco ML, Miller LA, McGeary JE, Poppas A, Cohen RA, Gunstad J. Brain-derived neurotrophic factor Val66Met polymorphism and cognitive function in persons with cardiovascular disease. Psychogeriatrics 2013; 13:206-12. [PMID: 24289461 PMCID: PMC3847660 DOI: 10.1111/psyg.12013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 10/08/2012] [Accepted: 03/14/2013] [Indexed: 12/01/2022]
Abstract
AIM Cognitive impairment is common among persons with cardiovascular disease (CVD), and several potential aetiological mechanisms have been described, including contributions of genetic markers such as variations in the brain-derived neurotrophic (BDNF) gene. This current study examined the associations of BDNF genotype with cognitive function among individuals with CVD. METHODS This study included 110 participants with CVD who completed a comprehensive neuropsychological battery that assessed global cognitive function, attention/executive function, memory, language, and visuospatial abilities. All participants also underwent blood draw to provide a DNA sample that was used to determine BDNF genotype. Carriers of either one or two copies of the methionine allele of BDNF were categorized into one group (n = 33); non-carriers were categorized into a second group (n = 77). RESULTS After adjustment for demographic and medical characteristics, hierarchical regression analyses revealed persons with one or more methionine alleles displayed better performance than valine/valine individuals for attention/executive function (β = 0.22, P = 0.047) and memory (β = 0.25, P = 0.03), as well as a trend for language (β = 0.19, P = 0.08) and visuospatial abilities (β = 0.21, P = 0.06). CONCLUSIONS BDNF Val66Met had little impact on cognitive functioning in a sample of older adults with CVD, and significant findings contradicted that predicted by past work. Future work is much needed to clarify the mechanisms of these findings, particularly studies examining both circulating BDNF levels and genetic variation in the BDNF gene and cognitive function over time.
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Affiliation(s)
- Ashley J Szabo
- Department of Psychology, Kent State University, Kent, Ohio, USA
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372
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Diniz MA, Tavares DMDS. Fatores de risco para doenças cardiovasculares em idosos de um município do interior de Minas Gerais. TEXTO & CONTEXTO ENFERMAGEM 2013. [DOI: 10.1590/s0104-07072013000400003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Esta pesquisa objetivou descrever as características sociodemográficas dos idosos de um município de pequeno porte, identificar a prevalência dos fatores de risco cardiovascular e compará-los entre os sexos e as faixas etárias. Tratou-se de um estudo de prevalência, constituído por 134 idosos. A coleta de dados foi realizada de abril a junho/2009 por meio de entrevista e aferição de dados antropométricos. Para análise utilizou-se frequência simples e teste de qui-quadrado (p<0,05). Entre os idosos, 50% tinham de 60├70 anos, 57,5% sexo feminino e 58,2% casados. Os fatores de risco cardiovascular mais prevalentes foram: circunferência abdominal aumentada (77,6%), hipertensão arterial (67,2%) e sedentarismo (59,7%). O sedentarismo (p=0,012) e a circunferência abdominal aumentada (p<0,001) apresentaram maior proporção entre as mulheres idosas.
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373
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Liu R, Qin Y, Wang H, Zhao Y, Hu Z, Wang S. The in vivo blood compatibility of bio-inspired small diameter vascular graft: effect of submicron longitudinally aligned topography. BMC Cardiovasc Disord 2013; 13:79. [PMID: 24083888 PMCID: PMC3850682 DOI: 10.1186/1471-2261-13-79] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 09/23/2013] [Indexed: 11/28/2022] Open
Abstract
Background Cardiovascular disease is the leading cause of deaths worldwide and the arterial reconstructive surgery remains the treatment of choice. Although large diameter vascular grafts have been widely used in clinical practices, there is an urgent need to develop a small diameter vascular graft with enhanced blood compatibility. Herein, we fabricated a small diameter vascular graft with submicron longitudinally aligned topography, which mimicked the tunica intima of the native arterial vessels and were tested in Sprague–Dawley (SD) rats. Methods Vascular grafts with aligned and smooth topography were prepared by electrospinning and were connected to the abdominal aorta of the SD rats to evaluate their blood compatibility. Graft patency and platelet adhesion were evaluated by color Doppler ultrasound and immunofluorescence respectively. Results We observed a significant higher patency rate (p = 0.021) and less thrombus formation in vascular graft with aligned topography than vascular graft with smooth topography. However, no significant difference between the adhesion rates on both vascular grafts (smooth/aligned: 0.35‰/0.12‰, p > 0.05) was observed. Moreover, both vascular grafts had few adherent activated platelets on the luminal surface. Conclusion Bionic vascular graft showed enhanced blood compatibility due to the effect of surface topography. Therefore, it has considerable potential for using in clinical application.
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Affiliation(s)
- Ruiming Liu
- Department of Vascular Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, P, R, China.
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374
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Marques A, Martins A, Jácome C, Figueiredo D. Linking the EASY-care standard to the international classification of functioning, disability and health. Disabil Rehabil 2013; 36:593-9. [PMID: 23786348 DOI: 10.3109/09638288.2013.804598] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study aimed to document the content of the EASY-Care Standard questionnaire to the International Classification of Functioning, Disability and Health (ICF) and present its ICF Core Set. METHOD The EASY-Care was linked to the ICF by two trained health professionals according to the established linking rules. The agreement between the health professionals was determined using the Cohen's kappa. RESULTS The agreement between the two health professionals was almost perfect for each level of the ICF (Cohen's kappas between 0.91 and 0.97). The 65 items of the EASY-Care were linked to 61 different ICF categories, 16 (26%) from the Body functions component, 3 from the Body structures (5%), 30 from the Activities and participation (49%) and 12 from the Environmental factors (20%). Twelve concepts could not be linked to the ICF at all: 6 were classified as Personal factors, 1 as not defined-general health and 5 were not classified. CONCLUSIONS The integration of the universal language of the ICF in the EASY-Care illustrates the potential of use this instrument in primary care settings at community level. IMPLICATIONS FOR REHABILITATION The integration of the universal language of the ICF in the EASY-Care potentiates the use of this comprehensive instrument in assessing older people needs at primary care settings. The information obtained with the EASY-Care Standard can be worldwide understood and can be used to plan rehabilitation interventions at community settings for older adults.
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Affiliation(s)
- Alda Marques
- School of Health Sciences, University of Aveiro (ESSUA) , Aveiro , Portugal
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375
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Félix-Redondo FJ, Grau M, Fernández-Bergés D. Cholesterol and cardiovascular disease in the elderly. Facts and gaps. Aging Dis 2013; 4:154-69. [PMID: 23730531 PMCID: PMC3660125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 02/26/2013] [Accepted: 02/27/2013] [Indexed: 06/02/2023] Open
Abstract
Hypercholesterolemia is a major cardiovascular risk factor that increases the incidence of atherosclerotic diseases in adults, although the association is less well established in the elderly. The role of statins is well characterized for the reduction of myocardial infarction incidence or death in individuals with a history or high risk of cardiovascular diseases, regardless of age. Therapeutic measures recommended to prevent cardiovascular diseases and to reduce cholesterol levels in the elderly, such as lifestyle changes and lipid-lowering drugs, particularly statins, are based on studies conducted in younger adults. This narrative review aims to summarize the main observational studies and randomized clinical trials that have studied the relationship between cholesterol and cardiovascular diseases and the potential benefits and drawbacks of statins use in elderly patients.
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Affiliation(s)
| | - Maria Grau
- Cardiovascular Epidemiology and Genetics, Program of Research in Inflammatory and Cardiovascular Disorders, Institut de Recerca Hospital del Mar, Barcelona, Spain
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376
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Social cognitive changes following weight loss and physical activity interventions in obese, older adults in poor cardiovascular health. Ann Behav Med 2013; 44:353-64. [PMID: 22773225 DOI: 10.1007/s12160-012-9390-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND The study objectives were to determine (a) the effects of group-mediated cognitive-behavioral interventions on change in performance self-efficacy, satisfaction with function, and with appearance among older, overweight/obese adults in poor cardiovascular health and (b) whether self-efficacy mediated change in 400-m walk time. METHODS This translational, randomized controlled trial of physical activity and weight loss was conducted within community Cooperative Extension Centers. Participants were randomized to three intervention arms: Physical Activity, Weight Loss + Physical Activity, or a Successful Aging education control. RESULTS Across 18 months, the Weight Loss + Physical Activity intervention demonstrated greater improvements in self-efficacy, satisfaction with function, and appearance versus other trial arms. Physical Activity intervention participants also experienced significant improvements in self-efficacy and satisfaction with function versus those in Successful Aging. Self-efficacy mediated 400-m walk time at 18 months. CONCLUSIONS Both group-mediated cognitive-behavioral interventions yielded desirable improvements in social cognitions and preserved mobility improvements post-intervention.
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377
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Dutta A, Henley W, Pilling LC, Wallace RB, Melzer D. Uric Acid Measurement Improves Prediction of Cardiovascular Mortality in Later Life. J Am Geriatr Soc 2013; 61:319-26. [DOI: 10.1111/jgs.12149] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ambarish Dutta
- Epidemiology and Public Health Group; Peninsula Medical School; University of Exeter; Exeter UK
| | - William Henley
- Peninsula Collaboration for Leadership in Applied Health Research and Care; Peninsula College of Medicine and Dentistry; University of Exeter; Exeter UK
| | - Luke C. Pilling
- Epidemiology and Public Health Group; Peninsula Medical School; University of Exeter; Exeter UK
| | - Robert B. Wallace
- Department of Epidemiology; Centre on Aging; College of Public Health; University of Iowa; Iowa City Iowa
| | - David Melzer
- Epidemiology and Public Health Group; Peninsula Medical School; University of Exeter; Exeter UK
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McCleary NJ, Odejide O, Szymonifka J, Ryan D, Hezel A, Meyerhardt JA. Safety and effectiveness of oxaliplatin-based chemotherapy regimens in adults 75 years and older with colorectal cancer. Clin Colorectal Cancer 2013; 12:62-9. [PMID: 23102897 PMCID: PMC3802549 DOI: 10.1016/j.clcc.2012.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 09/10/2012] [Accepted: 09/13/2012] [Indexed: 12/27/2022]
Abstract
UNLABELLED Although the safety and efficacy of oxaliplatin-based chemotherapy regimens for colorectal cancer (CRC) have been demonstrated in adults > 75 years of age enrolled in clinical trials, safety and effectiveness outside the trial setting are less established. In this comparative effectiveness study, we note that older adults with stage III and metastatic CRC treated outside of a clinical trial experienced safety and effectiveness of oxaliplatin-based chemotherapy regimens comparable to that of younger adults. BACKGROUND Although the safety and efficacy of oxaliplatin-based chemotherapy regimens for colorectal cancer (CRC) have been demonstrated in adults ≥ 75 years of age who are enrolled in clinical trials, safety and effectiveness outside the trial setting are less established. METHODS We retrospectively collected cases of patients ≥ 75 years of age who were diagnosed with stage III and metastatic CRC and initiated treatment between January 2000 and January 2007 at 2 academic hospitals in Boston, MA. Cases were matched in a 1:2 ratio to controls who were < 75 years of age by hospital site, stage of disease (stage III vs. metastatic) and line of therapy (first- or second-line or beyond). The primary study endpoints were grade ≥ 3 treatment-associated toxicities and intolerance (number of dose delays/reductions and hospital/facility admissions during treatment). The secondary endpoint was overall survival. RESULTS We identified 84 patients ≥ 75 years of age (25% ≥ 80 years) and 168 controls. In the cohort, 77% had colon cancer, 75% had metastatic disease, and 60% were receiving oxaliplatin as first-line therapy. There was no significant difference in grade ≥ 3 treatment-associated toxicities between the patients and the controls (71.4% vs. 68.5%, respectively; P = .63). Further there was no statistically significant difference between patients and controls for combined endpoints of any grade ≥ 3 toxicity or hospital/facility admission (P = .92). With a median follow-up of 52 months, 2-year overall survival was similar between patients and controls (43% vs. 52%, respectively; P = .87). CONCLUSION Older adults with stage III and metastatic CRC treated outside of a clinical trial experienced safety and effectiveness of oxaliplatin-based chemotherapy regimens that was comparable to that of younger adults.
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Recommendations for Aerobic Endurance Training Based on Subjective Ratings of Perceived Exertion in Healthy Seniors. J Aging Phys Act 2013; 21:100-11. [DOI: 10.1123/japa.21.1.100] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The study investigated physiological responses during 2-km walking at a certain intensity of a previously performed maximal exercise test where moderate perceived exertion was reported. Twenty seniors were examined by an incremental walking treadmill test to obtain maximal oxygen uptake (VO2max). A submaximal 2-km walking test was applied 1 wk later. The corresponding moderate perceived exertion (4 on the CR-10 scale) during the VO2maxtest was applied to the 2-km treadmill test. Moderate exertion (mean rating of perceived exertion [RPE]: 4 ± 1) led to 76% ± 8% of VO2maxand 79% ± 6% of maximal heart rate. RPE values drifted with a significant time effect (p= .001, ηp= .58) during the 2-km test from 3 ± 0.7 to 4.6 ± 0.8. Total energy expenditure (EE) was 3.3 ± 0.5 kcal/kg. No gender differences in ventilatory, heart-rate, or EE data occurred. Brisk walking at moderate RPE of 3–5 would lead to a beneficial physiological response during endurance training and a weekly EE of nearly 1,200 kcal when exercising 5 times/wk for 30 min.
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380
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Freitas WM, Carvalho LSF, Moura FA, Sposito AC. Atherosclerotic disease in octogenarians: A challenge for science and clinical practice. Atherosclerosis 2012; 225:281-9. [DOI: 10.1016/j.atherosclerosis.2012.06.070] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 06/13/2012] [Accepted: 06/29/2012] [Indexed: 10/28/2022]
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381
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Cabrera MAS, de Andrade SM, Mesas AE. A prospective study of risk factors for cardiovascular events among the elderly. Clin Interv Aging 2012; 7:463-8. [PMID: 23152676 PMCID: PMC3496195 DOI: 10.2147/cia.s37211] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To analyze the impact of cardiovascular (CV) risk factors on the occurrence of fatal and non-fatal CV events in elderly individuals. Methods The present research was a prospective cohort study of 800 elderly Brazilian outpatients (60 to 85 years old) with a 12-year follow-up period (baseline: 1997–1998). The outcome variable was CV mortality or non-fatal CV events (stroke, infarction, angina, heart failure). Hypertension, diabetes, global and abdominal obesity, dyslipidemias, and metabolic syndrome were analyzed as independent variables. The analyses were based on Cox proportional hazard models and adjusted for gender, age range, smoking, regular physical activity, and previous cardiovascular disease. Results A total of 233 fatal and non-fatal CV events were observed (29.1%). In the adjusted analysis, the following variables were associated with CV risk: hypertension hazard ratio (HR): 1.69; confidence interval (CI) 95%: 1.28–2.24, diabetes (HR: 2.67; CI 95%: 1.98–3.61), metabolic syndrome (HR: 1.61; CI 95%: 1.24–2.09), abdominal obesity (HR: 1.36; CI 95%: 1.03–1.79), hypertriglyceridemia (HR: 1.67; CI 95%: 1.22–2.30) and high triglyceride/HDL-c ratio (HR: 1.73; CI 95%: 1.31–2.84). Hypertension, diabetes, and dyslipidemia remained associated with CV risk regardless of abdominal obesity. Conclusion In this prospective study, hypertension, diabetes, metabolic syndrome, abdominal obesity, and hypertriglyceridemia were predictors of CV risk in elderly individuals. These results confirm the relevance of controlling these CV risk factors in this age group.
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382
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Sirois C, Couture J, Grégoire JP. Acetylsalicylic acid for primary prevention of cardiovascular diseases in older patients with diabetes: do the benefits overcome the risks? Ther Adv Drug Saf 2012; 3:213-26. [PMID: 25083237 PMCID: PMC4110868 DOI: 10.1177/2042098612451267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular diseases (CVDs) represent a huge health burden for older patients with diabetes. Acetylsalicylic acid (ASA) has long been used as a cardioprotective agent in primary and secondary prevention of CVD. However, there are important issues regarding the benefits and risks of ASA therapy in primary prevention of CVDs, for the older group in general and for individuals of all ages with diabetes. In this review, we summarize the benefits and risks related to ASA therapy by outlining the evidence for older patients and for patients with diabetes. There appear to be significant gaps in knowledge. The balance of benefits and risks is not well defined but ASA treatment seems to be unfavorable in many older patients.
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Affiliation(s)
- Caroline Sirois
- UQAR, Campus de Lévis 1595, boulevard Alphonse-Desjardins Lévis (Québec) Canada G6V 0A6
| | - Julie Couture
- Centre Hospitalier Universitaire de Québec - CHUL, Québec, Canada
| | - Jean-Pierre Grégoire
- Faculty of Pharmacy, Laval University, Quebec; and Centre de Recherche FRSQ du CHA, Universitaire de Québec - URESP, Québec, Canada
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383
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Fan L, Cao J, Liu L, Li X, Hu G, Hu Y, Zhu B. Frequency, risk factors, prognosis, and genetic polymorphism of the cyclooxygenase-1 gene for aspirin resistance in elderly Chinese patients with cardiovascular disease. Gerontology 2012; 59:122-31. [PMID: 23038044 DOI: 10.1159/000342489] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 08/10/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is an important cause of mortality in elderly patients worldwide. Aspirin resistance has been well reported in CVD. OBJECTIVE The frequency, risk factors, prognosis, and genetic polymorphism of the cyclooxygenase-1 (COX-1) gene for aspirin resistance have not been reported in elderly patients with CVD. We therefore undertook this study to evaluate these associations among elderly Chinese patients with CVD. METHODS Four hundred thirty-one elderly Chinese patients with CVD receiving daily aspirin therapy (≥75 mg) over 1 month were enrolled. Platelet aggregation was measured by light transmission aggregometry (LTA) and thromboelastography platelet mapping assay (TEG) using arachidonic acid (AA) as a stimulus. The median follow-up was 1.8 years. RESULTS After the median follow-up, aspirin-resistant patients were at an increased risk of the composite endpoint compared to nonresistant patients by LTAAA + TEGAA (23.7 vs. 9.2%, p = 0.025). Additionally, Cox proportional hazards regression modeling demonstrated that aspirin resistance and cerebrovascular disease were associated with major adverse long-term outcomes (HR for aspirin resistance = 2.31, 95% CI 1.11-4.81, p = 0.026). The variant G-allele of COX-1 rs1330344 (-1676 A/G) significantly increased the risk of aspirin resistance defined by LTAAA + TEGAA (OR = 1.82, 95% CI 1.13- 2.92, p = 0.01). CONCLUSIONS Aspirin resistance, evaluated by LTAAA + TEGAA, is associated with an increased risk of adverse clinical events in elderly Chinese patients with CVD. The variant G-allele of COX-1 rs1330344 is significantly associated with aspirin resistance defined by LTAAA + TEGAA.
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Affiliation(s)
- Li Fan
- Clinical Department of South Building, Chinese PLA General Hospital, Beijing, PR China.
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384
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Cao J, Liu L, Fan L, Chen T, Hu G, Hu Y, Zhu B, Li J, Wang H, Li X. The prevalence, risk factors and prognosis of aspirin resistance in elderly male patients with cardiovascular disease. Aging Male 2012; 15:140-7. [PMID: 22452804 DOI: 10.3109/13685538.2012.666584] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM Aspirin resistance is recognized in different population. However, the prevalence and clinical events of aspirin resistance in elderly male patients with cardiovascular disease (CVD) have not been reported. METHODS We enrolled 304 elderly male patients with CVD receiving daily aspirin therapy (≥ 75 mg) more than 1 month. Platelet aggregation was measured by light transmission aggregometry (LTA) and thrombelastography platelet mapping assay (TEG). The median follow-up time was 1.8 years. The primary outcome was the composite of death, myocardial infarction, unstable angina, stroke and transient ischemic attack. RESULTS By LTA, 25 (8.2%) of elderly patients were aspirin resistant and 106 (34.9%) patients were semiresponders. According to TEG, 62 patients (20.4%) were found to be resistant to aspirin therapy. Of the 62 patients with aspirin resistance by TEG, 21 patients were aspirin resistant by LTA. Twenty-two of the 106 semiresponders by LTA were aspirin resistant by TEG. Patients with aspirin resistance or aspirin semiresponders were at increased risk of the composite outcome compared with aspirin-sensitive patients by LTA (18.3% vs 9.8%, Hazard ratio (HR) = 1.864, 95% confidence interval (CI): 1.046-3.324 p = 0.039). However, aspirin resistance was not associated with an increased risk of clinical vascular events compared to aspirin-sensitive patients by TEG (17.7% vs 10.9%, p = 0.452). In addition, Cox proportional hazard regression modeling demonstrated that aspirin resistance or semiresponders (HR = 3.050, 95% CI: 1.464-6.354, p = 0.003) and diabetes (HR = 2.055, 95% CI: 1.060-3.981, p = 0.033) were associated with major adverse long-term outcomes. CONCLUSIONS Aspirin resistance or semiresponders, defined by LTA, are associated with an increased risk of adverse clinical events in elderly male patients with CVD.
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Affiliation(s)
- Jian Cao
- First Geriatric Cardiology Division, Chinese PLA General Hospital, Beijing, China
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385
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Diet and aging. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2012; 2012:741468. [PMID: 22928085 PMCID: PMC3425961 DOI: 10.1155/2012/741468] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 07/12/2012] [Accepted: 07/16/2012] [Indexed: 11/17/2022]
Abstract
Nutrition has important long-term consequences for health that are not only limited to the individual but can be passed on to the next generation. It can contribute to the development and progression of chronic diseases thus effecting life span. Caloric restriction (CR) can extend the average and maximum life span and delay the onset of age-associated changes in many organisms. CR elicits coordinated and adaptive stress responses at the cellular and whole-organism level by modulating epigenetic mechanisms (e.g., DNA methylation, posttranslational histone modifications), signaling pathways that regulate cell growth and aging (e.g., TOR, AMPK, p53, and FOXO), and cell-to-cell signaling molecules (e.g., adiponectin). The overall effect of these adaptive stress responses is an increased resistance to subsequent stress, thus delaying age-related changes and promoting longevity. In human, CR could delay many diseases associated with aging including cancer, diabetes, atherosclerosis, cardiovascular disease, and neurodegenerative diseases. As an alternative to CR, several CR mimetics have been tested on animals and humans. At present, the most promising alternatives to the use of CR in humans seem to be exercise, alone or in combination with reduced calorie intake, and the use of plant-derived polyphenol resveratrol as a food supplement.
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386
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Abstract
Rapid growth in the numbers of older adults with cardiovascular disease (CVD) is raising awareness and concern of the impact that common geriatric syndromes such as frailty may have on clinical outcomes, health-related quality of life, and rising economic burden associated with healthcare. Increasingly, frailty is recognized to be a highly prevalent and important risk factor that is associated with adverse cardiovascular outcomes. A limitation of previous studies in patients with CVD has been the lack of a consistent definition and measures to evaluate frailty. In this review, building upon the work of Fried and colleagues, a definition of frailty is provided that is applicable for evaluating frailty in older adults with CVD. Simple, well-established performance-based measures widely used in comprehensive geriatric assessment are recommended that can be readily implemented by nurses in most practice settings. The limited studies conducted in older adults with CVD have shown physical performance measures to be highly predictive of clinical outcomes. Implications for practice and areas for future research are described for the growing numbers of elderly cardiac patients who are frail frailty and at risk for disability.
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Affiliation(s)
- Rebecca Gary
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia 30322, USA.
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387
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Modig K, Drefahl S, Andersson T, Ahlbom A. The aging population in Sweden: can declining incidence rates in MI, stroke and cancer counterbalance the future demographic challenges? Eur J Epidemiol 2012; 27:139-45. [PMID: 22350145 DOI: 10.1007/s10654-012-9653-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 01/16/2012] [Indexed: 10/28/2022]
Abstract
It is often taken for granted that an ageing population will lead to an increased burden for the health care sector. However, for several diseases of big public health impact the rates have actually come down for a substantial period of time. In this study we investigate how much the incidence rates for myocardial infarction (MI), stroke, and cancer will have to decline in order to counterbalance future demographic changes (changes in population size and age structure) and compare these figures with observed historical trends. Information on incidence rates were obtained from the National Board of Health and Welfare and referred to the total Swedish population. Population projections were obtained from Statistics Sweden. We projected the number of MI events to increase 50-60% between 2010 and 2050. The decline in incidence rates that is required to keep the number of events constant over time is, on average, 1.2%/year for men and 0.9%/year for women, somewhat higher than the trend for the past 10 years. For stroke the corresponding figures were 1.3% (men) and 1% (women), well in line with historical trends. For cancer the results indicate an increasing number of events in the future. Population ageing is more important than population growth when projecting future number of MI, stroke and cancer events. The required changes in incidence rates in order to counterbalance the demographic changes are well in line with historical figures for stroke, almost in line regarding MI, but not in line regarding cancer. For diseases with age dependence similar to these diseases, a reduction of incidence rates in the order of 1-2% is sufficient to offset the challenges of the ageing population. These are changes that have been observed for several diseases indicating that the challenges posed by the ageing population may not be as severe as they may seem when considering the demographic component alone.
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Affiliation(s)
- Karin Modig
- Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Box 210, 171 77 Stockholm, Sweden.
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388
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Aviv A. Genetics of leukocyte telomere length and its role in atherosclerosis. Mutat Res 2012; 730:68-74. [PMID: 21600224 PMCID: PMC3202050 DOI: 10.1016/j.mrfmmm.2011.05.001] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 04/27/2011] [Accepted: 05/02/2011] [Indexed: 02/07/2023]
Abstract
Humans display a large inter-individual variation in leukocyte telomere length (LTL), which is influenced by heredity, sex, race/ethnicity, paternal age at conception and environmental exposures. LTL dynamics (birth LTL and its age-dependent attrition thereafter) mirror telomere dynamics in hematopoietic stem cells (HSCs). LTL at birth is evidently a major determinant of LTL throughout the human lifespan, such that individuals endowed with short (or long) LTL at birth probably have short (or long) LTL later in life. Therefore, the associations of short LTL with atherosclerosis and with diminished survival in the elderly may relate to short birth LTL, accelerated age-dependent LTL attrition, or both. The mechanisms underlying these associations are still not well understood, but they stem in part from genetic factors in control of telomere maintenance and the rate of HSC replication.
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Affiliation(s)
- Abraham Aviv
- The Center for Human Development and Aging, University of Medicine and Dentistry, New Jersey Medical School, Newark, NJ 07103, USA.
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389
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Ovbiagele B. Sex-specific time trends in very elderly patients (aged ≥80 years) hospitalized with myocardial infarction. Med Princ Pract 2012; 21:93-6. [PMID: 22024727 PMCID: PMC3696375 DOI: 10.1159/000332573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 05/11/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess sex-related time trends in the proportion of very elderly patients (age ≥80) hospitalized with myocardial infarction (MI). SUBJECTS AND METHODS Data were obtained from all states in the USA that contributed to the Nationwide Inpatient Sample. All patients admitted to hospital between 1997 and 2006 with a primary discharge diagnosis of MI, identified by the International Classification of Diseases, Ninth Revision procedure codes were included. Percentages of MI hospitalizations comprising men and women aged ≥80 were evaluated. RESULTS Overall, between 1997 and 2006, the absolute number of MI hospitalizations decreased from 732,170 to 674,988, but the percentage of very elderly men rose in a roughly linear pattern by 2.84% from 14.2% in 1997 to 17.1% in 2006 (95% CI 1.9-3.8%, p < 0.001) while among very elderly women, the percentages increased linearly by 4.95% from 31.0% in 1997 to 35.95% in 2006 (95% CI 3.6-6.3%, p < 0.001). Comparing women to men, the rise was 1.74 times larger (95% CI 1.26-2.23, p = 0.03). CONCLUSIONS Over the last decade, the percentage of very elderly women hospitalized with MI in the United States rose at almost twice the rate of similarly aged men. These trends may be expected to exponentially worsen given the aging global population.
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Affiliation(s)
- Bruce Ovbiagele
- *Bruce Ovbiagele, MD, MSc, Vascular Neurology Program, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093 (USA), Tel. +1 858 552 8585, E-Mail
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390
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Corcoran TB, Hillyard S. Cardiopulmonary aspects of anaesthesia for the elderly. Best Pract Res Clin Anaesthesiol 2011; 25:329-54. [DOI: 10.1016/j.bpa.2011.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 07/12/2011] [Indexed: 02/03/2023]
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391
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Uraoka M, Ikeda K, Kurimoto-Nakano R, Nakagawa Y, Koide M, Akakabe Y, Kitamura Y, Ueyama T, Matoba S, Yamada H, Okigaki M, Matsubara H. Loss of bcl-2 during the senescence exacerbates the impaired angiogenic functions in endothelial cells by deteriorating the mitochondrial redox state. Hypertension 2011; 58:254-63. [PMID: 21730299 DOI: 10.1161/hypertensionaha.111.176701] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Ageing is an important risk factor for ischemic cardiovascular diseases, although its underlying molecular mechanisms remain to be elucidated. Here, we report a crucial role of Bcl-2 in the impaired angiogenic functions in senescent endothelial cells (ECs) by modulating the mitochondrial redox state. Cellular senescence impaired angiogenic functions in ECs without attenuating the mitogen-activated protein kinase or Akt signaling, and vascular endothelial growth factor receptor 2 or Tie-2 expressions. We identified that Bcl-2 expression was markedly reduced in 3 independent models for senescent ECs, and pharmacological inhibition, as well as small interfering RNA-mediated gene silencing of Bcl-2, significantly impaired the angiogenic functions in young ECs. Bcl-2 has an antioxidative role by locating the glutathione at mitochondria, and we found that mitochondrial oxidative stress was significantly augmented in senescent ECs, in association with reduced mitochondria-associated glutathione. Transfection of Bcl-2 in senescent ECs significantly reduced the mitochondrial oxidative stress, restored the mitochondrial membrane potential, and improved the angiogenic capacity. Furthermore, gene transfer of Bcl-2 using adenovirus significantly improved the in vivo angiogenesis in the Matrigel plugs implanted into aged mice, whereas the Bcl-2 inhibitor reduced the angiogenesis in the Matrigel plugs implanted into young mice. Together, Bcl-2 plays a crucial role in the regulation of the mitochondrial redox state in ECs, and, thus, loss of Bcl-2 during the senescence exacerbates the impaired angiogenesis by augmenting the mitochondrial oxidative stress.
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Affiliation(s)
- Maki Uraoka
- Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, 465 Kajii, Kawaramachi-Hirokoji, Kamigyo, Kyoto 602-8566, Japan
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392
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Kirkland RA, Karlin NJ, Stellino MB, Pulos S. Basic Psychological Needs Satisfaction, Motivation, and Exercise in Older Adults. ACTIVITIES ADAPTATION & AGING 2011. [DOI: 10.1080/01924788.2011.596764] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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393
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Hartigan I, Murphy S, Hickey M. Older adults' knowledge of pressure ulcer prevention: a prospective quasi-experimental study. Int J Older People Nurs 2011; 7:208-18. [PMID: 21631885 DOI: 10.1111/j.1748-3743.2011.00274.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To test an evidence base patient education leaflet to evaluate older adults' knowledge of pressure ulcers and prevention strategies. BACKGROUND The increasing population of older adults living in the community managing chronic health conditions are at risk of pressure ulcer development. Education leaflets are a useful adjunct to reinforce healthcare professional's verbal information to promote healthy lifestyles choices. However, little is known of the effectives of pressure ulcer prevention educational leaflets for older adults. METHODS A quasi-experimental uncontrolled pre-test, post-test study of participants' knowledge of pressure ulcer and preventative strategies was conducted. Community dwelling older adults (n = 75) were recruited to this study. Older adult's knowledge was measured pre- and postdistribution of an education intervention. A risk assessment scale was recorded to identify whether this cohort of older adults were actually at risk of developing pressure ulcers. CONCLUSION The results indicate that an education leaflet enhanced patients' knowledge relating to pressure ulceration. Printed education materials increase knowledge and understanding which may lend to older adults adopting healthy behaviours. IMPLICATIONS FOR PRACTICE An education leaflet can help older adults and their carers to be more empowered as active participants in reducing the incidence of pressure ulceration.
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Affiliation(s)
- Irene Hartigan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland.
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394
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Rosano C, Longstreth WT, Boudreau R, Taylor CA, Du Y, Kuller LH, Newman AB. High blood pressure accelerates gait slowing in well-functioning older adults over 18-years of follow-up. J Am Geriatr Soc 2011; 59:390-7. [PMID: 21391929 PMCID: PMC3637929 DOI: 10.1111/j.1532-5415.2010.03282.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine whether the association between hypertension and decline in gait speed is significant in well-functioning older adults and whether other health-related factors, such as brain, kidney, and heart function, can explain it. DESIGN Longitudinal cohort study. SETTING Cardiovascular Health Study. PARTICIPANTS Of 2,733 potential participants with a brain magnetic resonance imaging (MRI) scan, measures of mobility and systolic blood pressure (BP), no self-reported disability in 1992 to 1994 (baseline), and with at least 1 follow-up gait speed measurement through 1997 to 1999, 643 (aged 73.6, 57% female, 15% black) who had received a second MRI in 1997 to 1999 and an additional gait speed measure in 2005 to 2006 were included. MEASUREMENTS Mixed models with random slopes and intercepts were adjusted for age, race, and sex. Main explanatory factors included white matter hyperintensity progression, baseline cystatin-C, and left cardiac ventricular mass. Incidence of stroke and dementia, BP trajectories, and intake of antihypertensive medications during follow-up were tested as other potential explanatory factors. RESULTS Higher systolic BP was associated with faster rate of gait speed decline in this selected group of 643 participants, and results were similar in the parent cohort (N = 2,733). Participants with high BP (n = 293) had a significantly faster rate of gait speed decline than those with baseline BP less than 140/90 mmHg and no history of hypertension (n = 350). Rates were similar for those with history of hypertension who were uncontrolled (n = 110) or controlled (n = 87) at baseline and for those who were newly diagnosed (n = 96) at baseline. Adjustment for explanatory factors or for other covariates (education, prevalent cardiovascular disease, physical activity, vision, mood, cognition, muscle strength, body mass index, osteoporosis) did not change the results. CONCLUSION High BP accelerates gait slowing in well-functioning older adults over a long period of time, even for those who control their BP or develop hypertension later in life. Health-related measurements did not explain these associations. Future studies to investigate the mechanisms linking hypertension to slowing gait in older adults are warranted.
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Affiliation(s)
- Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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395
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Association of systemic inflammatory activity with coronary and carotid atherosclerosis in the very elderly. Atherosclerosis 2011; 216:212-6. [PMID: 21316055 DOI: 10.1016/j.atherosclerosis.2011.01.040] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 12/22/2010] [Accepted: 01/22/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To verify the existence of association between plasma levels of pro- or anti-inflammatory mediators and atherosclerotic burden at coronary and carotid arteries in individuals aged of 80 or more years old. METHODS Healthy individuals aged between 80 and 102 years old (n = 178) underwent evaluation of plasma cytokines and acute phase proteins, intima-media thickness (IMT) and presence of plaques in carotid arteries by ultrasound and coronary artery calcification (CAC) by cardiac computed tomography. RESULTS There was no association between CAC and carotid plaques (p = 0.8), maximum (p = 0.06) or mean IMT (p = 0.2). No association was found between the presence of carotid plaques and CRP (p = 0.4), TNF-α (p = 0.8) or IL-10 (p = 0.2). Likewise, individuals in the first three quartiles for CRP, TNF-α or IL-10 had similar values of CAC, mean and maximum IMT. In contrast, individuals above the 75th percentile for CRP or for TNF-α had enhanced maximum IMT (p = 0.017 and p < 0.0001) and CAC (p = 0.026 and p = 0.01) and subjects with IL-10 levels above the 75th percentile had lower maximum IMT (p = 0.027) and CAC (p = 0.006) as compared with those below this percentile. There was no difference in mean IMT for individuals above or below the 75th percentile for CRP, TNF-α or IL-10. CONCLUSION In very old individuals, CAC and maximum IMT were positively associated with systemic inflammatory activity only in those above the 75th percentile. The markers of atherosclerotic burden at coronary and carotid arteries were not related to each other and were distinctly associated with pro- and anti-inflammatory mediators, suggesting that atherosclerosis development is different in these vascular beds.
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396
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Rejeski WJ, Brubaker PH, Goff DC, Bearon LB, McClelland JW, Perri MG, Ambrosius WT. Translating weight loss and physical activity programs into the community to preserve mobility in older, obese adults in poor cardiovascular health. ACTA ACUST UNITED AC 2011; 171:880-6. [PMID: 21263080 DOI: 10.1001/archinternmed.2010.522] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Limitations in mobility are common among older adults with cardiovascular and cardiometabolic disorders and have profound effects on health and well-being. With the growing population of older adults in the United States, effective and scalable public health approaches are needed to address this problem. Our goal was to determine the effects of a physical activity and weight loss intervention on 18-month change in mobility among overweight or obese older adults in poor cardiovascular health. METHODS The study design was a translational, randomized controlled trial of physical activity (PA) and weight loss (WL) on mobility in overweight or obese older adults with cardiovascular disease (CVD) or at risk for CVD. The study was conducted within the community infrastructure of Cooperative Extension Centers. Participants were randomized to 1 of 3 interventions: PA, WL + PA, or a successful aging (SA) education control arm. The primary outcome was time to complete a 400-m walk in seconds (400MWT). RESULTS A significant treatment effect (P = .002) and follow-up testing revealed that the WL + PA group improved their 400MWT (adjusted mean [SE], 323.3 [3.7] seconds) compared with both PA (336.3 [3.9] seconds; P = .02) and SA (341.3 [3.9] seconds; P < .001). Participants with poorer mobility at baseline benefited the most (P < .001). CONCLUSION Existing community infrastructures can be effective in delivering lifestyle interventions to enhance mobility in older adults in poor cardiovascular health with deficits in mobility; attention should be given to intervening on both weight and sedentary behavior since weight loss is critical to long-term improvement in mobility. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00119795.
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Affiliation(s)
- W Jack Rejeski
- Department of Health and Exercise Science and Geriatric Medicine, Wake Forest University, Winston-Salem, NC 27109, USA.
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