Level of cardiovascular disease knowledge, risk perception and intention towards healthy lifestyle and socioeconomic disparities among adults in vulnerable communities of Belgium and England

Risk factors of cardiovascular disease (CVD) in young adults: a community-based study of Iranian context

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of death and disability worldwide, particularly in low- and middle-income countries. Young adults are susceptible to CVD risk factors, especially in developing countries. This study aimed to compare CVD risk factors between medical and non-medical students.

METHODS

The present cross-sectional study was conducted on a sample of 302 students in Tehran, including 151 medical students and 151 non-medical students, in 2022. Data collection tools included four online questionnaires to collect demographic information, knowledge/attitudes, knowledge of risk factors, and risk factors. Data were analyzed using SPSS version 18 software at a 0.05 significance level.

RESULTS

Data analysis revealed that the mean age of medical and non-medical students was 22.06 ± 3.53 and 21.88 ± 4.20 years, respectively. The two groups were not significantly different in gender, age, marital status, and place of residence. Knowledge of CVD was significantly different between the two groups of students (P < 0.001), but attitudes were not significantly different (P = 0.208). A significant difference in the prognosis of diabetes and dyslipidemia was observed between the two groups (P < 0.001).

CONCLUSIONS

As a large group of young adults in society, students are at risk for CVD. Poor knowledge and inappropriate attitudes regarding CVD risk factors are among the contributing factors. Therefore, it is recommended to design and implement a healthy diet, physical activity, stress management, and healthy lifestyle programs for the young group along with screening programs to prevent complications and mortality caused by CVD.

Measuring Cardiovascular Disease Risk Perception: Translation and Validation of the Indonesian ABCD Risk Questionnaire

Background

Cardiovascular diseases (CVDs) are still increasing worldwide contributing to increasing death worldwide. To test CVDs' awareness, the Attitude and Belief about Cardiovascular Disease (ABCD) questionnaire was developed. However, this questionnaire is not available in Indonesia language.

Methods

The original questionnaire was translated in both directions forward and backward. The process is then continued with a content validity index created by three experts. The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) then determine the factors that support the translated questionnaire. The splitting sample method was applied in both factor analyses. Internal consistency testing of 18 items was performed on 236 samples.

Result

The validity of the entire questionnaire subscale was satisfactory. Three retained factors were supported by the EFA and CFA, namely, risk perception, perceived benefit, and healthy eating intention. The internal consistency was acceptable based on Cronbach alpha and ordinal alpha. The Indonesian version of ABCD questionnaire was statistically valid and reliable to be used.

Conclusion

The Indonesian version of the ABCD questionnaire is a valid questionnaire to access the attitude and belief of CVDs in Indonesia.

Cardiovascular Risk Factors in Socioeconomically Disadvantaged Populations in a Suburb of the Largest City in Western Romania

Background and Objectives: Cardiovascular disease (CVD) remains a major public health issue worldwide, disproportionately affecting socioeconomically disadvantaged populations due to the social determinants of health (SDOHs). In Western Romania, these populations are particularly vulnerable to CVD. This study aims to investigate the prevalence and impact of cardiovascular risk factors (CVRFs) among socioeconomically disadvantaged individuals in Western Romania and identify the primary CVRFs contributing to the high incidence of CVD within this population. Materials and Methods: A retrospective observational design was employed, utilizing data from the medical records of 1433 eligible individuals. The inclusion criteria were based on Eurostat's EU-SILC benchmarks, focusing on severe material deprivation, at-risk-of-poverty rates, and low work intensity. Data on demographics, familial and personal medical history, smoking status, blood pressure, glucose, cholesterol, triglycerides, and HbA1c levels were collected. Results: Of the 1433 subjects, 34.75% were male, with a median age of 52 years. Significant conditions included diabetes (7.39%), coronary disease (3.83%), arterial hypertension (35.58%), and dyslipidemia (21.28%). Median ages were higher for those with diabetes (65 vs. 51 years, p < 0.0001), coronary disease (64 vs. 51 years, p < 0.0001), arterial hypertension (65 vs. 43 years, p < 0.0001), and dyslipidemia (66 vs. 47 years, p < 0.0001). BMI (Body Mass Index) classifications showed 33.77% were overweight, 21.21% obese, and 15.07% morbidly obese. Smokers were younger than non-smokers (48 vs. 54 years, p < 0.0001). Conclusions: The findings highlight the significant prevalence of CVRFs among socioeconomically disadvantaged populations in Western Romania. Socioeconomically disadvantaged populations exhibit a significantly higher prevalence of cardiovascular risk factors such as diabetes, impaired glucose regulation, hypertension, and dyslipidemia compared to their before known status.

Knowledge of cardiovascular diseases and associated risk factors in the general adult population of Jeddah, Saudi Arabia: A cross-sectional study examining gender disparities

To assess knowledge about cardiovascular diseases (CVD) among the general population, we emphasized gender-related disparities and other lifestyle and health-related factors. This cross-sectional study was conducted among 395 individuals from the general population of Jeddah, Saudi Arabia. An online questionnaire was administered to assess knowledge of CVD types, symptoms, and risk factors. The majority of participants identified coronary heart disease (73.7%) as having CVD, with no sex effect. Males had higher knowledge regarding cerebrovascular disease (44% vs 31.5%) and congenital heart diseases (60% vs 51.9%) as being part of CVD, while they had lower knowledge of peripheral arterial disease (44% vs 50.7%) than females, respectively (P < .05). Males exhibited better knowledge of heart attack and stroke symptoms than females. Knowledge was optimal for major CVD risk factors, such as smoking (90.6%) and high low-density lipoprotein cholesterol levels (85.1%); however, gaps were observed in recognizing diabetes (56.2%) and stress (69.4%) as factors for CVD. The mean overall knowledge score was 16.33 ± 5.72 25, with no difference between sexes (P = .239). Predictors of good CVD knowledge included university-level education, daily healthy food consumption, and perceived life as highly stressful; nonetheless, sex showed no significant effect. While the general population displayed a suboptimal understanding of CVD, notable sex disparities were observed, highlighting the need for tailored public health interventions. Emphasizing cognitive and behavioral aspects can foster better prevention and management strategies, given the evident gender disparities.

Electrospun silk fibroin/fibrin vascular scaffold with superior mechanical properties and biocompatibility for applications in tissue engineering

Electrospun scaffolds play important roles in the fields of regenerative medicine and vascular tissue engineering. The aim of the research described here was to develop a vascular scaffold that mimics the structural and functional properties of natural vascular scaffolding. The mechanical properties of artificial vascular tissue represent a key issue for successful transplantation in small diameter engineering blood vessels. We blended silk fibroin (SF) and fibrin to fabricate a composite scaffold using electrospinning to overcome the shortcomings of fibrin with respect to its mechanical properties. Subsequently, we then carefully investigated the morphological, mechanical properties, hydrophilicity, hemocompatibility, degradation, cytocompatibility and biocompatibility of the SF/fibrin (0:100), SF/fibrin (15:85), SF/fibrin (25:75), and SF/fibrin (35:65) scaffolds. Based on these in vitro results, we implanted SF/fibrin (25:75) vascular scaffold subcutaneously and analyzed its in vivo degradation and histocompatibility. The fiber structure of the SF/fibrin hybrid scaffold was smooth and uniform, and its fiber diameters were relatively small. Compared with the fibrin scaffold, the SF/fibrin scaffold clearly displayed increased mechanical strength, but the hydrophilicity weakened correspondingly. All of the SF/fibrin scaffolds showed excellent blood compatibility and appropriate biodegradation rates. The SF/fibrin (25:75) scaffold increased the proliferation and adhesion of MSCs. The results of animal experiments confirmed that the degradation of the SF/fibrin (25:75) scaffold was faster than that of the SF scaffold and effectively promoted tissue regeneration and cell infiltration. All in all, the SF/fibrin (25:75) electrospun scaffold displayed balanced and controllable biomechanical properties, degradability, and good cell compatibility. Thus, this scaffold proved to be an ideal candidate material for artificial blood vessels.

Cardiovascular disease threat and perceived efficacy of selected preventive behaviors among Polish men: an analysis based on the extended parallel process model

Considering the low rate of preventive behaviors (5%), it is important to increase the effectiveness of actions that motivate the public to engage in health-promoting behaviors. The purpose of this study was to assess the way in which Polish men perceive the threat of cardiovascular diseases (CVDs) and the effectiveness of five preventive behaviors in the context of CVDs. We aimed to identify groups of recipients, based on the extended parallel process model (EPPM), for five preventive behaviors and to compare the identified groups in terms of selected characteristics. We conducted the survey in November 2022, using the computer-assisted web interviewing technique, on a representative sample of 1,000 men aged 18-65 years. Polish men showed relatively low levels of perceived susceptibility to CVDs (15.1%), but at the same time tended to perceive the consequences of CVDs as severe (54.2%). Segmentation of audiences according to the EPPM showed that regardless of the type of preventive behavior, the most numerous groups are responsive (31-37%) and indifferent (29-31%). This study revealed the need to increase awareness of the importance of a healthy diet to prevent CVDs among male population. Less than half of the men indicated that they would be able to implement effective stress management (49.8%) and smoking avoidance (39.4%), indicating the need to implement measures to increase self-efficacy in the areas.

Community-Dwelling Adults' Perceived Versus Actual Risk of Cardiovascular Disease, Body Mass Index, and Physical Activity Levels and Related Factors

CONTEXT

The difference between actual and perceived risk levels shows distorted risk perception. Unrealistic perceptions of cardiovascular disease (CVD) risks and insufficient knowledge about CVD risk factors can not only hinder the adoption of a positive lifestyle change but also obstruct preventive efforts.

OBJECTIVE

The aim of this study was to evaluate the concordance between perceived and actual risks, body mass index (BMI), and physical activity levels.

DESIGN

This descriptive study included 522 community-dwelling adults in 2 different regions of Antalya/Turkey. The actual CVD risk level of the participants was determined using the "HeartScore program," actual body weight was determined according to BMI, and actual activity levels were found using the "International Physical Activity Questionnaire Short Form (IPAQ-SF)." The perceived risks were measured with the CVD Risk and Risk Factors Perception Determination Questionnaire. CVD Risk Factors Knowledge Level (CARRF-KL) Scale was used to calculate the participants' level of knowledge about the risk factors.

RESULTS

There was no concordance between the participants' actual and perceived CVD risks. A below-average agreement was found between the participants' actual and perceived BMI levels. In terms of actual measurements, it was seen that slightly obese individuals have a realistic perception. There was a weak agreement between the actual and perceived physical activity levels of the adults. Knowledge about the CVD risk factors of adults does not affect the perception of CVD risk and BMI and physical activity.

CONCLUSIONS

Adults have an optimistic risk perception regarding CVD risk, BMI, and physical activity levels. It may be beneficial to periodically assess actual risks to change skewed perceptions of CVD and risk factors. These findings will inform the development of tailored intervention strategies and policies for these adults.

Disparities in the non-laboratory INTERHEART risk score and its components in selected countries of Europe and sub-Saharan Africa: analysis from the SPICES multi-country project

Aims

Accurate prediction of a person's risk of cardiovascular disease (CVD) is vital to initiate appropriate intervention. The non-laboratory INTERHEART risk score (NL-IHRS) is among the tools to estimate future risk of CVD. However, measurement disparities of the tool across contexts are not well documented. Thus, we investigated variation in NL-IHRS and components in selected sub-Saharan African and European countries.

Methods and results

We used data from a multi-country study involving 9309 participants, i.e. 4941 in Europe, 3371 in South Africa, and 997 in Uganda. Disparities in total NL-IHRS score, specific subcomponents, subcategories, and their contribution to the total score were investigated. The variation in the adjusted total and component scores was compared across contexts using analysis of variance. The adjusted mean NL-IHRS was higher in South Africa (10.2) and Europe (10.0) compared to Uganda (8.2), and the difference was statistically significant (P < 0.001). The prevalence and per cent contribution of diabetes mellitus and high blood pressure were lowest in Uganda. Score contribution of non-modifiable factors was lower in Uganda and South Africa, entailing 11.5% and 8.0% of the total score, respectively. Contribution of behavioural factors to the total score was highest in both sub-Saharan African countries. In particular, adjusted scores related to unhealthy dietary patterns were highest in South Africa (3.21) compared to Uganda (1.66) and Europe (1.09). Whereas, contribution of metabolic factors was highest in Europe (30.6%) compared with Uganda (20.8%) and South Africa (22.6%).

Conclusion

The total risk score, subcomponents, categories, and their contribution to total score greatly vary across contexts, which could be due to disparities in risk burden and/or self-reporting bias in resource-limited settings. Therefore, primary preventive initiatives should identify risk factor burden across contexts and intervention activities need to be customized accordingly. Furthermore, contextualizing the risk assessment tool and evaluating its usefulness in different settings are recommended.

Perceived Cardiovascular Disease Risk Following Preeclampsia: A Cross-Sectional Study

Preeclampsia has been linked to an increased risk of cardiovascular disease (CVD), and the preeclamptic women were unaware of this link. Therefore, this study aims to assess women's knowledge and perception of future CVD after preeclampsia. This study used a cross-sectional descriptive design. Two hundred and forty-six women with a preeclampsia history were recruited from the Al Salam MCH Center and Suez Canal University Hospital. Data were collected during March 2022 using a socio-demographic questionnaire, an Adapted Coronary Heart disease knowledge tool for preeclamptic women, and The Perception of Risk of Heart Disease Scale (PRHDS). Most women (96%) were unaware of the relationship between CVD and preeclampsia. The women had a low CVD knowledge level (10.26 ± 6.08) as well as a low perception of cardiovascular disease risk (37.15 ± 7.22). There was a significant positive correlation between CVD knowledge and CVD risk perception (r = 0.434, p = 0.000). This study found that preeclampsia survivors underestimated their CVD risk. Based on these findings, preeclamptic women should receive health education sessions on CVD risk and prevention from their nurses and obstetricians. The hospital pre-discharge plan must contain these sessions in written and electronic formats to help women remember and follow CVD risk reduction measures.

The Effect of Base Theory Educational Intervention on Health-Promoting Lifestyle in Women Susceptible to Cardiovascular Diseases: Application of the Theory of Planned Behavior

Background

Cardiovascular diseases are the second leading cause of mortality, disability, and reduced productivity in women over 40 years and the first cause of mortality in women over 60 years. Therefore, the present study aimed to determine the effect of educational intervention based on theory of planned behavior (TPB) on health-promoting lifestyle in women susceptible to cardiovascular diseases.

Methods

This quasiexperimental study was conducted on 200 women susceptible to cardiovascular diseases referred to health centers in Fasa city, Fars province, Iran. The available sampling was performed on women who referred to the centers and had a family record. In this study, two health-promoting lifestyle questionnaires consisting of 49 questions and the theory of planned behavior questionnaire consisting of 50 questions were used. The obtained data were analyzed by using the SPSS software version 24 in two stages before and six months after the educational intervention through paired t-test, independent t-test, chi-square test, and McNemar test.

Results

The mean age of women in the experimental and control groups was 38.74 ± 9.22 and 39.14 ± 9.08 years, respectively. The results showed a significant increase in the experimental group after six months of intervention in terms of health-promoting lifestyle and constructs of the theory of planned behavior. Also, mean blood pressure, fasting blood sugar, and smoking of experimental group decreased six months after the educational intervention.

Conclusion

Considering the irreplaceable role of education in adopting healthy behaviors and the role of women in strengthening the family foundation, quality educational programs should be designed and regularly implemented by health care providers for women.

The Pre-Implementation Phase of a Project Seeking to Deliver a Community-Based CVD Prevention Intervention (SPICES-Sussex): A Qualitative Study Exploring Views and Experience Relating to Intervention Development

BACKGROUND.

Community-led health care interventions may be an effective way to tackle cardiovascular disease (CVD) risk factors, especially in materially deprived communities where health care resources are stretched and engagement with institutions is often low. To do so effectively and equitably, interventions might be developed alongside community members through community engagement.

OBJECTIVES.

The aim of this project was to carry out stakeholder mapping and partnership identification and to understand the views, needs, experiences of community members who would be involved in later stages of a community-based CVD prevention intervention's development and implementation.

METHODS.

Stakeholder mapping was carried out to identify research participants in three communities in Sussex, United Kingdom. A qualitative descriptive approach was taken during the analysis of focus groups and interviews with 47 participants.

FINDINGS.

Three themes were highlighted related to intervention design (a) Management: the suitability of the intervention for the community, management of volunteers, and communication; (b) Logistics: the structure and design of the intervention; and (c) Sociocultural issues, the social and cultural expectations/experiences of participants and implementers.

CONCLUSIONS.

Study participants were open and willing to engage in the planned community-based intervention, particularly in elements of co-design and community-led delivery. They also highlighted the importance of sociocultural factors. Based on the findings, we developed recommendations for intervention design which included (but were not limited to): (a) a focus on a bottom-up approach to intervention design, (b) the recruitment of skilled local volunteers, and (c) the importance of fun and simplicity.

AlOsta M, Othman EH, Hamadneh S. Cardiovascular Disease Risk Factors Awareness among Women with a History of Preeclampsia in Jordan

Introduction

Preeclampsia is a pregnancy-specific hypertensive disease that affects 3-5% of pregnant women all over the world and 1.3% of pregnancies among Jordanian women.

Objectives

This study aims to assess the cardiovascular disease risk factors awareness among women with a recent history of preeclampsia in Jordan and assess the role of healthcare providers in providing counseling about cardiovascular disease risk factors.

Methods

A descriptive cross-sectional design was used to recruit 180 women with a recent history of preeclampsia during the last 12 months. Data were obtained from patients' medical records and the Attitude and Beliefs about Cardiovascular Disease Risk Questionnaires.

Results

The results revealed that 43.9% of women with a recent history of preeclampsia have hypertension, 6.7% have diabetes mellitus, 16.1% have dyslipidemia, 28.9% have a family history of cardiovascular disease, 66.1% are overweight or obese, and 7.2% are smokers. The mean total score of knowledge subscale was 5.5 (SD  =  1.21) out of 8. Only 20% of the participants had good cardiovascular disease knowledge. The mean total score of risk perception was 15.47 (SD  =  7.8). The mean score of perceived benefits and intention to change behaviors was 2.30 (SD  =  0.62). The mean score of healthy eating intentions was 2.54 (SD  =  0.81). Income, having diabetes mellitus, and receiving counseling about preeclampsia as cardiovascular disease risk factor were associated with some dimensions of cardiovascular disease risk factors awareness.

Conclusion

The prevalence of cardiovascular disease risk factors was relatively high among the study participants. The majority of participants had inadequate cardiovascular disease knowledge. In addition, the role of healthcare providers in providing counseling about cardiovascular disease and related risk factors, including PE was limited. Providing more counseling related to cardiovascular disease by nurses and doctors is essential to enhance women's cardiovascular disease knowledge and intention to change lifestyle.

Psychometric properties of the Chinese version of Attitudes and Beliefs about Cardiovascular Disease Risk Perception Questionnaire

Cardiovascular disease (CVD) is the leading cause of global mortality and disease burden. The perceived risk of CVD, a central psychological construct, may affect health behavior change and maintenance, such as lifestyle modification and medication adherence. Risk perception varies based on the knowledge of risk in the context of cultural health-world views. Little is known about CVD-related knowledge and risk perception in China. The aim of this study is to cross-culturally translate, adapt, and evaluate the psychometric properties of the Attitudes and Beliefs about Cardiovascular Disease (ABCD) Risk Perception Questionnaire in Chinese. The translation and cross-cultural adaptation process followed established guidelines. A cross-sectional study of 318 adults between April and May 2022 was conducted in Zhejiang province. The study evaluated the item- and scale-level psychometric properties and validity indices of the ABCD risk perception questionnaire. The exploratory and confirmatory factor analyses of the risk scale supported a three-factor solution that accounts for 69.63% of the total variance, corresponding to risk perception (F1), perceived benefits and intention to change physical activity (F2), and perceived benefits and intention to change dietary habits (F3). Adequate content validity (I-CVI = 0.852-1.00, S-CVI = 946) was ensured by expert panel. The internal consistency of the dimensions showed good results ranging from 0.801 to 0.940 for Cronbach's α, and 0.853 to 0.952 for McDonald's ω. The item analysis of knowledge dimension indicated that the item difficulty index was 0.440 to 0.852, the item discrimination index was 0.572 to 0.707. This study confirmed that the Chinese version of the ABCD risk perception questionnaire has good psychometric properties in terms of measuring CVD-related knowledge and risk perception in the Chinese adult population, which can lead to the development of individually tailored CVD-risk reduction intervention programs or risk communication programs by health providers.

Translation and validation of the Chinese ABCD risk questionnaire to evaluate adults' awareness and knowledge of the risks of cardiovascular diseases

BACKGROUND

Assessment of health beliefs and risk perception is a critical means to prevent coronary heart disease, but there are few such studies on assessment in the Chinese population. Given the demonstrated value and widespread use of the Attitudes and Beliefs about Cardiovascular Disease Risk Questionnaire (ABCD), this study was designed to translate it into Chinese, and to evaluate its reliability and validity in a Chinese population.

METHODS

The Chinese version of the ABCD was created using the Beaton translation model, which included forward and backward translation. The reliability and construct validity of the Chinese ABCD were examined in a sample of 353 adults who participated in the public welfare projects of the Chinese National Center for Cardiovascular Diseases in Guilin city, Guangxi. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure of the Chinse ABCD. The internal consistency of the questionnaire was assessed using Cronbach's α and corrected item-total correlations.

RESULTS

We deleted item 7 in the knowledge dimension of the Chinese ABCD and added two items about smoking and sleep knowledge, while retaining 25 of the original items, so that it finally included 27 items. The correlations were .20-.90; the correlations between each item and the total score of the ABCD were .34-.86; and the item-level Content Validity Index (I-CVI) was .86-1.00. The results of the EFA showed that all items were close to .40, and the cumulative variance contribution rate was 63.88%. The model fit was acceptable (χ² = 698.79, df = 243, χ²/df = 2.87, P < 0.001, SRMR = 0.06, RMSEA = 0.05, CFI = 0.96, and TLI = 0.94) according to the CFA. The Cronbach' s α of the entire questionnaire was .86, and the α of each of dimension was .65, .90, .88, and .78. The split-half reliability of the entire the ABCD was .67, and the test-retest reliability was .97 (P < 0.05). The questionnaire had good reliability and validity and was associated with sociodemographic and health-related characteristics (smoking and Body Mass Index).

CONCLUSION

The Chinese version of the ABCD has good reliability and validity, and provides a reliable assessment tool for measuring public health beliefs about the risk of cardiovascular disease, promoting the primary prevention of coronary heart disease.

Predictors of Adverse Outcomes in Healthy Aging Adults: Coronary Artery Disease, Lower Educational Status and Higher P-Selectin Levels

Background

Societal aging – as a global demographic phenomenon – shows no indication of abating. As a result, the problem of age-associated disability and related long-term care is emerging as a major public health challenge. It is important that methods for identifying older adults at risk of adverse outcomes are implemented early.

Methods

The study group consisted of 145 individuals, 44.1% women, who were randomized from community-dwelling 60–74-year-old adults. A comprehensive geriatric assessment was supplemented with Fried frailty phenotype evaluation and blood tests (including adhesion molecules, matrix metalloproteinases and neurotrophic factors). A follow-up by phone call was made for at least 3 years after the initial examination. Composite endpoint (CE) included falls, hospitalization, institutionalization and death.

Results

Mean study group age was 66.5 ± 4.1 years (\documentclass[12pt]{minimal} \usepackage{wasysym} \usepackage[substack]{amsmath} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage[mathscr]{eucal} \usepackage{mathrsfs} \DeclareFontFamily{T1}{linotext}{} \DeclareFontShape{T1}{linotext}{m}{n} {linotext }{} \DeclareSymbolFont{linotext}{T1}{linotext}{m}{n} \DeclareSymbolFontAlphabet{\mathLINOTEXT}{linotext} \begin{document} $$\overline {\rm{X}} {\rm{ \pm SD}}$$ \end{document}) and mean number of diseases was 3.7 ± 2.2. Functional status of the subjects was good, as indicated by high Barthel Index scores of 99.1 ± 2.4, MMSE scores of 29.0 ±1.5 and no frailty case. During a three-year follow-up, 71 participants (49.0%) experienced any CE-events. The Wilcoxon-Gehan test indicates that a higher probability of three-year CE completion was associated with an age >65 years (P = 0.006), coronary artery disease (CAD) (P = 0.008), 6-Minute Walk Test <432 m (P = 0.034), serum glucose >120 mg/dL (P = 0.047), serum cortisol >10 μg/dL (P = 0.011), leptin ≥15 ng/mL (P = 0.018), P-selectin ≥23 ng/mL (P = 0.006) and GDNF ≥20 pg/mL (P = 0.004). CAD (OR = 3.64, 95% CI = 1.53−8.69, P = 0.004), educational status (OR = 0.87, 95% CI = 0.77−0.98, P = 0.022) and P-selectin levels (OR = 1.07, 95% CI = 1.02−1.13, P = 0.013) were independent measures predicting three-year CE occurrence in multivariate logistic regression analysis adjusted for clinical and functional measures, and blood tests.

Conclusion

Coronary artery disease, poorer lower educational status and higher P-selectin levels were predictive of adverse outcomes in the community-dwelling healthy-aging early-old adults during three-year follow-up.