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Titolo:
Predictors of congestive heart failure in the elderly: The cardiovascular health study
Autore:
Gottdiener, JS; Arnold, AM; Aurigemma, GP; Polak, JF; Tracy, RP; Kitzman, DW; Gardin, JM; Rutledge, JE; Boineau, RC;
Indirizzi:
St Francis Hosp, Roslyn, NY 11576 USA St Francis Hosp Roslyn NY USA 11576St Francis Hosp, Roslyn, NY 11576 USA Georgetown Univ Hosp, Div Cardiol, Washington, DC 20007 USA Georgetown Univ Hosp Washington DC USA 20007 ol, Washington, DC 20007 USA Washington Univ, Dept Biostat, Seattle, WA USA Washington Univ Seattle WAUSA ngton Univ, Dept Biostat, Seattle, WA USA Univ Massachusetts, Med Ctr, Div Cardiol, Worcester, MA USA Univ Massachusetts Worcester MA USA Ctr, Div Cardiol, Worcester, MA USA Tufts New England Med Ctr, Dept Radiol, Boston, MA USA Tufts New England Med Ctr Boston MA USA Ctr, Dept Radiol, Boston, MA USA Univ Vermont, Colchester Res Facil, Colchester, VT USA Univ Vermont Colchester VT USA Colchester Res Facil, Colchester, VT USA Wake Forest Univ, Winston Salem, NC 27109 USA Wake Forest Univ Winston Salem NC USA 27109 , Winston Salem, NC 27109 USA Univ Calif Irvine, Irvine, CA USA Univ Calif Irvine Irvine CA USAUniv Calif Irvine, Irvine, CA USA Univ Calif Davis, Div Cardiovasc Med, Davis, CA 95616 USA Univ Calif Davis Davis CA USA 95616 v Cardiovasc Med, Davis, CA 95616 USA NHLBI, Div Epidemiol & Clin Applicat, Bethesda, MD 20892 USA NHLBI Bethesda MD USA 20892 emiol & Clin Applicat, Bethesda, MD 20892 USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 6, volume: 35, anno: 2000,
pagine: 1628 - 1637
SICI:
0735-1097(200005)35:6<1628:POCHFI>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR MASS; ISOLATED SYSTOLIC HYPERTENSION; 6 ANTIHYPERTENSIVE AGENTS; TO-MODERATE HYPERTENSION; SINGLE-DRUG THERAPY; VITAL CAPACITY; SERIAL CHANGES; UNITED-STATES; OLDER ADULTS; DISEASE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
61
Recensione:
Indirizzi per estratti:
Indirizzo: Gottdiener, JS St Francis Hosp, 100 Port Washington Blvd, Roslyn, NY 11576USA St Francis Hosp 100 Port Washington Blvd Roslyn NY USA 11576
Citazione:
J.S. Gottdiener et al., "Predictors of congestive heart failure in the elderly: The cardiovascular health study", J AM COL C, 35(6), 2000, pp. 1628-1637

Abstract

OBJECTIVES We sought to characterize the predictors of incident congestiveheart failure (CHF), as determined by central adjudication, in a community-based elderly population. BACKGROUND The elderly constitute a growing proportion of patients admitted to the hospital with CHF, and CHF is a leading source of morbidity and mortality in this group. Elderly patients differ from younger individuals diagnosed with CHF in terms of biologic characteristics. METHODS We analyzed data from the Cardiovascular Health Study, a prospective population-based study of 5,888 elderly people >65 years old (average 73+/- 5, range 65 to 100) at four locations. Multiple laboratory measures ofcardiovascular structure and function, blood chemistries and functional assessments were obtained. RESULTS During an average follow-up of 5.5 years (median 6.3), 597 participants developed incident CHF (rate 19.3/1,000 person-years). The incidence of CHF increased progressively across age groups and was greater in men than in women. On multivariate analysis, other independent predictors includedprevalent coronary heart disease, stroke or transient ischemic attack at baseline, diabetes, systolic blood pressure (BP), forced expiratory volume 1s, creatinine >1.4 mg/dl, C-reactive protein, ankle-arm index <0.9, atrialfibriuation, electrocardiographic (ECG) left ventricular (LV) mass, ECG ST-T segment abnormality, internal carotid artery wall thickness and decreased LV systolic function. Population-attributable risk, determined from predictors of risk and prevalence, was relatively high for prevalent coronary heart disease (13.1%), systolic BP greater than or equal to 140 mm Hg (12.8%)and a high level of C-reactive protein (9.7%), but was low for subnormal LV function (4.1%) and atrial fibrillation (2.2%). CONCLUSIONS The incidence of CHF is high in the elderly and is related mainly to age, gender, clinical and subclinical coronary heart disease, systolic BP and inflammation. Despite the high relative risk of subnormal systolic LV function and atrial fibrillation, the actual population risk of these for CHF is small because of their relatively low prevalence in community-dwelling elderly people. (C) 2000 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 13:34:23