Hypertension research : official journal of the Japanese Society of Hypertension
-
Multicenter Study
Cognitive dysfunction and physical disability are associated with mortality in extremely elderly patients.
A few reports have demonstrated that cognitive or physical dysfunction is associated with increased mortality in very elderly patients, those over 80 years of age. Using simple clinical tests, we evaluated the impact of cognitive or physical dysfunction on future total and cardiovascular deaths. We conducted a multicenter prospective study of 523 extremely elderly outpatients, aged > or = 80 years (mean +/- SD age: 84 +/- 5.3 years). ⋯ In a Cox regression analysis model controlling for age, sex, body mass index (BMI), diastolic blood pressure (BP), cholesterol level, and history of cardiovascular diseases, cognitive dysfunction was found to be an independent risk factor for total death (p < 0.001), and cognitive dysfunction (p < 0.001) and physical dysfunction (p = 0.05) were independent risk factors for cardiovascular death. The determinants of cognitive dysfunction were associated with a lower diastolic BP (p = 0.04) adjusted for age, BMI, and a history of cardiovascular disease. Cognitive function, which was associated with lower BP levels, and physical function were the independent predictors of total and cardiovascular mortality among all cardiovascular risk factors in the very elderly, those at least 80 years of age.
-
Both cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV) are noninvasive methods to estimate arterial stiffness. The purpose of this study is to determine whether CAVI or baPWV is superior as an index of arterial stiffness. One hundred and thirty patients with chest pain syndrome who underwent coronary angiography (CAG) were included in this study. ⋯ Additionally, LDL-C and T-C/HDL-C were also associated with only CAVI (LDL-C: r = 0.26, p < 0.02; T-C/HDL-C: r = 0.30, p < 0.01), not baPWV. Finally, only CAVI was significantly higher in the group with angina pectoris than in the normal group (9.708 +/- 1.423 vs. 9.102 +/- 1.412; p = 0.0178). All parameters associated with atherosclerosis suggested that CAVI was superior to baPWV as a parameter of arterial stiffness.