(Circulation. 2001;103:947.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Cardiovascular Disease, Interleukin-6, and Risk of Mortality in Older Women
The Women’s Health and Aging Study
From the Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, Md (S.V., J.M.G., L.F., J.B., T.B.H.); the Geriatric Department, I Fraticini, Italian National Institute for Research and Care on Aging (INRCA), Florence, Italy (L.F.); and the Departments of Medicine and Epidemiology, The Johns Hopkins Medical Institutions, Baltimore, Md (P.C., L.P.F.).
Correspondence to Stefano Volpato, MD, MPH, National Institute on Aging, 7201 Wisconsin Ave, Room 3C-309, Bethesda, MD 20892. E-mail volpatos{at}nia.nih.gov
Background—Systemic chronic inflammation has been found to be related to all-cause mortality risk in older persons. We investigated whether specific chronic conditions, particularly cardiovascular disease (CVD), affect the association between high interleukin (IL)-6 level and mortality in a sample of disabled older women.
Methods and
Results—IL-6 serum level was measured at
baseline in 620 women 
65 years old. The presence and severity of
medical conditions was ascertained by standard criteria that used
multiple sources of information. The sample was surveyed over the
3-year follow-up. After adjustment for potential confounders, compared
with those in the lowest tertile, women in the highest IL-6 tertile
were at higher risk of all-cause mortality. The presence of CVD,
however, strongly affected the risk of mortality associated with high
IL-6. Among women with prevalent CVD, those with high IL-6 levels had
>4-fold risk of death (RR 4.6; 95% CI 2.0 to 10.5) compared with
women in the lowest tertile, whereas the relative risk associated with
high IL-6 among those without CVD was much lower and not significant
(RR 1.8; 95% CI 0.7 to 4.2). Adjustment for all chronic diseases and
disease severity measures, including ankle-brachial index, forced
expiratory volume, and exercise tolerance, did not change the
results.
Conclusions—IL-6 level is helpful in identifying a subgroup of older CVD patients with high risk of death over a period of 3 years. Systemic inflammation, as measured by IL-6, may be related to the clinical evolution of older patients with CVD.
Key Words: interleukins • cardiovascular diseases • mortality • women • aging
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