Abstract 19639: Long-Term Change in Cardiovascular Risk Factor Profile at Baseline and 39-Year Follow-Up and Hs-C-Reactive Protein - - The Chicago Healthy Aging Study (CHAS)

Abstract

Background: High high-sensitivity C-reactive protein (hs-CRP) levels are associated with adverse levels of individual cardiovascular disease (CVD) risk factors and incident CVD events. However, little is known on the association of long-term changes in RF profile -- from young adulthood to older age -- with hs-CRP levels at older age.

Methods: Using data from CHAS, we assessed association of changes in CVD RF status from baseline (1967-73) to follow-up (2007-10) with follow-up hs-CRP levels (see Table for definition of RF groups). Hs-CRP was dichotomized as >3 mg/l (cutpoint for high risk of developing CVD). Participants with hs-CRP >10 mg/l were excluded.

Results: The study sample consists of 1,321 participants -- 27% women, 9% African American, baseline ages 25-44 years, free of major ECG abnormalities and MI (at baseline), mean follow-up age 71. After 39 years of follow-up, 17% of persons (117/681) with no adverse RFs at baseline remained RF-free at follow-up and 1.6% of persons with any 1+ RFs at baseline became RF-free at follow-up (62/640) (Group A). With adjustment for baseline age, sex, race, education, and current aspirin use, prevalence of high hs-CRP (>3mg/l) was lowest in Group A (11%) and higher in Group E (≥1 RF at both exams and not taking cholesterol-lowering medication) (34%) and in Group C (0 baseline RF status but ≥1 RF at follow-up) (26%). Further, within each risk category, persons who took cholesterol-lowering medication had a lower likelihood of high Hs-CRP than their counterparts not taking it (see Table).

Conclusion: Long-term absence of RFs or, among those with baseline adverse risk factors, improvement in risk status to having no adverse RFs in older age is associated with lower prevalence of high CRP levels. RF burden in both young adulthood and older age were associated with substantially increased odds of having high hs-CRP levels at older ages, especially for those who did not take cholesterol-lowering medication.