Abstract MP22: Cardiovascular Health in Young Adulthood and Middle Age is Associated with Cumulative Burden of Morbidity in Older Age
Introduction: Previous studies on the benefits of favorable cardiovascular (CV) health have examined single measures of morbidity. The aims of this study were to determine the association of CV health in young adulthood and middle-age on the trajectory of morbidity and cumulative morbidity burden in older age.
Methods: The CHA study is a longitudinal cohort of 39,522 men and women aged 18-59 years at baseline in 1967-1973 from 84 worksites in the Chicago area. Baseline risk factor levels including blood pressure, cholesterol, diabetes, BMI and smoking were identified by trained staff. Individuals were classified into one of four mutually exclusive categories: optimal levels of all factors, 0 factors high but 1+ borderline, 1 major, and ≥2 major risk factors. Linked CMS/NDI data from 1984-2010 were used to determine morbidity in older age. We included CHA participants who were age 65+ between 1984 and 2010 and enrolled in Medicare FFS. All-cause morbidity was defined using the Gagne score. CV morbidity was quantified using a CVD comorbidity score (the sum of 4 CVDs including CHD (includes MI), PVD, cerebrovascular disease and CHF).
Results: This study included 30,386 participants (43% female, 90% White, mean age 44 at baseline). 5% had optimal levels of all factors, 19% had 1+ risk factors at borderline levels, 40% had 1 major risk factor and 36% had 2+ major risk factors. Individuals with 2+ major risk factors had higher all-cause and CV morbidity scores at age 66 and continued to accrue morbid conditions throughout older age (see figure). Even after adjustment for demographics and education, an increasing burden of risk factors was associated with a greater cumulative burden of comorbidities (p=0.01).
Conclusion: Individuals with optimal levels of all major CV risk factors in young adulthood and middle-age experience lower levels of all-cause and CVD morbidity and less cumulative morbidity later in life. Primordial prevention of CV risk factors early in life is likely to reduce the future burden of morbidity and mortality in older age.
Author Disclosures: N.B. Allen: None. L. Zhao: None. L. Liu: None. K. Liu: None. T. Shih: None. T. Vu: None. J. Fries: None. M. Daviglus: None. D. Garside: None. D. Lloyd-Jones: None.
- © 2015 by American Heart Association, Inc.