A prospective study of risk factors for cardiovascular events among the elderly

OBJECTIVE To analyze the impact of cardiovascular (CV) risk factors on the occurrence of fatal and non-fatal CV events in elderly individuals. METHODS The present research was a prospective cohort study of 800 elderly Brazilian outpatients (60 to 85 years old) with a 12-year follow-up period (baseline: 1997-1998). The outcome variable was CV mortality or non-fatal CV events (stroke, infarction, angina, heart failure). Hypertension, diabetes, global and abdominal obesity, dyslipidemias, and metabolic syndrome were analyzed as independent variables. The analyses were based on Cox proportional hazard models and adjusted for gender, age range, smoking, regular physical activity, and previous cardiovascular disease. RESULTS A total of 233 fatal and non-fatal CV events were observed (29.1%). In the adjusted analysis, the following variables were associated with CV risk: hypertension hazard ratio (HR): 1.69; confidence interval (CI) 95%: 1.28-2.24, diabetes (HR: 2.67; CI 95%: 1.98-3.61), metabolic syndrome (HR: 1.61; CI 95%: 1.24-2.09), abdominal obesity (HR: 1.36; CI 95%: 1.03-1.79), hypertriglyceridemia (HR: 1.67; CI 95%: 1.22-2.30) and high triglyceride/HDL-c ratio (HR: 1.73; CI 95%: 1.31-2.84). Hypertension, diabetes, and dyslipidemia remained associated with CV risk regardless of abdominal obesity. CONCLUSION In this prospective study, hypertension, diabetes, metabolic syndrome, abdominal obesity, and hypertriglyceridemia were predictors of CV risk in elderly individuals. These results confirm the relevance of controlling these CV risk factors in this age group.