http://www.healio.com/cardiology/chd-prevention/news/online/%7B27b9d773-5f28-49f6-9986-7a9e2f01ea88%7D/cvd-events-often-occur-before-age-65-years-in-both-sexes?utm_source=maestro&utm_medium=email&utm_campaign=cardiology%20news
Sniderman A, et al. JAMA Cardiol. 2016;doi:10.1001/jamacardio.2016.0991.
Half of CVD events in men and nearly one-third of CVD events in
women are occurring before age 65 years, according to findings of a
research letter published in JAMA Cardiology.
Allan D. Sniderman, MD
, of the Royal Victoria Hospital-McGill University
Health Centre, McGill University, Montreal, and colleagues used average
event rates based on the American Heart Association 2015 heart disease
and stroke statistical update to estimate the expected number of new-onset CV events per decade for men and women starting at age 45 years.
The researchers wrote that although the biggest increase in the absolute rate of new-onset CV events occurs after age 65 years in both men and women, the population at risk decreases as age increases. As a result, approximately one-fourth of all new-onset CV events in men happens before age 55 years and half before age 65 years. In women, about one-seventh of events happens before age 55 years and one-third before age 65 years.
Although the incidence rate of CVD is highest in patients older than 84 years, “events happening after this age contribute only a small fraction to the total count,” the researchers wrote.
“This analysis demonstrated that CVD is not only a disease that affects older individuals. ... For those with premature [CV] events, their personal, family and societal contributions are cut short or diminished earlier, their earnings losses are greater, and for those who survive, their period of care is longer,” Sniderman and colleagues wrote.
“Our findings highlight the need to refine strategies to identify individuals younger than 60 years who are candidates for preventive therapies.”
Options include lowering the risk threshold established in U.S. guidelines; adopting age- and sex-specific thresholds; and considering additional risk factors, including LDL of at least 160 mg/dL, family history of premature CVD, elevated levels of C-reactive protein, high coronary artery calcium score, low ankle-brachial index and high lifetime risk for CVD, the researchers wrote. – by Tracey Romero
The researchers wrote that although the biggest increase in the absolute rate of new-onset CV events occurs after age 65 years in both men and women, the population at risk decreases as age increases. As a result, approximately one-fourth of all new-onset CV events in men happens before age 55 years and half before age 65 years. In women, about one-seventh of events happens before age 55 years and one-third before age 65 years.
Although the incidence rate of CVD is highest in patients older than 84 years, “events happening after this age contribute only a small fraction to the total count,” the researchers wrote.
“This analysis demonstrated that CVD is not only a disease that affects older individuals. ... For those with premature [CV] events, their personal, family and societal contributions are cut short or diminished earlier, their earnings losses are greater, and for those who survive, their period of care is longer,” Sniderman and colleagues wrote.
“Our findings highlight the need to refine strategies to identify individuals younger than 60 years who are candidates for preventive therapies.”
Options include lowering the risk threshold established in U.S. guidelines; adopting age- and sex-specific thresholds; and considering additional risk factors, including LDL of at least 160 mg/dL, family history of premature CVD, elevated levels of C-reactive protein, high coronary artery calcium score, low ankle-brachial index and high lifetime risk for CVD, the researchers wrote. – by Tracey Romero
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