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Cardiovascular Risk Profile and Subsequent Disability and Mental Well-being: The Zutphen Elderly Study

2008; Elsevier BV; Volume: 16; Issue: 11 Linguagem: Inglês

10.1097/jgp.0b013e3181784122

1545-7214

Erik J. Giltay, Frans G. Zitman, Daan Kromhout,

Health and Wellbeing Research

Objectives It is insufficiently known whether “classic” cardiovascular risk factors are associated with subsequent functional disability and mental well-being in elderly men. Design A population-based cohort study with 15 years of follow-up from 1985 onward. Setting The Zutphen Study started as the Dutch contribution to the Seven Countries Study. Participants Five hundred forty-five (59.2%) of 887 men (aged 64–84 years) who were free of preexisting cardiovascular disease and cancer. Measurements High cardiovascular risk was defined as having ≥2 “classic” risk factors: body mass index ≥30.0 kg/m2, presently smoking, hypertension (systolic blood pressure ≥160 mm Hg, diastolic blood pressure ≥95 mm Hg, or antihypertensive medication), serum cholesterol ≥6.5 mmol/L, and diabetes mellitus. Self-rated health and dispositional optimism were assessed in 1985, 1990, 1995, and 2000. Disability and depressive symptoms (by the Zung self-rating depression scale) were assessed from 1990 onward. Results The high-risk (N = 230) versus low-risk group (N = 315) had higher multivariate adjusted risks of all-cause and cardiovascular mortality (hazard ratios: 1.43; confidence interval[CI]: 1.15, 1.76; and 1.61; CI: 1.20, 2.18, respectively). High-risk status was also associated with more functional disability at 5, 10, and 15 years (odds ratios of 2.00, 95% CI: 1.25–3.20; 2.51, 95% CI: 1.36–4.65; and 2.45, 95% CI: 0.91–6.61, respectively), adjusted for baseline age, self-rated health, and dispositional optimism. Risk status was not associated with self-rated health, dispositional optimism, or depressive symptoms at follow-up. Conclusion Combined “classic” cardiovascular risk factors are not associated with impaired self-rated health or mental well-being in elderly men, but are predictive of functional disability. It is insufficiently known whether “classic” cardiovascular risk factors are associated with subsequent functional disability and mental well-being in elderly men. A population-based cohort study with 15 years of follow-up from 1985 onward. The Zutphen Study started as the Dutch contribution to the Seven Countries Study. Five hundred forty-five (59.2%) of 887 men (aged 64–84 years) who were free of preexisting cardiovascular disease and cancer. High cardiovascular risk was defined as having ≥2 “classic” risk factors: body mass index ≥30.0 kg/m2, presently smoking, hypertension (systolic blood pressure ≥160 mm Hg, diastolic blood pressure ≥95 mm Hg, or antihypertensive medication), serum cholesterol ≥6.5 mmol/L, and diabetes mellitus. Self-rated health and dispositional optimism were assessed in 1985, 1990, 1995, and 2000. Disability and depressive symptoms (by the Zung self-rating depression scale) were assessed from 1990 onward. The high-risk (N = 230) versus low-risk group (N = 315) had higher multivariate adjusted risks of all-cause and cardiovascular mortality (hazard ratios: 1.43; confidence interval[CI]: 1.15, 1.76; and 1.61; CI: 1.20, 2.18, respectively). High-risk status was also associated with more functional disability at 5, 10, and 15 years (odds ratios of 2.00, 95% CI: 1.25–3.20; 2.51, 95% CI: 1.36–4.65; and 2.45, 95% CI: 0.91–6.61, respectively), adjusted for baseline age, self-rated health, and dispositional optimism. Risk status was not associated with self-rated health, dispositional optimism, or depressive symptoms at follow-up. Combined “classic” cardiovascular risk factors are not associated with impaired self-rated health or mental well-being in elderly men, but are predictive of functional disability.