3 research outputs found
Ten-Year Survival in 75-Year-Old Men and Women: Predictive Ability of Total Cholesterol, HDL-C, and LDL-C
Objective. The purpose of this study was to investigate prognostic impact of cholesterol and its subfractions among 75-year-old people from the general population. Methods and Results. The study comprised a random sample (222 women and 210 men) from the general population (participation rate 70%). During 10-year follow-up, 19% of women and 35% of men experienced a major cardiovascular event (MCVE). The all-cause mortality was 29% for women and 47% for men. After adjustment for cardiovascular risk factors, a low level of high-density lipoprotein cholesterol (HDL-C) was significantly associated with MCVE (P = .006) and mortality (P = .011) in men but not in women. The prognostic sex disparity was nearly significant (P = .051 for MCVE and .067 for mortality). The associations of adjusted HDL-C to MCVE and mortality were unchanged after excluding individuals with prevalent stroke or MI. Total cholesterol and low-density lipoprotein cholesterol (LDL-C) were not significantly related to prognosis in either sex. Main Conclusions. HDL-C was associated with dismal prognosis in men but not in women. Elderly men with HDL-C <40 mg/dL deserve particular attention for cardiovascular prevention
Mitotic and meiotic chromosomes of the variable hare (Lepus timidus L.), the common hare (Lepus europaeus Pall.) and their hybrids
Global variations in heart failure etiology, management, and outcomes
Importance: Most epidemiological studies of heart failure (HF) have been conducted in high-income countries with limited comparable data from middle- or low-income countries.
Objective: To examine differences in HF etiology, treatment, and outcomes between groups of countries at different levels of economic development.
Design, Setting, and Participants: Multinational HF registry of 23âŻ341 participants in 40 high-income, upperâmiddle-income, lowerâmiddle-income, and low-income countries, followed up for a median period of 2.0 years.
Main Outcomes and Measures: HF cause, HF medication use, hospitalization, and death.
Results: Mean (SD) age of participants was 63.1 (14.9) years, and 9119 (39.1%) were female. The most common cause of HF was ischemic heart disease (38.1%) followed by hypertension (20.2%). The proportion of participants with HF with reduced ejection fraction taking the combination of a ÎČ-blocker, renin-angiotensin system inhibitor, and mineralocorticoid receptor antagonist was highest in upperâmiddle-income (61.9%) and high-income countries (51.1%), and it was lowest in low-income (45.7%) and lowerâmiddle-income countries (39.5%) (Pâ<â.001). The age- and sex- standardized mortality rate per 100 person-years was lowest in high-income countries (7.8 [95% CI, 7.5-8.2]), 9.3 (95% CI, 8.8-9.9) in upperâmiddle-income countries, 15.7 (95% CI, 15.0-16.4) in lowerâmiddle-income countries, and it was highest in low-income countries (19.1 [95% CI, 17.6-20.7]). Hospitalization rates were more frequent than death rates in high-income countries (ratioâ=â3.8) and in upperâmiddle-income countries (ratioâ=â2.4), similar in lowerâmiddle-income countries (ratioâ=â1.1), and less frequent in low-income countries (ratioâ=â0.6). The 30-day case-fatality rate after first hospital admission was lowest in high-income countries (6.7%), followed by upperâmiddle-income countries (9.7%), then lowerâmiddle-income countries (21.1%), and highest in low-income countries (31.6%). The proportional risk of death within 30 days of a first hospital admission was 3- to 5-fold higher in lowerâmiddle-income countries and low-income countries compared with high-income countries after adjusting for patient characteristics and use of long-term HF therapies.
Conclusions and Relevance: This study of HF patients from 40 different countries and derived from 4 different economic levels demonstrated differences in HF etiologies, management, and outcomes. These data may be useful in planning approaches to improve HF prevention and treatment globally