4 research outputs found
EFFETTO DELLA COMORBILITÀ SULLA MORTALITÀ A LUNGO TERMINE IN SOGGETTI ANZIANI CON INSUFFICIENZA CARDIACA CRONICA
Physical activity is inversely related to drug consumption in elderly patients with cardiovascular events
Abstract
Elderly patients with cardiovascular events are characterized by high drug consumptions. Whether high drug consumptions are related to physical activity is not known. In order to examine whether physical activity is related to drug consumption in the elderly, patients older than 65 years (n = 250) with a recent cardiovascular event were studied. Physical activity was analyzed according to the Physical Activity Scale for the Elderly (PASE) score and related to drug consumption. PASE score was 72.4 ± 45.0 and drug consumption was 8.3 ± 2.2. Elderly patients with greater comorbidity took more drugs (8.7 ± 2.1) and are less active (PASE = 64.4 ± 50.6) than patients with Cumulative Illness Rating Scale severity score higher than 1.8 than those with a score lower than 1.8 (76.3 ± 41.4, p < 0.05, and 8.0 ± 2.0, p = 0.006, respectively). Multivariate analysis correlation confirmed that PASE score is negatively associated with drug consumption (β = −0.149, p = 0.031), independently of several variables including comorbidity. Thus, physical activity is inversely related to drug consumption in elderly patients with cardiovascular events. This inverse relationship may be attributable to the high degree of comorbidity observed in elderly patients in whom poor level of physical activity and high drug consumption are predominant
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Mortality and heart rate in the elderly: role of cognitive impairment
Mortality related to heart rate ( HR) increase in the elderly has not yet been well established. To ascertain the relationships among cognitive impairment ( CI), mortality, and HR increase, the authors prospectively studied a random sample of elderly subjects stratified according to presence or absence of CI. Elderly subjects randomly selected in 1991 ( n = 1332) were followed up for 12 years. Mortality was established in 98.1% of the subjects. When HR was stratified in quartiles (< 69,70-75,76-80, and > 80 bpm), mortality was linearly associated with increased HR in all ( from 47.7 to 57.0; r(2) = .43, p = .019) and in subjects without ( from 41.7 to 51.1%; r(2) = .50, p = .043) but not in those with CI ( from 57.5 to 66.1; r(2) = .20, p = .363). Cox regression analysis, adjusted for several variables, shows that HR doesn't predict mortality in all subjects ( RR 0.69; 95% CI = 0.27-1.73) or in those with CI ( RR 0.91; 95% CI = 0.81-1.02). In contrast, HR predicts mortality in subjects without CI ( RR 1.10; 95% CI = 1.00-1.22). Hence, HR increase is a predictor of mortality in elderly subjects without CI. However, when considering all elderly subjects and those with CI, HR increase seems to have no effect on mortality. Thus, CI should be considered when focusing on HR increase as risk factor for mortality in the elderly
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Echocardiographic evaluation of left ventricular end-systolic elastance in the elderly
Background: The aging heart is characterized by structural changes, which are implicated in the development of left ventricular diastolic dysfunction. However, important changes in systolic function may also occur. Left ventricular end-systolic elastance (E-es) is a major determinant of cardiac systolic function and ventricular-arterial interaction.Aim: To evaluate left-ventricular E-es in elderly subjects compared with adult control subjects.Methods: We studied dilated (DA, n=14) and hypertensive (HA, n=21) cardiomyopathy patients, and both adult control (A, 11=25; age 55.6 +/- 6.6 years) and elderly (E, n=25; age 76.3 +/- 7.1 years) subjects without clinical-instrumental evidence of cardiovascular disease. M-mode, two-dimensional, and pulsed Doppler echocardiogram were performed. Doppler-derived indices of diastolic function were assessed and E-es was calculated by a modified single-beat method.Results: E-es was reduced in dilated cardiomyopathy (1.32 +/- 0.10 mmHg/ml) and increased in hypertensive cardiomyopathy(3.12 +/- 0.33 mm Hg/ml) patients compared to age-matched control subjects (1.96 +/- 0.26 mm Hg/ml; p < 0.01 and p < 0.05, respectively). More importantly, E-es was higher in the elderly (2.52 +/- 0.70 mm Hg/ml) than in the adult control group (p < 0.05) and was linearly correlated with age (r(2)=0.639; p < 0.0001).Conclusion: Age-related increase in E-es together with diastolic dysfunction, may lead to aging heart decompensation. (c) 2004 European Society of Cardiology. Published by Elsevier B.V. All rights reserved