Cardiovascular health of nonagenarians in southern Italy: a cross-sectional, home-based pilot study of longevity
Cardiovascular health of nonagenarians in southern Italy: a cross-sectional, home-based pilot study of longevity
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DOI：
10.2459/jcm.0000000000000910
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发表时间：
2020-02-01
影响因子：
3
通讯作者：
Di Somma, Salvatore
中科院分区：
文献类型：
--
作者：
Daniels, Lori B.;Antonini, Paula;Di Somma, Salvatore
背景意大利南部的奇伦托地区的90岁和百岁老人的患病率很高。很少有最古老的研究包括超声心动图和/或心电图数据，在家庭为基础的设置。目的：本试验研究的目的是通过一项全面的、基于家庭的心血管评估，描述来自奇伦托的90岁和百岁老人及其年轻同居者样本的主要生活方式、医疗、超声心动图和心电图特征。最终目的是确定与长寿相关的心血管特征和生活方式因素。方法26名90岁和百岁老人（平均年龄94 +/- 3岁）和48名年龄在50-75岁（平均62 +/- 5岁）的年轻同居者在家中接受了全面的心血管评估。结果与他们年轻的同居者相比，90岁和百岁老人不吸烟，空腹血糖水平较低，LDL胆固醇较低，尽管服用他汀类药物的可能性只有一半，并且对地中海饮食的坚持程度相似。超过一半的90岁和100岁的老人（15/26）仍然能够自主地进行日常生活活动。在90岁和100岁的老人中，自我报告的冠状动脉疾病和中风的患病率较低（11.5%），尽管有相当数量的人患有房颤（31%）或充血性心力衰竭（27%）。尽管62%的90岁和百岁老人在超声心动图上至少有中度瓣膜病，但只有不到25%的患者报告呼吸困难。结论奇伦托地区的90岁和百岁老人具有健康的代谢特征，临床心血管疾病的患病率较低。即使在结构性心脏异常的90岁和百岁老人中，症状的报告也很低。对奇伦托人群进行更大规模的研究可能有助于阐明高龄老人心血管健康的潜在机制。
Background The Cilento region of southern Italy has a high prevalence of nonagenarians and centenarians. Few studies of the oldest old have included echocardiographic and/or electrocardiographic data, in a home-based setting. Objectives The objective of this pilot study was to delineate the key lifestyle, medical, echocardiographic, and electrocardiographic features of a sample of nonagenarians and centenarians and their younger cohabitants from Cilento, via a comprehensive, home-based cardiovascular assessment. The ultimate aim is to identify the cardiovascular profile and lifestyle factors associated with longevity. Methods Twenty-six nonagenarians and centenarians (mean age 94 +/- 3 years) and 48 younger cohabitants aged 50-75 years (mean 62 +/- 5) underwent a comprehensive cardiovascular evaluation in their homes. Results In contrast to their younger cohabitants, nonagenarians and centenarians did not smoke, had lower fasting glucose levels, and lower LDL cholesterol despite being half as likely to be taking statins, and showing similar adherence to a Mediterranean diet. Over half of nonagenarians and centenarians (15/26) remained autonomous with their activities of daily living. Prevalence of self-reported coronary artery disease and stroke among nonagenarians and centenarians was low (11.5%), though a significant number had atrial fibrillation (31%) or congestive heart failure (27%). Although 62% of nonagenarians and centenarians had at least moderate valvular disease on echocardiography, less than 25% of those affected reported dyspnea. Conclusion Nonagenarians and centenarians in the Cilento region had a healthy metabolic profile and a low prevalence of clinical cardiovascular disease. Even among nonagenarians and centenarians with structural heart abnormalities, report of symptoms is low. Larger studies in the Cilento population may help elucidate the mechanisms underlying cardiovascular health in the oldest old.