Serum albumin and physical function as predictors of coronary heart disease mortality and incidence in older persons
Abstract
The role of traditional risk factors in predicting coronary heart disease (CHD) among men and women aged 65 years and over has been extensively debated, but the search for risk factors that are distinctive in the elderly is still ongoing. The relation of serum albumin levels and physical disability to risk of CHD morality and incidence was prospectively assessed in a cohort of 4116 men and women, aged 71 years and over, who were evaluated in 1987-1989 and followed for a mean of 4.0 years. Outcome events were based on death certificates and Medicare hospitalization records. Analyses were adjusted for major CHD risk factors. There were 275 CHD deaths (16.8/1000 person-years) among all participants and 503 incident (fatal and nonfatal) CHD events (39.4 per 1000 person-years) among participants free of prevalent CHD during the observation period. The relative risk (RR) of CHD morality for women with an albumin concentration < 38 g/liter was 2.5 times higher than for women with albumin > 43 g/liter (RR 2.5; 95% confidence interval [CI], 1.4-4.6). There was a significant and graded increase in CHD incidence with decreasing albumin concentration in women but not in men. The presence of physical disability doubled the risk of CHD mortality among both men and women, an increase in risk that was comparable to that imposed by a previous myocardial infarction and was independent of other coronary risk factors. Disability had a lesser impact on CHD incidence, which was significant only in women. Low albumin concentration (< 38 g/liter) identifies a group of women at higher risk of CHD mortality and incidence. Physical disability is an independent predictor of CHD mortality in both men and women and for CHD incidence only in women.
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Strong evidence from multiple large observational studies indicates that CVD is a risk factor for frailty and that frail patients are more likely to develop CVD than non-frail individuals.
“Strong evidence from multiple, large, observational studies indicates that the presence of CVD is a risk factor for frailty and that patients with frailty are more likely to develop CVD than those who are not frail”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [202]
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- Authors
- Corti, M.-C., Salive, M. E., & Guralnik, J. M.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Corti, Maria-Chiara
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 1996-05
- Volume
- 49
- Issue
- 5
- Pages
- 519-526
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W1998170975
- Cited by
- 107
- References
- 54
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 1 · 2015: 8 · 2014: 1 · 2013: 2 · 2012: 4
- FWCI
- 2.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (N01AG02106, N01-AG-0-2104, N01-AG02107)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- serum albumin, physical disability, coronary heart disease mortality, coronary heart disease incidence, older adults, sex differences, cardiovascular risk factors, myocardial infarction
- MeSH terms
- Aged, Aged, 80 and over, Coronary Disease, Female, Disabled Persons, Persons with Disabilities, Humans, Male, Prospective Studies, Risk Factors, Serum Albumin, Sex Factors, United States, Incidence, Survival Rate, Multivariate Analysis
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