Contribution of traditional risk factors to 10-year survival in elderly male patients with coronary heart disease

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Abstract

Aim. To estimate the contribution of traditional risk factors to the prediction of fatal outcomes in elderly and senile male patients with coronary heart disease (CHD). Subjects and methods. A 10-year prospective cohort study (from early 1997) included 167 male CHD patients aged 60 years or older (mean age 76,3±0,5 years); a comparison group comprised 38 males (mean age 76,9±1,06) with chronic obstructive pulmonary disease (COPD) without clinical and other signs of CHD. A control group consisted of 32 males over 60 years old without signs of cardiovascular and pulmonary diseases, who had been admitted to the therapeutic unit of the same clinic during the same period. The examined patients were followed up for 10 years, by analyzing the disease course and monitoring fatal events. Results. The probability of predicting 10-year cardiovascular mortality significantly increased the presence of arterial hypertension and low physical activity (OR, 1,67; CI, 1,11–2,51; p=0,01 and OR, 1,454; CI, 1,091–1,393; p=0,01). Elevations of systolic blood pressure up to 150 mm Hg or higher increased the risk of death from all causes in the examined males with CHD by 1.37-fold (p<0,05), from cardiovascular causes by 1,65-fold (p<0,05), chronic forms of CHD by 2,01-fold, acute myocardial infarction by 8-fold (p<0,05), and stroke by 2.13-fold. When obesity was concurrent with arterial hypertension, the likelihood of death was higher than when only a factor of obesity was present and was lower when arterial hypertension was. A combination of smoking and arterial hypertension increased the relative risk of death by 2.6 times. The maximum likelihood of death was found when there was a combination of arterial hypertension and low physical activity (p=0,02). The contribution of overweight only and smoking only (without combination with other risk factors) to cardiovascular mortality was insignificant. Conclusion. Thus, the higher spread of risk factors other than smoking was revealed in the examined patients with CHD and COPD than that in apparently healthy individuals. The contribution of traditional risk factors to cardiovascular mortality in elderly and senile males with existing CHD varies. Assessment of each factor permits prediction of the rate of disease progression, the development of complications, and clinical outcomes.

About the authors

E. G Volkova

Department of Therapy, Functional Diagnosis, Preventive and Family Medicine, Ural State Medical Academy of Postgraduate Education, Federal Agency for Health Care and Social Development, Chelyabinsk

д-р мед. наук, проф., проректор по НИР и международным связям ГОУ ДПО УГМАДО Росздрава, зав. каф. терапии, функциональной диагностики, профилактической и семейной медицины, гл. кардиолог МЗ Челябинской обл.

I. V Tantsyreva

Department of Therapy, Functional Diagnosis, Preventive and Family Medicine, Ural State Medical Academy of Postgraduate Education, Federal Agency for Health Care and Social Development, Chelyabinsk

канд. мед. наук; зам. гл. врача по медицинским вопросам Муниципального учреждения здравоохранения Городской клинической поликлиники №8 г. Челябинска

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