Cardiovascular risk factors predictive for survival and morbidity-free survival in the oldest-old Framingham Heart Study participants.
OBJECTIVE
To examine whether midlife cardiovascular risk factors predict survival and survival free of major comorbidities to the age of 85.


METHODS
Prospective community-based cohort study.


METHODS
Framingham Heart Study, Massachusetts.


METHODS
Two thousand five hundred thirty-one individuals (1,422 women) who attended at least two examinations between the ages of 40 and 50.


METHODS
Risk factors were classified at routine examinations performed between the ages of 40 and 50. Stepwise sex-adjusted logistic regression models predicting the outcomes of survival and survival free of morbidity to age 85 were selected from the following risk factors: systolic and diastolic blood pressure, total serum cholesterol, glucose intolerance, cigarette smoking, education, body mass index, physical activity index, pulse pressure, antihypertensive medication, and electrocardiographic left ventricular hypertrophy.


RESULTS
More than one-third of the study sample survived to age 85, and 22% of the original study sample survived free of morbidity. Lower midlife blood pressure and total cholesterol levels, absence of glucose intolerance, nonsmoking status, higher educational attainment, and female sex predicted overall and morbidity-free survival. The predicted probability of survival to age 85 fell in the presence of accumulating risk factors: 37% for men with no risk factors to 2% with all five risk factors and 65% for women with no risk factors to 14% with all five risk factors.


CONCLUSIONS
Lower levels of key cardiovascular risk factors in middle age predicted overall survival and major morbidity-free survival to age 85. Recognizing and modifying these factors may delay, if not prevent, age-related morbidity and mortality.
Terry
Dellara F
DF
Department of Geriatrics, Boston Medical Center, School of Medicine, Boston University, Boston, Massachusetts 02118, USA. laterry@bu.edu
Pencina
Michael J
MJ
Vasan
Ramachandran S
RS
Murabito
Joanne M
JM
Wolf
Philip A
PA
Hayes
Margaret Kelly
MK
Levy
Daniel
D
D'Agostino
Ralph B
RB
Benjamin
Emelia J
EJ
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis