Ribeiro Guilherme José Silva, Moriguchi Emilio Hideyuki, Pinto André Araújo
Graduate Program in Nutrition Science, Department of Nutrition, Federal University of Viçosa, Viçosa 36570-900, Brazil.
Graduate Program in Cardiology and Cardiovascular Sciences, Department of Cardiology, Federal University of Rio Grande do Sul, Rio Grande do Sul 90010-150, Brazil.
Healthcare (Basel). 2024 May 6;12(9):951. doi: 10.3390/healthcare12090951.
Given the aging global population, identifying heart failure (HF) phenotypes has become crucial, as distinct disease characteristics can influence treatment and prognosis in older adults. This study aimed to analyze the association between clustering of cardiovascular risk factors and HF in older adults. A cross-sectional epidemiological study was conducted with 1322 older adults (55% women, mean age 70.4) seen in primary health care. Diagnosis of HF was performed by a cardiologist based on diagnostic tests and medical history. Cardiovascular risk factors included hypertension, diabetes, hypercholesterolemia, and smoking. Using logistic regression, potential associations were tested. Individual risk factor analysis showed that older adults with hypertension, diabetes, or hypercholesterolemia had up to 7.6 times higher odds to have HF. The cluster where older adults had only one risk factor instead of none increased the odds of HF by 53.0%. Additionally, the odds of older patients having HF ranged from 3.59 times for the two-risk factor cluster to 20.61 times for the simultaneous presence of all four factors. The analysis of clusters substantially increasing HF risk in older adults revealed the importance of individualizing subgroups with distinct HF pathophysiologies. The clinical significance of these clusters can be beneficial in guiding a more personalized therapeutic approach.
鉴于全球人口老龄化，识别心力衰竭（HF）表型变得至关重要，因为不同的疾病特征会影响老年人的治疗和预后。本研究旨在分析老年人心血管危险因素聚集与HF之间的关联。对1322名在初级卫生保健机构就诊的老年人（55%为女性，平均年龄70.4岁）进行了横断面流行病学研究。由心脏病专家根据诊断测试和病史对HF进行诊断。心血管危险因素包括高血压、糖尿病、高胆固醇血症和吸烟。使用逻辑回归对潜在关联进行了测试。个体危险因素分析表明，患有高血压、糖尿病或高胆固醇血症的老年人患HF的几率高达7.6倍。老年人仅有一个而非没有危险因素的聚类使HF几率增加了53.0%。此外，老年患者患HF的几率在双危险因素聚类时为3.59倍，在同时存在所有四个因素时为20.61倍。对显著增加老年人HF风险的聚类分析揭示了区分具有不同HF病理生理学的亚组的重要性。这些聚类的临床意义有助于指导更个性化的治疗方法。
