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Changes in Cardiovascular Health Status and Risk of Sudden Cardiac Death in Older Adults

Yonsei Medical Journal 2021년 62권 4호 p.298 ~ 305
김민, 양필성, 유희태, 김태훈, 장은선, 엄재선, 박희남, 이문형, 정보영,
소속 상세정보
김민 ( Kim Min ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
양필성 ( Yang Pil-Sung ) - CHA University CHA Bundang Medical Center Department of Cardiology
유희태 ( Yu Hee-Tae ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
김태훈 ( Kim Tae-Hoon ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
장은선 ( Jang Eun-Sun ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
엄재선 ( Uhm Jae-Sun ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
박희남 ( Pak Hui-Nam ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
이문형 ( Lee Moon-Hyoung ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine
정보영 ( Joung Bo-Young ) - Yonsei University College of Medicine Severance Cardiovascular Hospital Department of Internal Medicine

Abstract


Purpose: Cardiovascular health (CVH) status is associated with several cardiovascular outcomes; however, correlations between changes in CVH status and risk of sudden cardiac death (SCD) are unknown. We aimed to evaluate associations between changes in CVH status and risk of SCD and all-cause death in older adults.

Materials and Methods: We used data from the Korea National Health Insurance Service-Senior cohort database (2005?2012). Six metrics from the American Heart Association (smoking, body mass index, physical activity, blood pressure, total cholesterol, and fasting blood glucose) were used to calculate CVH scores. Changes in CVH status between two health checkups were categorized as low to low, low to high, high to low, and high to high.

Results: We included 105200 patients whose CVH status for an initial and follow-up health checkup (2-year interval) was available. During a median of 5.2 years of follow-up after a second health checkup, 688 SCDs occurred. Compared to patients with a persistent low CVH status, those with a consistently high CVH status had a reduced risk of SCD [adjusted hazard ratio (HR), 0.69; 95% confidence interval (CI), 0.56?0.86] and all-cause death (adjusted HR, 0.74; 95% CI, 0.69?0.78). The risk of all-cause death followed similar trends. However, an inconsistent linear relationship was observed for changes in CVH status and the risk of SCD, but not of all-cause death.

Conclusion: Maintaining a high CVH status was associated with future risks of SCD and all-cause death among an older adult population.

키워드

Sudden cardiac death; mortality; health status index; elderly

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