Health-related quality of life and incident cardiovascular disease events in community-dwelling older people: A prospective cohort study

on behalf of the ASPREE Investigator Group

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Abstract

Background: Lower health-related quality of life (HRQoL) has been shown to predict a higher risk of hospital readmission and mortality in patients with cardiovascular disease (CVD). Few studies have explored the associations between HRQoL and incident CVD. We explored the associations between baseline HRQoL and incident and fatal CVD in community-dwelling older people in Australia and the United States. Methods: Longitudinal study using ASPirin in Reducing Events in the Elderly (ASPREE) trial data. This includes 19,106 individuals aged 65–98 years, initially free of CVD, dementia, or disability, and followed between March 2010 and June 2017. The physical (PCS) and mental component scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Incident major adverse CVD events included fatal CVD (death due to atherothrombotic CVD), hospitalizations for heart failure, myocardial infarction or stroke. Analyses were performed using Cox proportional-hazard regression. Results: Over a median 4.7 follow-up years, there were 922 incident CVD events, 203 fatal CVD events, 171 hospitalizations for heart failure, 355 fatal or nonfatal myocardial infarction and 403 fatal or nonfatal strokes. After adjustment for sociodemographic, health-related behaviours and clinical measures, a 10-unit higher PCS, but not MCS, was associated with a 14% lower risk of incident CVD, 28% lower risk of hospitalization for heart failure and 15% lower risk of myocardial infarction. Neither PCS nor MCS was associated with fatal CVD events or stroke. Conclusion: Physical HRQoL can be used in combination with clinical data to identify the incident CVD risk among older individuals.

Original languageEnglish
Pages (from-to)170-178
Number of pages9
JournalInternational Journal of Cardiology
Volume339
Early online date7 Jul 2021
DOIs
Publication statusPublished - 15 Sep 2021

Bibliographical note

Funding Information:
This was mainly supported by grants from the National Institute on Ageing and the National Cancer Institute at the U.S. National Institutes of Health (grant number U01AG029824 and U19AG062682 ); the National Health and Medical Research Council of Australia (grant numbers 334047 and 1127060 ); Monash University (Australia) and the Victorian Cancer Agency (Australia). Other funding resources and collaborating organizations of the ASPREE study are listed on http://www.aspree.org . AZZP is supported by Monash International Tuition Scholarship (Medicine, Nursing, and Health Sciences) and Monash Graduate Scholarship ( 30072360 ). RFP is supported by a National Heart Foundation of Australia Postdoctoral Fellowship ( 101927 ). JR and CMR are supported by a National Health and Medical Research Council Dementia Research Leader Fellowship ( APP 1135727 ) and Principal Research Fellowship ( APP1136372 ) respectively. Funders played no role in the design of the study, in the collection, analysis, and interpretation of data and in the writing of the manuscript.

Publisher Copyright:
© 2021 Elsevier B.V.

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