Abstract 12233: Low Cardiovascular Risk in Midlife Predicts Active and Healthy Aging

Abstract

Introduction and hypothesis: Low cardiovascular disease (CVD) risk in midlife predicts survival and fewer CVD events up to old age. But do they also predict a broad concept of “active and healthy aging” (“successful aging”)? We studied this in our long-term cohort. Methods: The Helsinki Businessmen Study is a follow-up study of socioeconomically homogenous cohort of men born 1919-1934 (n=3293). Midlife (average age 42 years) risk factors included BMI, smoking, cholesterol, blood pressure, and one-hour glucose. Total CVD risk was also assessed with Keys’ risk score including age, BMI, smoking, cholesterol, and systolic blood pressure. Mortality follow-up was through 2010 whereupon mailed questionnaire data, including lifestyle, diseases, and quality of life was obtained from survivors. As there is no consensus criteria on active and healthy aging, our definition included the following 6 criteria which in general could be considered important: survival to an average age of 82 years, and 5 dimensions related to health, wellbeing, and physical, cognitive, and social functioning. In the analyses we divided the cohort into 3 age groups: men born 1919-1924 (n=969), 1925-1929 (n=1481), and 1930-1934 (n=843). Results: By 2010, 1788 of the midlife cohort had died and 894 (59% of survivors) responded to mailed questionnaire survey. According to our definition, only 154 men (4.8%) of the whole cohort experienced active and healthy aging fulfilling all 6 criteria. Of the individual midlife CVD risk factors only higher systolic blood pressure reduced odds of active and healthy aging (OR per SD 0.65. 95% CI 0.52 to 0.82, P<0.001) in adjusted analyses. Keys’ score was a powerful predictor of active and healthy aging overall (OR per SD of log value: 0.49, 95% CI 0.41-0.60, P<0.001), and in all age groups. ORs were: 0.52, 95% CI 0.29-0.95 (P=0.03); 0.52, 95% CI 0.38-0.72 (P<0.001), and 0.65, 95% CI 0.46-0.92 (P=0.01) in the oldest, middle and youngest age group, respectively. Conclusions: From a life-course viewpoint, active and healthy aging was relatively infrequent among men of higher social class. Lower systolic blood pressure and CVD risk overall in early midlife strongly predicted active and healthy aging giving impetus to controlling CVD risk in time in aging societies.