Inflammatory markers, clinical and subclinical cardiovascular disease in older persons: the Health ABC study

Abstract

P37 Inflammation is a potentially important mechanism underlying cardiovascular disease (CVD). Several studies have assessed the asociations of inflammation with clinical CVD, but data on inflammation and sub-clinical CVD are limited. We assessed the association of C-reactive protein (CRP) and interleukin-6 (IL-6) with clinical and subclinical CVD in the Health and Body Composition study (Health ABC), a cohort study of 3075 well functioning older adults living in Memphis, TN, and Pittsburgh, PA. Mean±SDM age was 73.6±2.9 years, 51.5% were women and 41.7% were African American. History of heart attack, heart failure, stroke, peripheral artery disease or CV procedures was reported by 31.4% of participants. Subclinical disease (positive Rose questionnaire for angina or claudication, ECG abnormalities, or ankle brachial index <0.9 in persons with no clinical CVD) was found in 32.4% of participants. CRP (mean 2.31±3.01 μg/ml, range 0.16-54.03 μg/ml) was measured in 1370 participants, and IL-6 (mean±SDM 2.39±1.92 ng/ml, range 0.21-15.96 ng/ml) was measured in 2824 participants. After adjustment for age, gender, race, site, history of diabetes, smoking status, body-mass index, use of anti-inflammatory drugs and serum cholesterol, HDL cholesterol, creatinine and albumin, higher CRP levels were significantly associated with a higher risk of clincal CVD, but not with risk of subclinical CVD (p for trend with increasing IL-6 tertiles =0.0082 and =0.55)(see Table). Higher IL-6 levels were significantly associated with a higher risk of both clinical and sub-clinical CVD (p for trend with increasing IL-6 tertiles <0.0001 and =0.0003). Table 1.