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Evidence is presented of low magnesium and albumin serum levels, especially in women with low bone density, as well as of low calcium and trace minerals.

Background: The plasma brain natriuretic peptide (BNP) level in elderly patients is elevated, but the mechanism of this increase is not clear. Objective: To examine the relationship between left ventricular geometry and BNP levels in elderly subjects. Methods: We investigated the effects of left ventricular (LV) geometry on plasma BNP levels by measuring these levels in elderly patients with or without LV hypertrophy. Patients were classified into 4 groups based on echocardiographic data: normal geometry; concentric remodeling; eccentric hypertrophy (EH), and concentric hypertrophy (CH). The samples were analyzed for BNP and endothelin-1 (ET-1). Results: Among the 4 groups, there were no differences in plasma ET-1 levels, ejection fraction, percent fractional shortening, or indices of diastolic function. Plasma BNP levels in EH and CH were higher than those in the normal geometry and concentric remodeling groups. There was a good correlation between plasma BNP levels and the relative wall thickness in EH, and between plasma BNP levels and the posterior wall thickness in CH (r = –0.474, r = 0.396, respectively, both p < 0.05). There were also good correlations between plasma BNP levels and LV mass index (LVMI). A stepwise multiple regression analysis showed that age and LVMI were significant independent contributors to plasma BNP levels. Conclusions: These results suggest that aging, increased wall stress and the extent of cardiac hypertrophy contribute to elevated BNP levels in the elderly.

Background and Objective: Recently, attention has been focused on endothelin-1 (ET-1) as an indicator of atherosclerosis. However, normal levels of ET-1 are frequently found in elderly patients. We investigated the relationships between echocardiographic findings and ET-1 in 117 inpatients for rehabilitation. Methods: The patients were 34 men and 83 women, 83.4 ± 0.8 years old (mean ± SE), with the following diseases: cerebrovascular diseases (n = 83), cardiovascular diseases of New York Heart Association Class I or II (n = 57), diabetes mellitus (n = 11) and hyperlipidemia (n = 12). Ejection fraction (EF) and left ventricular mass index (LVMI) were calculated by echocardiographic studies. Results: The average ET-1 was within the normal range, but a significant positive correlation was observed between age and ET-1 (ET-1 = 1.8 ± 0.1 pg/ml, r = 0.248, p < 0.01). Moreover, plasma ET-1 was positively correlated to total cholesterol and to low density lipoprotein cholesterol in patients with a history of hypertension (n = 41, r = 0.318 and r = 0.314, both p < 0.05). Gender was not a significant factor. There was no significant difference in ET-1 between patients with mild renal dysfunction (n = 54) and patients with normal renal function (n = 63) (blood urea nitrogen = 30.9 ± 2.4 vs. 15.1 ± 0.5 mg/dl, serum creatinine = 1.03 ± 0.06 vs. 0.59 ±0.02 mg/dl, ET-1 = 1.7 ± 0.1 vs. 1.8 ± 0.1 pg/ml), or between patients with (n = 50) and without (n = 67) left ventricular hypertrophy (LVMI = 146 ± 6 vs. 83 ± 2 g/m², ET-1 = 1.8 ± 0.1 vs. 1.8 ± 0.1 pg/ml). There was no difference in ET-1 between patients with EF <50% (n = 27) and EF ≥50% (n = 90) (ET-1 = 1.8 ± 0.2 vs. 1.7 ± 0.1 pg/ml). Conclusion: There were no significant relationships between echocardiographic findings and ET-1 in elderly subjects without overt heart failure. However, in patients with a history of hypertension, measuring ET-1 may be useful for estimating the extent of atherosclerosis.

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