Major cardiovascular disease (CVD) risk factors in midlife and extreme longevity

Abstract

Background The studies on the association of various midlife risk factors with reaching 90 years or more are scarce. We studied this association in a socioeconomically homogenous cohort of businessmen. Methods The study consists of men (n = 970) from the Helsinki Businessmen Study cohort (born 1919–1928). Five major cardiovascular disease (CVD) risk factors (smoking, BMI, blood pressure, serum lipids, fasting glucose), consumption of alcohol and coffee, self-rated health and self-rated fitness, were assessed in 1974, at an average age of 50 years. The number of major risk factors was tested as a risk burden. The Charlson Comorbidity Index and the RAND-36 (SF-36) Physical and Mental health summary scores were calculated from surveys in year 2000, at age of 73 years. Mortality dates were retrieved through 31 March 2018 from the Population Information System of Finland. Results 244 men survived to the age of 90 representing 25.2% of the study cohort. The survivors had less risk factor burden in midlife, and less morbidity and higher physical health summary score in 2000. Of those with five major risk factors only 7% survived up to 90 years, whereas 51% of those without any risk factors reached that age. Single risk factors reducing odds of reaching 90 years were smoking (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.34–0.67), glucose (0.66, 0.49–0.88), BMI (0.63, 0.46–0.86), and cholesterol (0.71, 0.53–0.96). Conclusion Lack of five major CVD risk factors in midlife strongly increased odds of reaching 90 years of age and also predicted factors related to successful ageing in late life.

Cardiovascular risk factors and lifestyle behaviours in relation to longevity: a Mendelian randomization study

“…Blood pressure, LDL cholesterol, smoking initiation and educational level were robustly associated with longevity in this MR study without indication of violation of the MR assumptions. Moreover, the associations were in similar direction as previously reported by prospective observational studies [5,7,8,10,11] and by the previous MR study on cardiovascular risk factors and parental longevity [13], although they used a smaller number of SNPs as instrumental variables. Taken together, these traditional cardiovascular risk factors are likely to be causally associated with longevity.…”

“…The goal was to optimize cardiovascular health by focusing on seven modifiable risk factors, including three cardiovascular risk factors (glucose, blood pressure and cholesterol) and four lifestyle behaviours (body mass index (BMI), smoking, physical activity and diet). Cardiovascular disease remains the leading cause of death worldwide [4] , and the majority of the Life's Simple 7 modifiable risk factors have been associated with longevity in previous prospective observational studies [5][6][7][8][9][10][11]. Yet, from these observational studies it is not possible to infer causality, due to potential reverse causation bias and residual confounding.…”

Reply to the Letter “Coffee consumption and extreme longevity: a risk assessment”

“…We would like to thank Dr. Tomoyuki Kawada [1] for his interest in our manuscript "Major cardiovascular disease (CVD) risk factors in midlife and extreme longevity" [2].…”

Coffee consumption and extreme longevity: a risk assessment

“…Urtamo et al conducted a prospective study to investigate the cardiovascular disease (CVD) risk and protective factors for extreme longevity [1]. Adjusted odds ratios of smoking, glucose intolerance, BMI and total cholesterol were significant, and adjusted odds ratios of systolic blood pressure, alcohol, self-rated health, and self-rated fitness did not reach the level of significance.…”

“…Third, unfiltered coffee consumption relates to the significant increases of low-density lipoprotein cholesterol and triglyceride levels, which is not observed in filtered coffee [4]. Urtamo et al specified that increased total cholesterol was inversely related to extreme longevity [1], and lipid metabolism should be considered by considering the sub classification and related lifestyle factors.…”