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Examinando Enfermedades crónicas por Materia "ANCIANOS"
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Ítem Pulse blood pressure and cardiovascular mortality in a population-based cohort of elderly Costa Ricans(Journal of Human Hypertension; Volumen 30, Número 9, 2016) Rosero Bixby, Luis; Coto Yglesias, Fernando; Dow, William H.We studied the relationships between blood pressure (BP), pulse pressure (PP) and cardiovascular (CV) death in older adults using data from 2346 participants enrolled in the Costa Rican CRELES study, mean age 76 years (s.d. 10.2), 31% qualified as wide PP. All covariates included and analyzed were collected prospectively as part of a 4-year home-based follow-up; mortality was tracked for an additional 3 years, identifying 266 CV deaths. Longitudinal data revealed little change over time in systolic BP (SBP), a decline in diastolic BP, and widening of PP. Wide PP was associated with higher risk of CV death but only among individuals receiving antihypertensive drug therapy. Individuals with both wide PP and receiving therapy had 2.6 hazard rate of CV death relative to people with normal-PP plus not taking treatment (TRT), even adjusting for SBP. Increasing PP between visits was significantly associated to higher CV death independently of TRT status. SBP and DBP were not significantly associated to CV death when the effect of PP was controlled for. Conclusion: elderly hypertensive patients with wide or increasing PP, especially if receiving TRT, are the highest CV risk group, thus must be carefully assessed, monitored and treated with caution.Ítem Traditional rural dietary pattern and all-cause mortality in a prospective cohort study of elderly Costa Ricans: the Costa Rican Longevity and Healthy Aging Study (CRELES)(The American Journal of Clinical Nutrition, 2024) Zhang, Yundan; Cortés Ortiz, Mónica V.; Leung, Cindy W.; Baylin, Ana; Rosero Bixby, Luis; Ruiz Narváez, Edward A.Costa Rica, as many other Latin American countries, is experiencing a fast demographic aging. It is estimated that by 2030, 18.5% of the population, or almost 1 of every 5 Costa Ricans, will be 60 y or older, compared with 7.9% or 1 of every 13 Costa Ricans in 1999 [1]. As the population ages, chronic health conditions such as cardiovascular diseases (CVDs) and neurodegenerative disorders are expected to increase in prevalence posing growing challenges to the health of the Costa Rican population. With the demographic shift toward an aging population, there is an urgent need to study determinants of longevity and healthy aging. Diet—as part of a healthy lifestyle—is a key modifiable factor that may help to minimize the burden of age-related health conditions. Beans are a major source of protein and fiber in Costa Rican adults and part of traditional diets in most Latin American countries. High bean consumption has been found associated with a protective cardiometabolic prolife such as low total cholesterol and LDL cholesterol [2,3]. In the Costa Rican population specifically, intake of beans has been associated with lower risk of nonfatal myocardial infarction in middle-aged adults [4]. We recently reported that a traditional Costa Rican rural dietary pattern, rich in beans and rice, was associated with longer leukocyte telomeres—a marker of biologic aging—in Costa Rican adults 60 y and older [5]. However, no studies have examined whether adherence to a traditional diet in elderly Costa Ricans may also be associated with lower mortality. Because of the nutrition transition (i.e., a shift from traditional diets to an increased consumption of processed foods highs in sugars, fats, and salt) experienced by Costa Rica in the last decades [4,6,7], it is essential to evaluate the potential impact of traditional diets on promoting healthy aging and longevity within an aging population. In this study, we assessed the association between a traditional rural dietary pattern, as well as their major food components beans and rice, and all-cause mortality among elderly Costa Ricans aged 60 y and older at baseline. We hypothesized that higher scores on the traditional dietary pattern are associated with lower all-cause mortality in elderly Costa Ricans. We also assessed whether additional dietary patterns may be associated with all-cause mortality. We used longitudinal and nationally representative data from the Costa Rican Longevity and Healthy Aging Study (CRELES).