Waist circumference in older adults shown important risk factor for mortality
Jacobs E. Arch Intern Med. 2010;170:1293-1301.
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Waist circumference regardless of BMI proved to be an important risk factor for mortality in older adults, according to a study appearing in Archives of Internal Medicine.
The study featured patients (n=104,843, 53.7% women) at least 50 years of age from the Cancer Prevention Study II Nutrition Cohort. BMI categories were defined as normal (18.5 to <25), overweight (25 to <30) and obese (≥30). Patients were excluded if they had missing information regarding waist circumference or BMI, waist circumference values determined extreme or implausible, BMI determined underweight or extreme, or unknown smoking status.
According to study results, high levels of waist circumference correlated with a roughly twofold higher risk for mortality in patients (men, RR=2.02; 95% CI, 1.71-2.39 for waist circumference ≥120 cm vs. <90 cm; women, RR=2.36; 95% CI, 1.98-2.82 for waist circumference ≥110 cm vs. <75 cm). Further, researchers found that waist circumference was associated with mortality within all BMI categories
Additional findings indicated that a 10-cm increase in waist circumference for men was associated with the following RRs: 1.16 (95% CI, 1.09-1.23) for normal BMI, 1.18 (95% CI, 1.12-1.24) for overweight BMI and 1.21 (95% CI, 1.13-1.30) for obese BMI. This same incremental increase in women corresponded with RRs of 1.25 (95% CI, 1.18-1.32) for normal BMI, 1.15 (95% CI, 1.08-1.22) for overweight and 1.13 (95% CI, 1.06-1.20) for obese.
“Results from this large, prospective study emphasize the importance of waist circumference as a risk factor for mortality in older adults, regardless of whether the BMI is categorized as normal, overweight or obese,” the researchers concluded. “Our results suggest that, regardless of weight, avoiding gains in waist circumference may reduce risk of premature mortality.”
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Acute, hospital-acquired anemia found common in patients with acute MI
Salisbury AC. Circ Cardiovasc Qual Outcomes. 2010;3:337-346.
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Nearly half of the patients with acute MI who were treated medically or with percutaneous coronary intervention developed acute, hospital-acquired anemia, according to the outcomes of a new study.
Researchers identified patients (≥18 years, n=2,909) with acute MI who had normal hemoglobin on admission in the TRIUMPH multicenter registry. They used criteria proposed by Beutler and Waalen to define acute, hospital-acquired anemia (HAA), and they identified independent correlates of HAA and multivariable proportional hazards regression to identify the relationship between HAA and mortality and health status.
Of the study patients, 1,321 (45.4%) had HAA, with 348 (26.3%) developing moderate-severe HAA (hemoglobin <11 g/dL). Incidence of HAA varied across hospitals (range, 33%-69%; median rate ratio for HAA, 1.13; 95% CI, 1.07-1.23). Fewer than half of the patients with moderate-severe HAA had documented bleeding, although documented bleeding was more frequent with more severe HAA.
Researchers determined the following as independent correlates of HAA: age, female sex, white race, STEMI, chronic kidney disease, acute renal failure, use of glycoprotein IIb/IIIa inhibitors, in-hospital complications and length of stay.
“We found that HAA is common in acute MI patients who are treated medically or with PCI and varies significantly across hospitals,” the researcher concluded. “Development of moderate-severe HAA is associated with higher mortality and worse health status in the first year after acute MI, independent of documented in-hospital bleeding. Better understanding of whether prevention of HAA is feasible and can improve patient outcomes is needed.”