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      Association between vitamin D deficiency and heart failure risk in the elderly

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          Abstract

          Aims

          The aim of this study was to evaluate the association between vitamin D deficiency and risk of heart failure in elderly patients of cardiology outpatient clinics.

          Methods and results

          A cross‐sectional study with an analytical approach was employed. Clinical data were collected from the elderly from August 2015 to February 2016. The dependent variable was the risk of heart failure; the independent variable was vitamin D deficiency; and intervening factors were age, gender, education, ethnicity, hypertension, diabetes mellitus, hypothyroidism, renal failure, dementia, stroke, dyslipidaemia, depression, smoking, alcoholism, obesity, andropause, and cardiac arrhythmia. To analyse the association between vitamin D deficiency and risk of heart failure, we used the bivariate logistic analysis, followed by analysis through the multivariate logistic regression model. Of the 137 elderly, the study found the following: women (75.9%); overweight (48.2%); obese (30.6%); increase in the index waist/hip (88.3%); dyslipidaemia (94.2%) and hypertension (91.2%); coronary artery disease (35.0%); and 27.7% with cardiac arrhythmia or left ventricular hypertrophy. Sixty‐five per cent of the elderly were deficient in vitamin D. The risk of heart failure was significantly associated with vitamin D deficiency [odds ratio (OR): 12.19; 95% confidence interval (CI) = 4.23–35.16; P = 0.000], male gender (OR: 15.32; 95% CI = 3.39–69.20, P = 0.000), obesity (OR: 4.17; 95% CI = 1.36–12.81; P = 0.012), and cardiac arrhythmia (OR: 3.69; 95% CI = 1.23–11.11; P = 0.020).

          Conclusions

          There was a high prevalence of vitamin D deficiency in the elderly, and the evidence shows a strong association between vitamin D deficiency and increased risk of heart failure in this population.

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          Most cited references41

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          Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales.

          Although the rise in ischaemic heart disease in England and Wales has been associated with increasing prosperity, mortality rates are highest in the least affluent areas. On division of the country into two hundred and twelve local authority areas a strong geographical relation was found between ischaemic heart disease mortality rates in 1968-78 and infant mortality in 1921-25. Of the twenty-four other common causes of death only bronchitis, stomach cancer, and rheumatic heart disease were similarly related to infant mortality. These diseases are associated with poor living conditions and mortality from them is declining. Ischaemic heart disease is strongly correlated with both neonatal and postneonatal mortality. It is suggested that poor nutrition in early life increases susceptibility to the effects of an affluent diet.
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            The thrifty phenotype hypothesis.

            The thrifty phenotype hypothesis proposes that the epidemiological associations between poor fetal and infant growth and the subsequent development of type 2 diabetes and the metabolic syndrome result from the effects of poor nutrition in early life, which produces permanent changes in glucose-insulin metabolism. These changes include reduced capacity for insulin secretion and insulin resistance which, combined with effects of obesity, ageing and physical inactivity, are the most important factors in determining type 2 diabetes. Since the hypothesis was proposed, many studies world-wide have confirmed the initial epidemiological evidence, although the strength of the relationships has varied from one study to another. The relationship with insulin resistance is clear at all ages studied. Less clear is the relationship with insulin secretion. The relative contribution of genes and environment to these relationships remains a matter of debate. The contributions of maternal hyperglycaemia and the trajectory of postnatal growth need to be clarified.
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              Aging-associated cardiovascular changes and their relationship to heart failure.

              Aging represents a convergence of declining cardioprotective systems and increasing disease processes that is fertile ground for the development of heart failure. Fifty percent of all heart failure diagnoses and 90% of all heart failure deaths occur in individuals older than 70. This article discusses the microscopic and macroscopic changes in cardiovascular structure, function, protective systems, and disease associated with aging. In addition to outlining important clinical considerations and conditions in older persons, the link between normal aging and the elevated risk for development of stage B heart failure is explained and potential therapeutic pathways are highlighted. Published by Elsevier Inc.
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                Author and article information

                Contributors
                catarinamqo@gmail.com
                Journal
                ESC Heart Fail
                ESC Heart Fail
                10.1002/(ISSN)2055-5822
                EHF2
                ESC Heart Failure
                John Wiley and Sons Inc. (Hoboken )
                2055-5822
                17 August 2017
                February 2018
                : 5
                : 1 ( doiID: 10.1002/ehf2.v5.1 )
                : 63-74
                Affiliations
                [ 1 ] Post‐graduate Program in Neuropsychiatry Federal University of Pernambuco Av. Prof. Moraes Rego, 1235, Cidade Universitária Recife‐PE Brazil
                [ 2 ] Department of Cardiology‐Hospital das Clínicas Federal University of Pernambuco Av. Prof. Moraes Rego, 1235, Cidade Universitária Recife‐PE Brazil
                [ 3 ] Department of Speech and Hearing Therapy Federal University of Pernambuco Av. Prof. Moraes Rego,1235, Cidade Universitária Recife‐PE Brazil
                [ 4 ] Post‐graduate Program in Therapeutic Innovation Federal University of Pernambuco Av. Prof. Moraes Rego, 1235, Cidade Universitária Recife‐PE Brazil
                [ 5 ] Department of Infectology‐Hospital das Clínicas Federal University of Pernambuco Av. Prof. Moraes Rego,1235, Cidade Universitária Recife‐PE Brazil
                Author notes
                [*] [* ] Correspondence to: Catarina Magalhães Porto, Rua Jacobina, 45, Apto 2801, Graças, Recife, Brazil. Tel: + 55 (81) 32313135/(81)996557408.

                Email: catarinamqo@ 123456gmail.com

                Article
                EHF212198 ESCHF-17-00015
                10.1002/ehf2.12198
                5793960
                28817241
                7bf3cdbe-3408-4af0-9739-c2627149e9e0
                © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 26 January 2017
                : 22 May 2017
                : 21 June 2017
                Page count
                Figures: 3, Tables: 3, Pages: 12, Words: 3858
                Categories
                Original Research Article
                Original Research Articles
                Custom metadata
                2.0
                ehf212198
                February 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.2.2 mode:remove_FC converted:14.02.2018

                vitamin d,heart failure,risk,elderly
                vitamin d, heart failure, risk, elderly

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