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RESEARCH PRODUCT

Body Mass Index and Cardiac Events in Elderly Patients

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description

Body Mass Index has been challenged as an anthropometric measurement in elderly patients. Recent data, even in elderly patients, has demonstrated that elevated body mass index affords a worse long-term prognosis, although the magnitude of this relationship weakens as one ages. Underweight patients, possibly due to elements of sarcopenia and/or frailty, are also at a higher risk of overall mortality. A number of inflammatory mediators may be responsible for such factors which likely contribute to the increased risk of cardiovascular events observed. Although body mass index has been implicated in the development of heart failure, coronary artery disease and mediates its effects through other cardiovascular risk factors, it appears that it may indeed be protective in elderly patients who are overweight or mildly obese. Conversely, low body mass index may be harmful, a concept known as the obesity paradox which has been observed in a number of settings including congestive heart failure following cardiac surgery and in particular following hip fracture repair. This chapter examines the impact of body mass index on overall mortality and cardiovascular events in elderly patients. Although there are similarities between older patients and those of young and middle age, there are striking differences which will be delineated in this review.