Elevated serum uric acid is associated with vascular inflammation but not coronary artery calcification in the healthy octogenarians: the Brazilian study on healthy aging.

BACKGROUND: There is a limited data on the association between serum uric acid (SUA) and cardiovascular disease (CVD) among the very elderly population. AIMS: We evaluated the association of SUA, highly sensitive C-reactive protein (hs-CRP, a marker of vascular and systemic inflammation), and coronary artery calcification (CAC, a marker of subclinical CVD) in a cohort of Brazilian octogenarians (≥80 years) free from known clinical CVD. METHODS: 208 individuals were included and evaluated for an association between increasing tertiles of SUA, elevated hs-CRP (>3 mg/dL), the presence and burden of CAC (CAC > 0 and CAC > 400). RESULTS: The median hs-CRP was 1.9 (IQR = 1.0-3.4) mg/L and mean SUA was 5.3 (±1.4) mg/dL. The overall prevalence of elevated hs-CRP (>3 mg/dL) was 31 %. A significant increase in the prevalence of hs-CRP was noted across the higher SUA tertiles (p < 0.001) with 3.4 times the odds of having elevated hs-CRP in the highest SUA tertile (3.40; CI = 1.27-9.08). No association was noted with either the CAC presence and/or CAC burden (CAC > 0 or CAC > 400) across the increasing SUA tertiles. DISCUSSION: In the healthy octogenarians, higher SUA levels are associated with vascular inflammation (hs-CRP) but not with coronary atherosclerosis (CAC); markers for the subclinical CVD.

Habitual sleep duration and its relationship with cardiovascular health, healthcare costs, and resource utilization in a working population.

OBJECTIVE: Little is known about the relationship between habitual sleep duration, cardiovascular health (CVH) and their impact on healthcare costs and resource utilization. We describe the relationship between sleep duration and ideal CVH, and the associated burden of healthcare expenditure and utilization in a large South Florida employee population free from known cardiovascular disease. METHODS: The study used data obtained from a 2014 voluntary Health Risk Assessment among 8629 adult employees of Baptist Health South Florida. Health expenditures and resource utilization information were obtained through medical claims data. Frequencies of the individual and cumulative CVH metrics across sleep duration were computed. Mean and marginal per-capita healthcare expenditures were estimated. RESULTS: The mean age was 43 years, 57% were of Hispanic ethnicity. Persons with 6-8.9hours and ≥9 hours of sleep were significantly more likely to report optimal goals for diet, physical activity, body mass index, and blood pressure when compared to those who slept less than 6 hours. Compared to those who slept less than 6 hours, those sleeping 6-8.9hours and ≥9hours had approximately 2- (odds ratio 2.1, 95% confidence interval: 1.9-3.0) and 3-times (odds ratio 3.0, 95% confidence interval: 1.6-5.6) higher odds of optimal CVH. Both groups with 6 or more hours of sleep had lower total per-capita expenditure (approximately $2000 and $2700 respectively), lower odds of visiting an emergency room, or being hospitalized compared to those who slept < 6 hours. CONCLUSION: Sleeping 6 or more hours was associated with better CVH, lower healthcare expenditures, and reduced healthcare resource utilization.