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Cardiovascular and metabolic conditions in males aging with a spinal cord injury

LaVela SL, Evans CT, Prohaska TR, Chen K, Weaver FM. Cardiovascular and metabolic conditions in males aging with a spinal cord injury. Paper presented at: American Paraplegia Society Annual Meeting; 2005 Sep 1; Las Vegas, NV.

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Abstract:

Background: Physiologic changes due to aging make older persons more susceptible to illness and may delay recovery. Added vulnerability exists in special populations that are both older and living with another chronic debilitating condition, such as spinal cord injury (SCI). Research Design: Cross sectional surveyMethods: A national survey of veterans with SCI was conducted using Behavioral Risk Factor Surveillance System (BRFSS) survey questions. SCI participants injured at least 20 years were compared to 2003 CDC BRFSS data for male veteran and non-veteran general populations aged 65 and above. Odds ratios were used to assess crude associations among veterans with SCI, veterans, and the general population, and logistic regression was used to adjust for confounding in multivariate analysis. Results: Unadjusted analyses showed that high blood pressure (HBP) was less prevalent in the general population than in veterans with SCI (OR = 0.77 [CI95 0.67-0.88], p = 0.0002), but general veterans and those with SCI did not differ. High cholesterol was more likely in the veteran population than in those with SCI (OR = 1.15 [CI95 1.00-1.33], p = 0.0499), but did not differ between SCI and the general population. Stroke was less likely in veteran (OR = 0.71, [CI95 0.55-0.91], p = 0.0067) and general populations (OR = 0.74, [CI95 0.58-0.95], p = 0.0189) than in SCI. The general veteran population was more likely to report coronary heart disease (CHD) than veterans with SCI (OR = 1.28, [CI95 1.04-1.57], p = 0.0194). Unadjusted analyses showed no significant differences between groups in diabetes or heart attack prevalence. After controlling for confounders, the findings from unadjusted analyses remained the same for HBP, heart attack, stroke, and CHD. Diabetes was less likely to occur in the general population than in SCI (OR = 0.79, [CI95 0.64-0.99], p = 0.041). There were no significant differences in high cholesterol between groups after adjustment.Conclusion(s): In older males, HBP and stroke were more prevalent in veterans with SCI than in both veterans and non-veterans. Diabetes was more common in veterans with and without SCI compared to older males in general. SCI may be an independent predictor of certain conditions regardless of veteran status. This information is useful for developing prevention strategies and planning long-term care for males aging with SCI.





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