Geriatrics Research Today is a free monthly online journal that collates and summarizes the latest research about Geriatrics, including details on old age, psychiatry, depression, medicine.

Reverse epidemiology beyond dialysis patients: chronic heart failure, geriatrics, rheumatoid arthritis, COPD, and AIDS.

Horwich TB, Fonarow GC

Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, Los Angeles, California, USA. thorwich@mednet.ucla.edu

"Reverse epidemiology" refers to paradoxical and counterintuitive epidemiologic associations between survival outcomes and traditional cardiovascular risk factors such as obesity, high blood pressure, and high cholesterol. Reverse epidemiology has been well described in end stage renal disease, but also has been observed in chronic disease states, including chronic heart failure, rheumatoid arthritis, chronic obstructive pulmonary disease, and Acquired Immune Deficiency Syndrome, and in elderly populations. This review will highlight the recent medical literature on reverse epidemiology in these populations. Common pathophysiologic underpinnings in these chronic disease states may help explain the reversal of risk factors observed in these diverse populations. Furthermore, guidelines for the general population for optimal goals of weight, cholesterol levels, and blood pressure may not apply to special populations, including patients with chronic diseases or elderly persons.

Published 9 November 2007 in Semin Dial, 20(6): 549-53.
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