https://doi.org/10.1007/s00392-025-02625-4
1Medizinische Hochschule Hannover Kardiologie und Angiologie, EMAH-Zentrum Hannover, Deutschland; 2Medizinische Hochschule Hannover Kardiologie und Angiologie Hannover, Deutschland
Introduction: Aging adults with congenital heart disease are prone to develop acquired cardiovascular disease. In Down syndrome (DS) presumed higher metabolic risk factors, congenital kidney disease and impaired immunology causing chronic inflammation might modify heart failure, cardiovascular and all-cause mortality. Presently, it is unclear, whether DS is burdened by an elevated cardiovascular risk (CVR).
Methods: Differences in classical CVR factors and organ dysfunction were analysed in 114 patients (38 DS; 76 age, sex and heart defect matched controls). Based on these findings we evaluated the cardiovascular morbidity and mortality risk in various established risk scores (LIVE CVD model, MAGGIC, PREVENT, Reynolds Risk Index).
Results: DS had higher BMI (29.01±5.48 vs. 25.47±4.61kg/m2 ; p<001), but significantly lower systolic blood pressure (p=0.008) and less active smokers (p=0.007). HBA1c and cholesterol level were comparable. DS showed significantly higher sCRP (p=0.014) and more severe renal impairment (p=0.001). In DS the ESC LIVE CVD Model calculated a significantly lower cardiovascular mortality risk ( 10 years: 0.6±0.49 vs. 1.2±2.02%, p=0.0015; Life time: 21.89±5.37 vs. 25.4±9.14%, p=0.012). Risk assessment of all other analysed scores were similar.
Conclusion: Adults with DS exhibited both, lower (less smoking, lower blood pressure) and higher CVR factors (elevated sCRP and BMI, worse renal function). Only LIVE CVD model, which excluded sCRP and renal function, calculated a lower CVR in DS. Disparities in parameter selection may explain diverging results. Our findings illustrate that handicapped, usually excluded from studies, might profit from surveys focussing on their distinct conditions