The reverse metabolic syndrome in the elderly: Is it a “catabolic” syndrome?

Francesco Curcio, Giuseppe Sasso, Ilaria Liguori, Gaetana Ferro, Gennaro Russo, Michele Cellurale, David Della-Morte, Gaetano Gargiulo, Gianluca Testa, Francesco Cacciatore, Domenico Bonaduce, Pasquale Abete

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations


Traditional risk factors of cardiovascular death in the general population, including body mass index (BMI), serum cholesterol, and blood pressure are also found to relate to outcomes in the geriatric population, but in a differing direction. A higher body mass index, hypercholesterolemia and hypertension are not harmful but even permit better survival at advancing age. This phenomenon is called “reverse epidemiology” or “risk factor paradox” and is also detected in a variety of chronic disease states such as chronic heart failure. Accordingly, a low BMI, blood pressure and cholesterol values are associated with a worse prognosis. Several possible causes are hypothesized to explain this elderly paradox, but this phenomenon remains controversial and its underlying reasons are poorly understood. The aim of this review is to recognize the factors behind this intriguing phenomenon and analyse the consequences that it can bring in the management of the cardiovascular therapy in elderly patient. Finally, a new phenotype identified as “catabolic syndrome” has been postulated.

Original languageEnglish (US)
Pages (from-to)547-554
Number of pages8
JournalAging Clinical and Experimental Research
Issue number6
StatePublished - Jun 1 2018
Externally publishedYes


  • Blood pressure
  • Body mass index
  • Catabolic syndrome
  • Cholesterol
  • Reverse epidemiology

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


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