Electronic health records reveals resilience patterns of cardiovascular disease in Basque centenarians

Background: Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Although their prevalence increases with age, their impact on centenarians remains poorly understood. Methods: We analyzed Electronic Health Records (EHRs) to assess the incidence and effect of CVDs in centenarians (n = 649) and non-centenarians (n = 62,753) in the Basque Country. Descriptive statistics were applied to discern differences between the two population groups in terms of prevalence, number of diagnoses, and treatments. Survival analysis was performed through Kaplan-Meier estimator. Trajectories of laboratory parameters were explored through non-linear mixed models (NLMMs). Results: Centenarians had lower incidence of severe conditions such as ischemic heart disease, despite overall CVD incidence being similar between groups. Survival analyses revealed extended longevity in centenarians after both first and last CVD diagnosis. Biomarker trajectories suggested favorable biological profiles with greater resilience and faster recovery in centenarians. Conclusion: Despite experiencing CVDs, centenarians demonstrate delayed onset, reduced severity, and more favorable biological recovery compared to non-centenarians. These findings indicate potential resilience mechanisms that may contribute to healthy ageing.