The leading cause of death in the elderly, the fastest growing segment of the population, is cardiovascular disease (CVD). Prevention of cardiovascular events in elderly patients presents a therapeutic challenge because this age group is generally underrepresented in clinical trials, and doctors often assume that it is too late to initiate preventive therapy in the elderly. A review by clinical experts of the best available evidence concluded that cholesterol-lowering and blood pressure-controlling therapy are the most effective treatments for reducing cardiovascular events in older adults, but that treatment needs to be individualized, reports the Canadian Journal of Cardiology.
"Primary prevention trials in younger populations demonstrate small absolute risk reductions over many years, which is difficult to extrapolate to older patients," explained senior author Michelle M. Graham, MD, FRCPC, Professor of Medicine, Division of Cardiology, Mazankowski Alberta Heart Institute and University of Alberta Faculty of Medicine and Dentistry. "Some assume elderly individuals may not have the life expectancy to derive benefit from preventive cardiovascular therapy; however, their baseline level of risk, and subsequent relative risk reduction with appropriate therapy, may actually be higher than in younger patients."
The review provided substantial evidence that:
"Primary prevention of CVD can improve health and reduce future healthcare costs. Prevention of a first cardiovascular event in elderly patients should be individualized based on consideration of the current evidence, as well as goals of therapy, functionality and/or frailty, comorbidities, and concomitant medications," stated Dr. Graham.
Materials provided by Elsevier Health Sciences. Note: Content may be edited for style and length.
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