The Prevention of Cardiovascular Disease in Older Adults

Patrick P. Coll, MD, AGSF; Vivyenne Roche, MD, AGSF; Jaclyn S. Olsen, DO; Jessica H. Voit, MD; Emily Bowen, MD; Manish Kumar, MD

Disclosures

J Am Geriatr Soc. 2020;68(5):1098-1106. 

In This Article

Abstract and Introduction

Abstract

Cardiovascular disease (CVD) is common in older adults. CVD is a significant cause of both death and disability in old age. Though the prevention and treatment of CVD have been extensively studied, historically older adults and especially those older than 75 years have been underrepresented in clinical investigations designed to determine the best way to prevent or treat CVD. As a result, geriatrics clinicians frequently need to decide which interventions to recommend for their patients by extrapolation from existing data, which may or may not be applicable to the patients they are caring for. This narrative review summarizes existing data regarding the prevention of three common CVDs in older adults: stroke, coronary artery disease, and peripheral artery disease. Special emphasis is given to the prevention of CVD in those aged 75 years or older.

Introduction

In this narrative review, we address the significance of cardiovascular disease (CVD) for older adults and the challenges presented by a paucity of data on preventing CVD for adults older than 75 years. Understanding that many CVDs have common risk factors and being aware that the benefits of risk factor reduction are often measured by composite outcomes, we have divided our recommendations into the prevention of three common CVDs in older adults: stroke, coronary artery disease (CAD), and peripheral artery disease (PAD). Our recommendations are based on published research and guidelines provided by other medical organizations. Our goal is to provide a resource for busy clinicians that can assist them when discussing and implementing CVD prevention for their older patients. Though diabetes mellitus is an important risk factor for CVD, the prevention of, screening for, and treatment of diabetes mellitus as a means of decreasing CVD risk for older adults are not addressed in this review.

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