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


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

In This Article

Challenges Regarding the Prevention of CVD in Older Adults

To make an informed decision regarding the prevention of disease and disability, clinicians require knowledge regarding the epidemiology of the condition they are trying to prevent. They need an awareness of the natural history of the condition if it is left untreated, how quickly it will progress, and what the likelihood is that the condition will result in death or disability. They should have access to information regarding the effectiveness of the intervention being considered.[4] They should also know how quickly the intervention will have a meaningful impact. The benefits, risks, and costs of the intervention are also important. All this information should pertain to the patients they are caring for. Because of a lack of clinical trials data for adults older than 75 years, clinicians who care for complex older adults frequently do not have the information they require to make informed decisions regarding the best way to prevent CVD in this population.

Because polypharmacy is common in older adults, the impact of preventing or treating CVD in older adults also needs to take into consideration the goal of avoiding polypharmacy and its associated complications.[5]

A principle of CVD prevention that is generally accepted is that the intensity of the intervention for an individual (or population) should be adjusted to the level of baseline risk. There are a variety of tools available to determine CVD risk in younger patients. There are, however, no CVD risk assessment tools specifically designed to assess CDV risk in adults older than 75 years.