Risk Factors and the Prevention of Heart Disease

Abstract

Cardiovascular disease, and in particular coronary heart disease, is the predominant cause of death and disability worldwide in populations older than 65 yr of age; about half of elderly individuals in industrialized countries have clinical evidence of coronary heart disease. The World Health Organization (WHO) Study Group report on the epidemiology and prevention of cardiovascular diseases in elderly people (1) identified coronary heart disease as the major cause of mortality in industrialized nations, where 50% of such deaths occur in the population older than 65 yr of age and 60% at older than age 75. Coronary heart disease is responsible for half of all deaths in the population older than 80 yr of age (2). Forty-five percent of octogenarians have clinical evidence of cardiovascular disease, with coronary heart disease being the most common problem. However, the variation in rates of cardiovascular mortality in elderly populations indicates a substantial potential for effective coronary prevention because many risk factors for coronary heart disease are modifiable. The highest risk for development of clinical evidence of coronary heart disease is in the population 65 yr of age and older, double that in the under age 65 population, with the difference more pronounced among women.