Abstract
Coronary disease is currently a major cause of disability and mortality in older populations. Due to several factors - including increased noncardiovascular mortality, atypical presentation of coronary events, selective survival, and, possibly, clustering of protective genetic traits - the relative risk associated with almost all risk factors decreases with advancing age. Nonetheless, all available evidences from both observational studies and randomized trials indicate that, due to the higher event rates, the absolute risk reduction yielded by preventive interventions is much greater in the older age segments of populations. Another implication of the complex relationships between risk factors and comorbid conditions in the pathogenesis of coronary-related events and mortality, typical of the elderly subjects, is represented by the multiple effects of treatment for single risk factors, such as the decrease in LDL-cholesterol levels and inflammation markers yielded by statins. Taken together, these factors account for the more favorable cost-effectiveness ratios of preventive interventions in the older, as compared with the middle-aged subjects. On the other hand, the high level of interaction between coexistent risk factors and comorbidity renders a global approach to the prevention of coronary events in older subjects mandatory for physicians, as well as for decision-makers. In fact, a multidimensional assessment - including the evaluation of cognitive, affective and social disturbances- driving a multidisciplinary treatment of risk factors -encompassing behavioral counseling and social support - is essential to improve patients compliance and to effectively reduce the burden of coronary-related morbidity and mortality in older populations.
Keywords: coronary risk factors, coronary disease, coronary events, ldl-cholesterol, inflammation markers, statins, coronary-related morbidity
Current Pharmaceutical Design
Title: Coronary Risk Factors in the Elderly: Their Interactions and Treatment
Volume: 9 Issue: 29
Author(s): Pierugo Carbonin, Giuseppe Zuccala, Emanuele Marzetti and Maria Rita Lo Monaco
Affiliation:
Keywords: coronary risk factors, coronary disease, coronary events, ldl-cholesterol, inflammation markers, statins, coronary-related morbidity
Abstract: Coronary disease is currently a major cause of disability and mortality in older populations. Due to several factors - including increased noncardiovascular mortality, atypical presentation of coronary events, selective survival, and, possibly, clustering of protective genetic traits - the relative risk associated with almost all risk factors decreases with advancing age. Nonetheless, all available evidences from both observational studies and randomized trials indicate that, due to the higher event rates, the absolute risk reduction yielded by preventive interventions is much greater in the older age segments of populations. Another implication of the complex relationships between risk factors and comorbid conditions in the pathogenesis of coronary-related events and mortality, typical of the elderly subjects, is represented by the multiple effects of treatment for single risk factors, such as the decrease in LDL-cholesterol levels and inflammation markers yielded by statins. Taken together, these factors account for the more favorable cost-effectiveness ratios of preventive interventions in the older, as compared with the middle-aged subjects. On the other hand, the high level of interaction between coexistent risk factors and comorbidity renders a global approach to the prevention of coronary events in older subjects mandatory for physicians, as well as for decision-makers. In fact, a multidimensional assessment - including the evaluation of cognitive, affective and social disturbances- driving a multidisciplinary treatment of risk factors -encompassing behavioral counseling and social support - is essential to improve patients compliance and to effectively reduce the burden of coronary-related morbidity and mortality in older populations.
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Cite this article as:
Carbonin Pierugo, Zuccala Giuseppe, Marzetti Emanuele and Monaco Rita Lo Maria, Coronary Risk Factors in the Elderly: Their Interactions and Treatment, Current Pharmaceutical Design 2003; 9 (29) . https://dx.doi.org/10.2174/1381612033453857
DOI https://dx.doi.org/10.2174/1381612033453857 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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