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Primary Prevention of Cardiovascular Events in Older Individuals

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Aging Issues in Cardiology

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 250))

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Abstract

Cardiovascular diseases (CVD) account for about one half of deaths in the adult population in the western world, and the chronic sequelae of cardiovascular diseases (e.g. congestive heart failure, stroke) impose an ever greater burden of suffering on individuals as our population ages. Many of the risk factors for CVD are known, and most are potentially modifiable. Physicians have an obligation to seek out risk factors and address them. As the incidence of CVD rises exponentially with age, the obligation increases, rather than decreases, as the opportunities for prevention also rise with the age of the patient.

If we believe a thing to be bad, and if we have a right to prevent it, it is our duty to try to prevent it ...Alfred Viscount Milner, 1854-1925

Better use medicines at the outset than at the last moment. Publius Syrus, Moral Sayings, 1st Century B.C., tr. Darius Lyman

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References

  1. Abernethy D.R., Gutkowska J., Winterbottom L.M. Effects of amlodipine, a long-acting dihydropyridine calcium antagonist in aging hypertension: pharmacodynamics in relation to disposition. Clin Pharmacol Ther 1990;48:76–86.

    Article  PubMed  CAS  Google Scholar 

  2. Abernethy D.R., Schwartz J.B., Todd E.L., Luchi R., Snow E. Verapamil pharmacodynamics and disposition in young and elderly hypertensive patients. Altered electrocardiographic and hypotensive responses. Ann Intern Med 1986;105:329–336.

    PubMed  CAS  Google Scholar 

  3. Abernethy D.R., Wainer I.W., Anacleto A.I. Verapamil metabolite exposure in older and younger men during steady-state oral verapamil administration. Drug Metab Dispos 2000;28:760–765.

    PubMed  CAS  Google Scholar 

  4. Abernethy D.R., Wainer I.W., Longstreth J.A., Andrawis N.S. Stereoselective verapamil disposition and dynamics in aging during racemic verapamil administration. J Pharmacol Exp Ther 1993;266:904–911.

    PubMed  CAS  Google Scholar 

  5. Abernethy D.R. An overview of the pharmacokinetics and pharmacodynamics of amlodipine in elderly persons with systemic hypertension. Am J Cardiol 1994;73:10A–17A.

    Article  PubMed  CAS  Google Scholar 

  6. Al-Windi A, Elmfeldt D, Svardsudd K. The relationship between age, gender, well-being and symptoms, and the use of pharmaceuticals, herbal medicines and self-care products in a Swedish municipality. Eur J Clin Pharmacol 2000;56:311–317.

    Article  PubMed  CAS  Google Scholar 

  7. Amery A, Birkenhager W, Brixko P, et al. Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly trial. Lancet 1985;1:1349–1354.

    Article  PubMed  CAS  Google Scholar 

  8. Appel L.J. The verdict from ALLHAT--thiazide diuretics are the preferred initial therapy for hypertension. JAMA 2002;288:3039–3042.

    Article  PubMed  Google Scholar 

  9. Astin J.A., Pelletier K.R., Marie A., Haskell W.L. Complementary and alternative medicine use among elderly persons: one-year analysis of a Blue Shield Medicare supplement. J Gerontol A Biol Sci Med Sci 2000;55:M4–M9.

    Article  PubMed  CAS  Google Scholar 

  10. Bakris G.L., Weir M.R. Angiotensin-converting enzyme inhibitor-associated elevations in serum creatinine: is this a cause for concern? Arch Intern Med 2000;160:685–693.

    Article  PubMed  CAS  Google Scholar 

  11. Barat I, Andreasen F, Damsgaard E.M. The consumption of drugs by 75-year-old individuals living in their own homes. Eur J Clin Pharmacol 2000;56:501–509.

    Article  PubMed  CAS  Google Scholar 

  12. Behavioral counseling in primary care to promote physical activity: recomm endation and rationale. Ann Intern Med 2002;137:205–207.

    Google Scholar 

  13. Beresford S.A., Farmer E.M., Feingold L., Graves K.L., Sumner S.K., Baker R.M. Evaluation of a self-help dietary intervention in a primary care setting. Am J Public Health 1992;82:79–84.

    Article  PubMed  CAS  Google Scholar 

  14. Bianchetti G, Billy S, Ascalone V, Saivin S, Houin G, Rosenzweig P. Multicenter studies on the pharmacokinetic profile of sustained-release oral diltiazem (300 mg) after once a day repeated administration: influence of age. Int J Clin Pharmacol Ther 1996;34:195–201.

    PubMed  CAS  Google Scholar 

  15. Blair S.N., Kohl H.W., 3rd, Paffenbarger R.S., Jr., Clark D.G, Cooper K.H, Gibbons L.W. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA 1989;262:2395–2401.

    Article  PubMed  CAS  Google Scholar 

  16. Booth G.L, Wang E.E. Preventive health care, 2000 update: screening and management of hyperhomocysteinemia for the prevention of coronary artery disease events. The Canadian Task Force on Preventive Health Care. CMAJ 2000;163:21–29.

    PubMed  CAS  Google Scholar 

  17. Boshuizen HC, Izaks GJ, van Buuren S, Ligthart GJ. Blood pressure and mortality in elderly people aged 85 and older: community based study. BMJ 1998;316:1780–1784.

    Article  PubMed  CAS  Google Scholar 

  18. Brown B.G, Zhao X.Q, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583–1592.

    Article  PubMed  CAS  Google Scholar 

  19. Bucher H.C, Griffith L.E, Guyatt G.H. Effect of HMGCoA reductase inhibitors on stroke. A meta-analysis of randomized, controlled trials. Ann Intern Med 1998;128:89–95.

    PubMed  CAS  Google Scholar 

  20. Bulpitt C, Fletcher A, Beckett N, et al. Hypertension in the Very Elderly Trial (HYVET): Protocol for the Main Trial. Drugs & Aging 2001;18:151–164.

    Article  CAS  Google Scholar 

  21. Castleden C.M, George C.F. The effect of ageing on the hepatic clearance of propranolol. Br J Clin Pharmacol 1979;7:49–54.

    Article  PubMed  CAS  Google Scholar 

  22. Castleden C.M, Kaye C.M, Parsons R.L. The effect of age on plasma levels of propranolol and practolol in man. Br J Clin Pharmacol 1975;2:303–306.

    Article  PubMed  CAS  Google Scholar 

  23. Chalmers J.P, Smith S.A, Wing L.M. Hypertension in the elderly: the role of calcium antagonists. J Cardiovasc Pharmacol 1988;12:S147–S155.

    PubMed  Google Scholar 

  24. Cleland J.G, Bristow M.R, Erdmann E, Remme WJ, Swedberg K, Waagstein F. Beta-blocking agents in heart failure. Should they be used and how? European Heart Journal 1996;17:1629–1639.

    Article  PubMed  CAS  Google Scholar 

  25. Cockcroft D.W, Gault M.H. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31–41.

    Article  PubMed  CAS  Google Scholar 

  26. Cook D.G, Shaper A.G, Pocock S.J, Kussick S.J. Giving up smoking and the risk of heart attacks. A report from The British Regional Heart Study. Lancet 1986;2:1376–1380.

    CAS  Google Scholar 

  27. Cook N.R, Cohen J, Hebert P.R, Taylor J.O, Hennekens C.H. Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med 1995;155:701–709.

    Article  PubMed  CAS  Google Scholar 

  28. Coope J, Warrender T.S. Randomised trial of treatment of hypertension in elderly patients in primary care. Br Med J (Clin Res Ed) 1986;293:1145–1151.

    Article  CAS  Google Scholar 

  29. Crome P, Baksi A, Edwards J, Marley J. Plasma nitrendipine concentrations in elderly normotensive volunteers after single and multiple dosing. Curr Med Res Opin 1989;11:279–282.

    Article  PubMed  CAS  Google Scholar 

  30. Crome P, Baksi A, MacMahon D, Pandita-Gunawardena ND, Edwards J, Mariey J. Plasma nitrendipine concentrations in elderly hypertensive patients after single and multiple dosing. Br J Clin Pharmacol 1988;26:323–326.

    Article  PubMed  CAS  Google Scholar 

  31. Dahlof B., Devereux R.B., Kjeldsen S.E., et al. Cardiovascular morbidity and mortality in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002;359:995–1003.

    Article  PubMed  CAS  Google Scholar 

  32. Dahlof B., Lindholm L.H, Hansson L., Schersten B., Ekbom T., Wester P.O. Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). Lancet 1991;338:1281–1285.

    Article  PubMed  CAS  Google Scholar 

  33. de Lorgeril M., Salen P., Martin J.L., Monjaud I., Delaye J., Mamelle N.. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 1999;99:779–785.

    Article  PubMed  Google Scholar 

  34. Dello Buono M., Urciuoli O., Marietta P., Padoani W., De Leo D.. Alternative medicine in a sample of 655 community-dwelling elderly. J Psychosom Res 2001;50:147–154.

    Article  PubMed  CAS  Google Scholar 

  35. Doll R., Peto R. Mortality in relation to smoking: 20 years’ observations on male British doctors. Br Med J 1976;2:1525–1536.

    Article  PubMed  CAS  Google Scholar 

  36. Downs J.R., Clearfield M., Weis S., et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA 1998;279:1615–1622.

    Article  PubMed  CAS  Google Scholar 

  37. Dowsen G.K., Gareeboo H., Alberti K.G., et al. Changes in population cholesterol concentrations and other cardiovascular risk factor levels after five years of the non-communicable disease intervention programme in Mauritius. Mauritius Non-communicable Disease Study Group. BMJ 1995;311:1255–1259.

    Article  Google Scholar 

  38. Eckel R.H., Krauss R.M. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation 1998;97:2099–2100.

    Article  PubMed  CAS  Google Scholar 

  39. Eden K.B., Orleans C.T., Mulrow C.D., Pender N.J., Teutsch S.M. Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2002;137:208–215.

    PubMed  Google Scholar 

  40. Elliott H.L., Green S.T., Vincent J., Meredith P.A. An assessment of the pharmacokinetics and pharmacodynamics of single doses of amlodipine in elderly normotensives. Pharmacol Res 1992;26:33–39.

    Article  PubMed  CAS  Google Scholar 

  41. Fagan T.C. Blood pressure reduction and tolerability of felodipine ER in older and younger hypertensive patients. The Felodipine ER in the Elderly versus Young Working Group. Journal of the American Geriatrics Society 1997;45:712–717.

    PubMed  CAS  Google Scholar 

  42. Feldman R.D., Campbell N., Larochelle P., et al. 1999 Canadian recommendations for the management of hypertension. Task Force for the Development of the 1999 Canadian Recommendations for the Management of Hypertension. CMAJ 1999;161:S1–S17.

    PubMed  Google Scholar 

  43. Fichtenberg C.M, Glantz S.A. Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ 2002;325:188.

    Article  PubMed  Google Scholar 

  44. Fodor J.G, Frohlich J.J, Genest J.J, Jr., McPherson PR. Recommendations for the management and treatment of dyslipidemia. Report of the Working Group on Hypercholesterolemia and Other Dyslipidemias. CMAJ 2000;162:1441–1447.

    PubMed  CAS  Google Scholar 

  45. Fodor JG, Whitmore B, Leenen F, Larochelle P. Lifestyle modifications to prevent and control hypertension. 5. Recommendations on dietary salt. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada. CMAJ 1999;160:S29–S34.

    PubMed  CAS  Google Scholar 

  46. Forette F., Seux M.L, Staessen J.A, et al. Prevention of dementia in randomised doubleblind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet 1998;352:1347–1351.

    Article  PubMed  CAS  Google Scholar 

  47. Frick M.H, Elo O., Haapa K., et al. Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Engl J Med 1987;317:1237–1245.

    Article  PubMed  CAS  Google Scholar 

  48. Gibson D.M, Bron N.J, Richens A, Hounslow N.J, Sedman A.J, Whitfield LR. Effect of age and gender on pharmacokinetics of atorvastatin in humans. J Clin Pharmacol 1996;36:242–246.

    PubMed  CAS  Google Scholar 

  49. Gourlay SG, Benowitz NL. The benefits of stopping smoking and the role of nicotine replacement therapy in older patients. Drugs Aging 1996;9:8–23.

    Article  PubMed  CAS  Google Scholar 

  50. Grady D, Rubin S.M, Petitti D.B, et al. Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med 1992; 117:1016–1037.

    PubMed  CAS  Google Scholar 

  51. Grossman E, Messerli F.H, Goldbourt U. High blood pressure and diabetes mellitus: are all antihypertensive drugs created equal? Arch Intern Med 2000;160:2447–2452.

    Article  PubMed  CAS  Google Scholar 

  52. Grundy S.M, Pasternak R, Greenland P, Smith S, Jr., Fuster V. Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Circulation 1999;100:1481–1492.

    Article  PubMed  CAS  Google Scholar 

  53. Gueyffier F, Bulpitt C, Boissel J.P, et al. Antihypertensive drugs in very old people: a subgroup meta-analysis of randomised controlled trials. INDANA Group. Lancet 1999;353:793–796.

    Article  PubMed  CAS  Google Scholar 

  54. Gurwitz J.H, Avorn J. The ambiguous relation between aging and adverse drug reactions. Ann Intern Med 1991;114:956–966.

    PubMed  CAS  Google Scholar 

  55. Hanlon J.T, Schmader K.E, Ruby C.M, Weinberger M. Suboptimal prescribing in older inpatients and outpatients. J Am Geriatr Soc 2001;49:200–209.

    Article  PubMed  CAS  Google Scholar 

  56. Hansson L, Zanchetti A, Carruthers S.G, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet 1998;351:1755–1762.

    Article  PubMed  CAS  Google Scholar 

  57. Harris T.B, Makuc D.M, Kleinman J.C, et al. Is the serum cholesterol-coronary heart disease relationship modified by activity level in older persons? J Am Geriatr Soc 1991;39:747–754.

    PubMed  CAS  Google Scholar 

  58. Hayden M, Pignone M, Phillips C, Mulrow C. Aspirin for the primary prevention of cardiovascular events: A summary of the evidence for the US Preventive Services Task Force. Ann Intern Med. 2002; 136: 161–171.

    PubMed  CAS  Google Scholar 

  59. Heath J.M, Stuart M.R. Prescribing exercise for frail elders. J Am Board Fam Pract 2002;15:218–228.

    PubMed  Google Scholar 

  60. Heiat A, Vaccarino V, Krumholz H.M. An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Arch Intern Med 2001;161:1194–1203.

    Article  PubMed  CAS  Google Scholar 

  61. Herman R.J. Drug interactions and the statins. CMAJ 1999;161:1281–1286.

    PubMed  CAS  Google Scholar 

  62. Hughes J.R, Stead L.F, Lancaster T. Antidepressants for smoking cessation. Cochrane Database Syst Rev 2000;4.

    Google Scholar 

  63. Hyman D.J, Pavlik V.N. Characteristics of patients with uncontrolled hypertension in the United States. N Engl J Med 2001;345:479–486.

    Article  PubMed  CAS  Google Scholar 

  64. Insull W, Jr., Henderson M.M, Prentice R.L, et al. Results of a randomized feasibility study of a low-fat diet. Arch Intern Med 1990;150:421–427.

    Article  PubMed  Google Scholar 

  65. Jinks M.J, Evenson L.M, Campbell R.K, Kreager M.C. Prescription labels for aging eyes. AmPharm 1989; NS29:31–33.

    CAS  Google Scholar 

  66. Jitramontree N. Evidence-based protocol: exercise promotion--encouraging older adults to walk. J Gerontol Nurs 2001;27:7–18.

    PubMed  CAS  Google Scholar 

  67. Johnson A.G. NSAIDs and increased blood pressure. What is the clinical significance? Drug Saf 1997;17:277–289.

    Article  Google Scholar 

  68. Jousilahti P, Korhonen H.J, Vartiainen E, Puska P. [The community approach in the prevention of cardiovascular disease: evaluation of the Finnish experience in North Karelia (1972–1992)]. Union Med Can 1995;124:7–16.

    PubMed  CAS  Google Scholar 

  69. Kaufman D.W, Kelly J.P, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. JAMA 2002;287:337–344.

    Article  PubMed  Google Scholar 

  70. Kelly J.G, McGarry K, O’Malley K, O’Brien ET. Bioavailability of labetalol increases with age. Br J Clin Pharmacol 1982;14:304–305.

    Article  PubMed  CAS  Google Scholar 

  71. Kelly J.G, O’Malley K. Calcium antagonists in the elderly. Drugs Aging 1993;3:400–407.

    Article  PubMed  CAS  Google Scholar 

  72. Ko D.T, Hebert P.R, Coffey C.S, Sedrakyan A, Curtis JP, Krumholz HM. Beta-blocker therapy and symptoms of depression, fatigue, and sexual dysfunction. JAMA 2002;288:351–357.

    Article  PubMed  CAS  Google Scholar 

  73. Krumholz H.M, Seeman T.E, Merrill SS, et al. Lack of association between cholesterol and coronary heart disease mortality and morbidity and all-cause mortality in persons older than 70 years. JAMA 1994;272:1335–1340.

    Article  PubMed  CAS  Google Scholar 

  74. Lancaster T, Stead L.F. Individual behavioural counseling for smoking cessation. Cochrane Database Syst Rev 2002;3.

    Google Scholar 

  75. Landahl S, Edgar B, Gabrielsson M, et al. Pharmacokinetics and blood pressure effects of felodipine in elderly hypertensive patients. A comparison with young healthy subjects. Clin Pharmacokinet 1988;14:374–383.

    Article  PubMed  CAS  Google Scholar 

  76. Law M, Tang J.L. An analysis of the effectiveness of interventions intended to help people stop smoking. Arch Intern Med 1995;155:1933–1941.

    Article  PubMed  CAS  Google Scholar 

  77. Lee S.C, Park S.W, Kim D.K, Lee S.H, Hong K.P. Iron supplementation inhibits cough associated with ACE inhibitors. Hypertension 2001;38:166–170.

    Article  PubMed  CAS  Google Scholar 

  78. Lettieri J.T, Krol G.J, Yeh S.C, Burkholder D.E, Zinny M, O’Donnell D. The effects of age and race on nitrendipine pharmacokinetics and pharmacodynamics. J Cardiovasc Pharmacol 1988;12:S129–S132.

    Article  PubMed  CAS  Google Scholar 

  79. Liu L, Wang J.G, Gong L, Liu G, Staessen JA. Comparison of active treatment and placebo in older Chinese patients with isolated systolic hypertension. Systolic Hypertension in China (Syst-China) Collaborative Group. J Hypertens 1998; 16:1823-1829.

    Article  PubMed  CAS  Google Scholar 

  80. Loera J.A, Black S.A, Markides K.S, Espino D.V, Goodwin J.S. The use of herbal medicine by older Mexican Americans. J Gerontol A Biol Sci Med Sci 2001;56:M714–M718.

    Article  PubMed  CAS  Google Scholar 

  81. Lonn E, Yusuf, S. Emerging approaches in cardiovascular prevention. In: Yusuf SC, JA, Camm, AJ, Fallen EL, Gersh,Bh, ed. Evidence Based Cardiology. London.: BMJ Books, 1998.

    Google Scholar 

  82. Luque C.A, Vazquez Ortiz M. Treatment of ACE inhibitor-induced cough. Pharmacotherapy 1999;19:804–810.

    Article  PubMed  CAS  Google Scholar 

  83. Maron D.J, Ridker P.M, Pearson T.A, Grundy S.M. Dyslipidemia, other risk factors and the prevention of coronary heart disease. In: Fuster V, Alexander, RW, O’Rourke, RA, (eds). Hurst. The Heart. McGraw-Hill, 2001.

    Google Scholar 

  84. McAlister FA, Zarnke KB, Campbell NR, et al. The 2001 Canadian recommendations for the management of hypertension: Part two-Therapy. Can J Cardiol 2002:18:625–641.

    PubMed  CAS  Google Scholar 

  85. Medical Research Council trial of treatment of hypertension in older adults: principal results. MRC Working Party. BMJ 1992;304:405–412.

    Article  Google Scholar 

  86. Messerli F.H, Grossman E., Goldbourt U. Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? A systematic review. JAMA 1998;279:1903–1907.

    Article  PubMed  CAS  Google Scholar 

  87. Messerli F.H, Grossman E. Beta-blocker therapy and depression. JAMA 2002;288:1845–1846.

    Article  PubMed  Google Scholar 

  88. Metge C, Black C, Peterson S, Kozyrskyj A.L. The population’s use of pharmaceuticals. Med Care 1999;37:JS42–JS59.

    Article  Google Scholar 

  89. Miller N.H. Compliance with treatment regimens in chronic asymptomatic diseases. Am J Med 1997;102:43–49.

    Article  PubMed  CAS  Google Scholar 

  90. Mitniski A, Mogilner A.J, Rockwood K. Accumulation of deficits as a proxy measure of aging. The Scientific World 2001;1:323–336.

    Article  Google Scholar 

  91. Morgan T.O, Anderson A.I, MacInnis R.J. ACE inhibitors, beta-blockers, calcium blockers, and diuretics for the control of systolic hypertension. American Journal of Hypertension 2001;14:241–247.

    Article  PubMed  CAS  Google Scholar 

  92. MRC trial of treatment of mild hypertension: principal results. Medical Research Council Working Party. Br Med J (Clin Res Ed) 1985;291:97–104.

    Article  Google Scholar 

  93. Muck W, Breuel H.P, Kuhlmann J. The influence of age on the pharmacokinetics of nimodipine. Int J Clin Pharmacol Ther 1996;34:293–298.

    PubMed  CAS  Google Scholar 

  94. Nguyen T.T, Ellefson R.D, Hodge D.O, Bailey K.R, Kottke T.E, Abu-Lebdeh H.S. Predictive value of electrophoretically detected lipoprotein(a) for coronary heart disease and cerebrovascular disease in a community-based cohort of 9936 men and women. Circulation 1997;96:1390–1397.

    Article  PubMed  CAS  Google Scholar 

  95. Nikolaus T, Sommer N, Becker C. Treatment of arterial hypertension with diuretics, beta- and calcium channel blockers in old patients. Zeitschrift fur Gerontologie und Geriatrie 2000;33:427–432.

    Article  PubMed  CAS  Google Scholar 

  96. Pahor M, Psaty B.M, Alderman M.H, et al. Health outcomes associated with calcium antagonists compared with other first-line antihypertensive therapies: a meta-analysis of randomised controlled trials. Lancet 2000;356:1949–1954.

    Article  PubMed  CAS  Google Scholar 

  97. Patterson C, Chambers L.W. Preventive health care. Lancet 1995;345:1611–1615.

    Article  PubMed  CAS  Google Scholar 

  98. Phillips P.S, Haas R.H, Bannykh S, et al. Statin-associated myopathy with normal creatine kinase levels. Ann Intern Med 2002;137:581–585.

    PubMed  Google Scholar 

  99. Pignone M, Phillips C, Mulrow C. Use of lipid lowering drugs for primary prevention of coronary heart disease: meta-analysis of randomised trials. BMJ 2000;321:983–986.

    Article  PubMed  CAS  Google Scholar 

  100. Pignone M.P, Phillips C.J, Atkins D, Teutsch S.M, Mulrow C.D, Lohr K.N. Screening and treating adults for lipid disorders. Am J Prev Med 2001;20:77–89.

    Article  PubMed  CAS  Google Scholar 

  101. Playford D.A, Watts G.F. Management of lipid disorders in the elderly. Drugs Aging 1997;10:444–462.

    Article  PubMed  CAS  Google Scholar 

  102. Porchet H.C, Loew F, Gauthey L, Dayer P. Serum concentration-effect relationship of (+/-)-nicardipine and nifedipinein elderly hypertensive patients. Eur J Clin Pharmacol 1992;43:551–553.

    Article  PubMed  CAS  Google Scholar 

  103. Pratt J, Jones, J.J. Noncompliance with therapy: an ongoing problem in treating hypertension. Primary Cardiology 1995;21:34–38.

    Google Scholar 

  104. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA 1991;265:3255–3264.

    Article  Google Scholar 

  105. Prochaska J, DiClemete, C. Towards a comprehensive model of change. In: Miller W, Heather N., ed. Treating addictive behaviours: Processes of change. New York: Plenum, 1986.

    Google Scholar 

  106. Psaty B.M, Smith N.L, Siscovick DS, et al. Health outcomes associated with antihypertensive therapies used as first-line agents. A systematic review and metaanalysis. JAMA 1997;277:739–745.

    Article  PubMed  CAS  Google Scholar 

  107. Quinn K, Baker M.J, Evans B. A population-wide profile of prescription drug use in Saskatchewan, 1989. Can Med Assoc J 1992;146:2177–2186.

    CAS  Google Scholar 

  108. Rajala S, Haavisto M, Heikinheimo R, Mattila K. Blood pressure and mortality in the very old. Lancet 1983;2:520–521.

    Article  PubMed  CAS  Google Scholar 

  109. Ridker P.M, Buring J.E, Shih J, Matias M, Hennekens C.H. Prospective study of Creactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation 1998;98:731–733.

    Article  PubMed  CAS  Google Scholar 

  110. Robertson D.R, Waller D.G, Renwick A.G, George C.F. Age-related changes in the pharmacokinetics and pharmacodynamics of nifedipine. Br J Clin Pharmacol 1988;25:297–305.

    Article  PubMed  CAS  Google Scholar 

  111. Rochon P.A, Clark J.P, Gurwitz J.H. Challenges of prescribing low-dose drug therapy for older people. CMAJ 1999;160:1029–1031.

    PubMed  CAS  Google Scholar 

  112. Rochon P.A, Tu J.V, Anderson G.M, et al. Rate of heart failure and 1-year survival for older people receiving low-dose beta-blocker therapy after myocardial infarction. Lancet 2000;356:639–644.

    Article  PubMed  CAS  Google Scholar 

  113. Rogers E.A, Gough J.E, Brewer K.L. Are emergency department patients at risk for herbdrug interactions? Acad Emerg Med 2001;8:932–934.

    Article  PubMed  CAS  Google Scholar 

  114. Rose G. A Strategy of Preventive Medicine. Oxford.: Oxford University Press., 1992.

    Google Scholar 

  115. Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med 1999;340:115–126.

    Article  PubMed  CAS  Google Scholar 

  116. Rossouw J.E, Anderson G.L, Prentice R.L, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA 2002;288:321–333.

    Article  PubMed  CAS  Google Scholar 

  117. Roux A, Henry J.F, Fouache Y, et al. A pharmacokinetic study of acebutolol in aged subjects as compared to young subjects. Gerontology 1983;29:202–208.

    Article  PubMed  CAS  Google Scholar 

  118. Russell M.A, Merriman R, Stapleton J, Taylor W. Effect of nicotine chewing gum as an adjunct to general practitioner’s advice against smoking. Br Med J (Clin Res Ed) 1983;287:1782–1785.

    Article  CAS  Google Scholar 

  119. Satish S, Freeman D.H, Jr., Ray L, Goodwin JS. The relationship between blood pressure and mortality in the oldest old. J Am Geriatr Soc 2001;49:367–374.

    Article  PubMed  CAS  Google Scholar 

  120. Schmucker D.L. Liver function and phase I drug metabolism in the elderly: a paradox. Drugs Aging 2001;18:837–851.

    Article  PubMed  CAS  Google Scholar 

  121. Schwartz J.B, Abernethy, D.R. Responses to intravenous and oral diltiazem in elderly and younger patients with essential hypertension. Am J Cardiol 1987;59:1111–1117.

    Article  PubMed  CAS  Google Scholar 

  122. Schwartz J.B, Capili H, Daugherty J. Aging of women alters Sverapamil pharmacokinetics and pharmacodynamics. Clin Pharmacol Ther 1994;55:509–517.

    Article  PubMed  CAS  Google Scholar 

  123. Schwartz J.B. Aging alters verapamil elimination and dynamics: single dose and steadystate responses. J Pharmacol Exp Ther 1990;255:364–373.

    PubMed  CAS  Google Scholar 

  124. Scott HD, Laake K. Statins for the prevention of Alzheimer’s disease. Cochrane Database Syst Rev 2001;CD 003160.

    Google Scholar 

  125. Scott M, Castleden C.M, Adam H.K, Smith R.P, Fitzsimons T.J. The effect of ageing on the disposition of nifedipine and atenolol. Br J Clin Pharmacol 1988;25:289–296.

    Article  PubMed  CAS  Google Scholar 

  126. Selhub J, Jacques P.F, Wilson P.W, Rush D, Rosenberg I.H. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA 1993;270:2693–2698.

    Article  PubMed  CAS  Google Scholar 

  127. Shekelle R.B, Stamler J. Dietary cholesterol and ischaemic heart disease. Lancet 1989;1:1177–1179.

    Google Scholar 

  128. Shepherd J, Blauw G.J, Murphy M.B, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet 2002;360:1623–1630.

    Article  PubMed  CAS  Google Scholar 

  129. Shepherd J, Cobbe S.M, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med 1995;333:1301–1307.

    Article  PubMed  CAS  Google Scholar 

  130. Silagy C, Mant D, Fowler G, Lodge M. Meta-analysis on efficacy of nicotine replacement therapies in smoking cessation. Lancet 1994;343:139–142.

    Article  PubMed  CAS  Google Scholar 

  131. Sorensen H.T, Mellemkjaer L, Olsen J.H. Risk of suicide in users of beta-adrenoceptor blockers, calcium channel blockers and angiotensin converting enzyme inhibitors. Br J Clin Pharmacol 2001;52:313–318.

    Article  PubMed  CAS  Google Scholar 

  132. Staessen J.A, Fagard R, Thijs L, et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet 1997;350:757–764.

    Article  PubMed  CAS  Google Scholar 

  133. Staessen J.A, Gasowski J, Wang J.G, et al. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet 2000;355:865–872.

    Article  PubMed  CAS  Google Scholar 

  134. Stampfer M.J, Colditz G.A. Estrogen replacement therapy and coronary heart disease: a quantitative assessment of the epidemiologic evidence. Prev Med 1991;20:47–63.

    Article  PubMed  CAS  Google Scholar 

  135. Stapleton J.A, Lowin A, Russell M.A. Prescription of transdermal nicotine patches for smoking cessation in general practice: evaluation of cost-effectiveness. Lancet 1999;354:210–215.

    Article  PubMed  CAS  Google Scholar 

  136. The ALLHAT officers and coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. JAMA 2002;288:2998–3007.

    Article  Google Scholar 

  137. The Lipid Research Clinics Coronary Primary Prevention Trial results. II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA 1984;251:365–374.

    Article  Google Scholar 

  138. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997;157:2413–2446.

    Article  Google Scholar 

  139. The West of Scotland Coronary Prevention Study Group. Baseline risk factors and their association with outcome in the West of Scotland Coronary Prevention Study. Am J Cardiol 1997;79:756–762.

    Article  Google Scholar 

  140. Tomlinson B, Chan P, Lan W. How well tolerated are lipid-lowering drugs? Drugs Aging 2001;18:665–683.

    Article  PubMed  CAS  Google Scholar 

  141. Tune L, Carr S, Hoag E, Cooper T. Anticholinergic effects of drugs commonly prescribed for the elderly: potential means for assessing risk of delirium. Am J Psychiatry 1992;149:1393–1394.

    PubMed  CAS  Google Scholar 

  142. Tune L.E. Anticholinergic effects of medication in elderly patients. Journal of Clinical Psychiatry 2001;62:11–14.

    PubMed  CAS  Google Scholar 

  143. Vestal R.E. Aging and determinants of hepatic drug clearance. Hepatology 1989;9:331–334.

    Article  PubMed  CAS  Google Scholar 

  144. Weber M.A. Commentary: The ALLHAT report: a case of information and misinformation. J Clin Hypertens (Greenwich) 2003;5:9–13.

    Article  Google Scholar 

  145. Wei J.Y. Use of calcium entry blockers in elderly patients. Special considerations. Circulation 1989;80:IV171–IV177.

    CAS  Google Scholar 

  146. Wenger T.L, Stern W.C. The cardiovascular profile of bupropion. J Clin Psychiatry 1983;44:176–182.

    PubMed  CAS  Google Scholar 

  147. Whelton A. Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med 1999;106:13S–24S.

    Article  PubMed  CAS  Google Scholar 

  148. Whelton P.K, He J, Appel L.J, et al. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. JAMA 2002;288:1882–1888.

    Article  PubMed  Google Scholar 

  149. White I.R. The cardioprotective effects of moderate alcohol consumption. BMJ 1996;312:1179–1180.

    Article  PubMed  CAS  Google Scholar 

  150. Wing LMH, Reid C.M, Ryan P, Beilin L.J, Brown M.A, Jennings G.L.R et al. A comparison of outcomes with angiotensin-converting enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med 2003;348: 583–592.

    Article  PubMed  CAS  Google Scholar 

  151. Woolacott N.F, Jones L, Forbes C.A, et al. The clinical effectiveness and cost-effectiveness of bupropion and nicotine replacement therapy for smoking cessation: a systematic review and economic evaluation. Health Technol Assess 2002;6:1–245.

    CAS  Google Scholar 

  152. Wright J.M, Lee C.H, Chambers G.K. Systematic review of antihypertensive therapies: does the evidence assist in choosing a first-line drug? CMAJ 1999;161:25–32.

    PubMed  CAS  Google Scholar 

  153. Wynne H.A, Cope L.H, Mutch E, Rawlins M.D, Woodhouse K.W, James O.F. The effect of age upon liver volume and apparent liver blood flow in healthy man. Hepatology 1989;9:297–301.

    Article  PubMed  CAS  Google Scholar 

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Patterson, C., Grymonpre, R. (2004). Primary Prevention of Cardiovascular Events in Older Individuals. In: Turpie, I.D., Heckman, G.A. (eds) Aging Issues in Cardiology. Developments in Cardiovascular Medicine, vol 250. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-8865-2_5

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