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.
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References
WHO Study Group on Epidemiology and Prevention of Cardiovascular Disease in the Elderly. Epidemiology and Prevention of Cardiovascular Diseases in Elderly People. Report of a World Health Organization Study Group. WHO Technical Report Series No. 853. World Health Organization, Geneva, 1995.
Abrams J, Coultas DB, Malhotra D, Vela BS, Samaan SA, Roche RJ. Coronary risk factors and their modification: lipids, smoking, hypertension, estrogen, and the elderly. Curr Prob Cardiol 1995; 20: 535 - 610.
Lee PY, Alexander KP, Hammill BG, Pasquali SK, Peterson ED. Representation of elderly persons and women in published randomized trials of acute coronary syndromes. JAMA 2001; 286: 708 - 713.
Kannel WB. Clinical misconceptions dispelled by epidemiological research. Circulation 1995; 92: 3350 - 3360.
Kannel WB. Coronary heart disease risk factors in the elderly. Am J Geriatr Cardiol 2002; 11: 101 - 107.
Burke GL, Arnold AM, Bild DE, et al. Factors associated with healthy aging: the Cardiovascular Health Study. J Am Geriatr Soc 2001; 49: 254 - 262.
Larson MG. Assessment of cardiovascular risk factors in the elderly: the Framingham Heart Study. Stat Med 1995; 14: 1745 - 1756.
Menotti A, Mulder I, Nissinen A, et al. Cardiovascular risk factors and 10-year all-cause mortality in elderly European male populations. The FINE study. Eur Heart J 2001; 22: 573 - 579.
Kuller L, Borhani N, Furberg C, et al. Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. AmJ Epidemiol 1994; 139: 1164 - 1179.
Kuller LH, Shemanski L, Psaty BM, et al. Subclinical disease as an independent risk factor for cardiovascular disease. Circulation 1996; 92: 720 - 726.
Maroo A, O’Connell CJ. CME Paper. Current practice and future promise for clinical noninvasive measurements of subclinical atherosclerotic disease in the elderly. Am J Geriatr Cardiol 2002; 11: 108 - 116.
The Clinical Quality Improvement Network (CQIN) Investigators. Low incidence of assessment and modification of risk factors in acute care patients at high risk for cardiovascular events, particularly among females and the elderly. Am J Cardiol 1995; 76: 570 - 573.
Williams MA, Fleg JL, Ades PA, et al. Secondary prevention of coronary heart disease in the elderly (with emphasis on patients >_75 years of age): An American Heart Association Scientific Statement from the Council on Clinical Cardiology Subcommittee on Exercise Testing, Cardiac Rehabilitation, and Prevention. Circulation 2002; 105: 1735 - 1743.
Glynn RJ, Chae CU, Guralnik JM, et al. Pulse pressure and mortality in old people. Arch Intern Med 2000; 160: 2765 - 2772.
O’Donnell CJ, Kannel WB. Epidemiologic appraisal of hypertension as a coronary risk factor in the elderly. Am J Geriatr Cardiol 2002; 11: 86 - 92.
Sutton-Tyrrell K, Alcorn HG, Herzog H, Kelsey SF, Kuller LH. Morbidity, mortality, and hypertensive treatment effects by extent of atherosclerosis in older adults with isolated systolic hypertension. Stroke 1995; 26: 1319 - 1324.
Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension in the US adult population: results from the third National Health and Nutrition Examination Survey, 1988-1991. Hypertension 1995; 25: 305 - 313.
National High Blood Pressure Education Program Working Group. National High Blood Pressure Education Program Working Group report on hypertension in the elderly. Hypertension 1994; 23: 275 - 285.
Kannel WB, D’ Agostino RB, Silberschatz H. Blood pressure and cardiovascular morbidity and mortality rates in the elderly. Am Heart J 1997; 134: 758 - 763.
27th Bethesda Conference. Matching the intensity of risk factor management with the hazard for coronary disease events. J Am Coll Cardiol 1996; 27: 957 - 1047.
Psaty BM, Furberg CD, Kuller LH, et al. Traditional risk factors and subclinical disease measures as predictors of first myocardial infarction in older adults: the Cardiovascular Health Study. Arch Intern Med 1999; 159: 1339 - 1347.
Psaty BM, Furberg CD, Kuller LH, et al. Association between blood pressure level and the risk of myocardial infarction, stroke, and total mortality: the Cardiovascular Health Study. Arch Intern Med 2001; 161: 1183 - 1192.
van den Hoogen PC, van Popele NM, Feskens EJ, et al. Blood pressure and risk of myocardial infarction in elderly men and women: the Rotterdam Study. J Hypertension 1999; 17: 1373 - 1378.
Franklin SS, Larson MG, Khan SA, et al. Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study. Circulation 2001; 103: 1245 - 1249.
Madhavan S, Ooi WL, Cohen H, Alderman MH. Relation of pulse pressure and blood pressure reduction to the incidence of myocardial infarction. Hypertension 1994; 23: 395 - 401.
Lee ML, Rosner BA, Weiss ST. Relationship of blood pressure to cardiovascular death: the effects of pulse pressure in the elderly. Ann Epidemiol 1999; 9: 101 - 107.
Whelton PK, Appel LJ, Espeland MA, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. JAMA 1998; 279: 839 - 846.
Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaC 1) diet on blood pressure. J Hum Hypertens 1999; 13: 367 - 374.
Sowers JR, Farrow AL. Treatment of elderly hypertensive patients with diabetes, renal disease, and coronary heart disease. Am J Geriatr Cardiol 1996; 5: 57 - 70.
Frost PH, Davis BR, Burlando AJ, et al. Coronary heart disease risk factors in men and women aged 60 years and older: findings from the Systolic Hypertension in the Elderly Program. Circulation 1996; 94: 26 - 34.
Curb JD, Pressel SL, Cutler JA, et al. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. JAMA 1996; 276: 1886 - 1892.
Savage PJ, Pressel SL, Curb JD, et al. Influence of long-term, low-dose, diuretic-based, antihypertensive therapy on glucose, lipid, uric acid, and potassium levels in older men and women with isolated systolic hypertension: The Systolic Hypertension in the Elderly Program. SHEP Cooperative Research Group. Arch Intern Med 1998; 158: 741 - 751.
Staessen JA, Gasowski J, Wang JE, et al. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet 2000; 355: 865 - 872.
MacMahon S, Rodger A. The effects of blood pressure reduction in older patients: an overview of five randomized controlled trials in elderly hypertensives. J Clin Exp Hypertension 1993; 15: 967 - 978.
Pearce KA, Furberg CD, Rushing J. Does antihypertensive treatment of the elderly prevent cardiovascular events or prolong life? A meta-analysis of hypertension treatment trials. Arch Fam Med 1995; 4: 943 - 949.
Staessen JA, 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 (SystEur) Trial Investigators. Lancet 1997; 350: 757 - 764.
Gueyffier F, Bulpitt C, Boissel J-P, et al. Antihypertensive drugs in very old people: a subgroup meta-analysis of randomised controlled trials. Lancet 1999; 353: 793 - 796.
Ogihara T, Kuramoto K. Effect of long-term treatment with antihypertensive drugs on quality of life of elderly patients with hypertension: a double-blind comparative study between a calcium antagonist and a diuretic. NICS-EH Study Group. National Intervention Cooperative Study in Elderly Hypertensives. Hypertension Res 2000; 23: 33 - 37.
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.
Setaro JF, Black HR. Refractory hypertension. N Engl J Med 1992; 327: 543 - 547.
Ettinger WH, Wahl PW, Kuller LH, et al., for the CHS Collaborative Research Group. Lipoprotein lipids in older people. Results from the Cardiovascular Health Study. Circulation 1992; 86: 858 - 869.
Kannel WB. Range of serum cholesterol values in the population developing coronary artery disease. Am J Cardiol 1995; 76: 69C - 77C.
Houterman S, Verschuren WM, Hofman A, Witteman JC. Serum cholesterol is a risk factor for myocardial infarction in elderly men and women: the Rotterdam Study. J Intern Med 1999; 246: 25 - 33.
Oomen CM, Ocke MC, Feskens EJ, van Erp-Baart MA, Kok FJ, Kromhout D. Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study. Lancet 2001; 357: 746 - 751.
Houterman S, Verschuren WM, Giampaoli S, et al. Total but not high-density lipoprotein cholesterol is consistently associated with coronary heart disease mortality in elderly men in Finland, Italy, and The Netherlands. Epidemiology 2000; 11: 327 - 332.
Corti MC, Guralnik JM, Salive ME, et al. Clarifying the direct relation between total cholesterol levels and death from coronary heart disease in older persons. Ann Intern Med 1997; 126: 753 - 760.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). JAMA 1993; 269: 3015 - 3023.
Sempos CT, Cleeman JI, Carroll MD, et al. Prevalence of high blood cholesterol among U.S. adults: an update based on guidelines from the Second Report of the National Cholesterol Education Program Adult Treatment Panel. JAMA 1993; 269: 3009 - 3014.
Grundy SM, Cleeman JI, Rifkind BM, Kuller LH. Cholesterol lowering in the elderly population. Coordinating Committee of the National Cholesterol Education Program. Arch Intern Med 1999; 159: 1670 - 1678.
Miettinen TA, Pyorala K, Olsson AG, et al., for the Scandinavian Simvastatin Study Group. Cholesterol-lowering therapy in women and elderly patients with myocardial infarction or angina pectoris. Findings from the Scandinavian Simvastatin Survival Study (4S). Circulation 1997; 96: 4211 - 4218.
Lewis SJ, Moye LA, Sacks FM, et al., for the CARE Investigators. Effect of pravastatin on cardiovascular events in older patients with myocardial infarction and cholesterol levels in the average range. Results of the Cholesterol and Recurrent Events (CARE) Trial. Ann Intern Med 1998; 129: 681 - 689.
The Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349 - 1357.
West of Scotland Coronary Prevention Study Group. Influence of pravastatin and plasma lipids on clinical events in the West of Scotland Coronary Prevention Study (WOSCOPS). Circulation 1998; 97: 1440 - 1445.
Downs JR, Clearfield M, Weis S, et al., for the AFCAPS/TexCAPS Research Group. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. Results of AFCAPS/TexCAPS. JAMA 1998; 279: 1615 - 1622.
LaRosa JC, He J, Vupputuri S. Effect of statins on risk of coronary disease. A meta-analysis of randomized controlled trials. JAMA 1999; 282: 2340 - 2346.
Lilly LS. Drug therapy of lipid disorders: benefits and limitations in elderly patients. Am J Geriatr Cardiol 1996;5: 15-16, 21 - 26.
Sacks FM, Tonkin AM, Shepherd J, et al. Effect of pravastatin on coronary disease events in subgroups defined by coronary risk factors: the Prospective Pravastatin Pooling Project. Circulation 2000; 102: 1893 - 1900.
Campeau L, Hunninghake DB, Knatterud GL, et al., and Post CABG Trial Investigators. Aggressive cholesterol lowering delays saphenous vein graft atherosclerosis in women, the elderly, and patients with associated risk factors. NHLBI Post Coronary Artery Bypass Graft Clinical Trial. Circulation 1999; 99: 3241 - 3247.
Shepherd J, Blauw GJ, Murphy MB, et al. The design of a prospective study of Pravastatin in the Elderly at Risk (PROSPER). PROSPER Study Group. Prospective Study of Pravastatin in the Elderly at Risk. Am J Cardiol 1999; 84: 1192 - 1197.
Heart Protection Study Collaborative Group. MRC/BHF Heart Protection study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 2000; 360: 7 - 22.
Rockwood K, Kirkland S, Hogan DB, et al. Use of lipid-lowering agents, indication bias, and the risk of dementia in community-dwelling elderly people. Arch Neurol 2002; 59: 223 - 227.
Hamilton VH, Racicot F-E, Zowall MA, Coupal L, Grover SA. The cost-effectiveness of HMG-CoA reductase inhibitors to prevent coronary heart disease: estimating the benefits of increasing HDL-C. JAMA 1995; 273: 1032 - 1038.
Ganz DA, Kuntz KM, Jacobson GA, et al. Cost-effectiveness of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor therapy in older patients with myocardial infarction. Ann Intern Med 2000; 132: 780 - 787.
Santanello N, Barber BL, Applegate WB, et al., for the CRISP Collaborative Study Group. Effect of pharmacologic lipid lowering on health-related quality of life in older persons: results form the Cholesterol Reduction in Seniors Program (CRISP) Pilot Study. J Am Geriatr Soc 1997; 45: 8 - 14.
McAlister FA, Taylor L, Teo KK, et al. The treatment and prevention of coronary heart disease in Canada: do older patients receive efficacious therapies? The Clinical Quality Improvement Network (CQIN) Investigators. J Am Geriatr Soc 1999; 47: 811 - 818.
Shaefer EJ, Lichtenstein AH, Lamon-Fava S, et al. Effects of National Cholesterol Education Program Step 2 diets relatively high or relatively low in fish-derived fatty acids on plasma lipoproteins in middle-aged and elderly subjects. Am J Clin Nutr 1996; 63: 234 - 241.
Kromhout D, Feskens EJM, Bowles CH. The protective effect of a small amount of fish on coronary heart disease mortality in an elderly population. Int J Epidemiol 1995; 24: 340 - 345.
Ades PA, Poehlman ET. The effects of exercise training on serum lipids in the elderly. J Am Geriatr Cardiol 1996; 5: 27 - 31.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486 - 2497.
Harris TB, Launer LJ, Madans J, Feldman JJ. Cohort study of effect of being overweight and change in weight of coronary heart disease in old age. Br Med J 1997; 314: 1791 - 1794.
Vokonas PS, Kannel WB. Epidemiology of coronary heart disease in the elderly. In: Tresch DD, Aronow WS, eds., Cardiovascular Disease in the Elderly Patient. Marcel Dekker, New York, 1994, pp. 91 - 123.
Harvey-Berino J. Weight loss in the clinical setting: applications for cardiac rehabilitation. Coronary Artery Dis 1998; 9: 795 - 798.
Krauss RM, Eckel RH, Howard B, et al. AHA Dietary Guidelines. Revision 2000: A Statement for Healthcare Professionals from the Nutrition Committee of the American Heart Association. Circulation 2000; 102: 2284 - 2299.
Heiat A, Vaccarino V, Krumholz HM. An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Arch Intern Med 2001; 161: 1194 - 1203.
LaCroix AZ, Lang J, Scherr P, et al. Smoking and mortality among older men and women in three cornmunities. N Engl J Med 1991; 324: 1619 - 1625.
Hermanson B, Omenn GS, Kronmal RA, Gersh BJ, and participants in the Coronary Artery Surgery Study. Beneficial six-year outcome of smoking cessation in older men and women with coronary artery disease. Results from the CASS Registry. N Engl J Med 1988; 319: 1365 - 1369.
Morgan GD, Noll EL, Orleans BK, et al. Reaching midlife and older smokers: tailored interventions for routine medical care. Prey Med 1996; 25: 346 - 354.
Fiore MC, Bailey WC, Cohen SJ, et al. Treating Tobacco Use and Dependence. Clinical Practice Guideline. Rockville, MD. US Department of Health and Human Services. Public Health Service. June, 2000.
Kohrt WM, Kirwan JP, Staten MA, et al. Insulin resistance in aging is related to abdominal obesity. Diabetes 1993; 42: 273 - 281.
Kirwan JP, Lohrt WM, Wojta DM, et al. Endurance exercise training reduces glucose-stimulated insulin levels in 60- to 70-year-old men and women. J Gerontol 1993; 48: M84 - M90.
Brochu M, Poehlman EP, Savage PD, et al. Coronary risk profiles in male coronary patients: effects of body composition, fat distribution, age and fitness. Coronary Artery Dis 2000; 1: 137 - 144.
Diabetes and the heart. Lancet 1997; 350 (Suppl I): 1 - 32.
Lindholm LH, Hansson L, Ekbom T, et al. Comparison of antihypertensive treatments in preventing cardiovascular events in elderly diabetic patients: results from the Swedish Trial in Old Patients with Hypertension-2. STOP Hypertension-2 Study Group. J Hypertens 2000; 18: 1671 - 1675.
Wannamethee SG, Shaper AG, Walker M. changes in physical activity, mortality, and incidence of coronary heart disease in older men. Lancet 1998; 351: 1603 - 1608.
Siscovick DS, Fried L, Mittelmark M, Rutan G, Bild D, O’Leary DH. Exercise intensity and subclinical cardiovascular disease in the elderly. The Cardiovascular Health Study. Am J Epidemiol 1997; 145: 977 - 986.
Fried LP, Kronmal RA, Newman AB, et al. Risk factors for 5-year mortality in older adults. JAMA 1998; 279: 585 - 592.
Wenger NK. Physical inactivity and coronary heart disease in elderly patients. Clin Geriatr Med 1996; 12: 79 - 88.
Hakim AA, Petrovitch H, Burchfiel CM, et al. Effects of walking on mortality among nonsmoking retired men. N Engl J Med 1998; 338: 94 - 99.
Kushi LH, Fee RM, Folsom AR, et al. Physical activity and mortality in postmenopausal women. JAMA 1997; 277: 1287 - 1292.
LaCroix AZ, Leveille SG, Hecht JA, Grothaus LC, Wagner EH. Does walking decrease the risk of cardiovascular disease hospitalizations and death in older adults? J Am Geriatr Soc 1996; 44: 113 - 120.
Lee IM, Sesso HD, Paffenbarger RS Jr. Physical activity and coronary heart disease risk in men: does the duration of exercise episodes predict risk? Circulation 2000; 102: 981 - 986.
Hakim AA, Curb JD, Petrovitch H, et al. Effects of walking on coronary heart disease in elderly men: the Honolulu Heart Program. Circulation 1999; 100: 9 - 13.
Young DR, Appel LJ, Jee S, Miller ER III. The effects of aerobic exercise and T’ ai Chi on elderly men: blood pressure in older people: results of a randomized trial. J Am Geriatr Soc 1999; 47: 277 - 284.
Williams MA, Maresh CM, Esterbrooks DJ, et al. Early exercise training in patients older than age 65 years compared with that in younger patients after acute myocardial infarction or coronary artery bypass grafting. Am J Cardiol 1985; 55: 263 - 266.
Lavie CJ, Milani RV, Littman AB. Benefits of cardiac rehabilitation and exercise training in secondary coronary prevention in the elderly. J Am Coll Cardiol 1993; 22: 678 - 683.
Wannamethee SG, Shaper AG, Walker M. Physical activity and mortality in older men with diagnosed heart disease. Circulation 2000; 102: 1358 - 1363.
Williams MA. Exercise testing in cardiac rehabilitation: exercise prescription and beyond. Cardiology Clinics 2001; 19: 415 - 431.
Pollock ML, Franklin BA, Balady GJ, et al. Resistance exercise in individuals with and without car- diovascular disease: benefits, rationale, safety, and prescription. Circulation 2000; 101: 828 - 833.
Onder G, Penninx BWJH, Balkrishnan R, et al. Relation between use of angiotensin-converting enzyme inhibitors and muscle strength and physical function in older women: an observational study. Lancet 2002; 359: 926 - 930.
Wenger NK. A cardiologist’s view of hormone replacement therapy and alternatives for cardioprotection. Women’s Health Gender-Based Med 2001; 10: 257 - 260.
Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA 1998; 280: 605 - 613.
Mosca L, Collins P, Herrington DM, et al. Hormone replacement therapy and cardiovascular disease. A statement for healthcare professionals from the American Heart Association. Circulation 2001; 104: 499 - 503.
Grady D, Herrington D, Bittner V, et al. Cardiovascular disease outcomes during 6.8 years of hormone therapy. Heart and Estrogen/progestin Replacement Study follow-up (HERS II). JAMA 2002; 288: 49 - 57.
Writing Group for the Women’s Health Initiative Investigators. 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.
O’Leary DH, Polak JF, Kronmal RA, et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999; 340: 14 - 22.
Newman AB, Shemanski L, Manolio TA, et al. Ankle-arm index as a predictor of cardiovascular disease and mortality in the Cardiovascular Health Study. The Cardiovascular Health Study Group. Arterioscler Thromb Vasc Biology 1999; 19: 538 - 545.
Ariyo AA, Haan M, Tangen CM, et al. Depressive symptoms and risks of coronary heart disease and mortality in elderly Americans. Cardiovascular Health Study Collaborative Research Group. Circulation 2000; 102: 1773 - 1779.
Wassertheil-Smoller S, Applegate WB, Berge K, et al. Change in depression as a precursor of cardiovascular events. SHEP Cooperative Research Group (Systolic Hypertension in the Elderly). Arch Intern Med 1996; 156: 553 - 561.
Sesso HD, Kawachi I, Vokonas PS, Sparrow D. Depression and the risk of coronary heart disease in the Normative Aging Study. Am J Cardiol 1998; 82: 851 - 856.
Mendes de Leon CF, Krumholz HM, Seeman TS, et al. Depression and risk of coronary heart disease in elderly men and women: New Haven EPESE, 1982-1991. Established Populations for the Epidemiologic Studies of the Elderly. Arch Intern Med 1998; 158: 2341 - 2348.
Bostom AG, Silbershatz H, Rosenberg IH, et al. Nonfasting plasma total homocysteine levels and all-cause and cardiovascular disease mortality in elderly Framingham men and women. Arch Intern Med 1999; 159: 1077 - 1080.
Bots ML, Launer LJ, Lindemans J, Hofman A, Grobbee DE. Homocysteine, atherosclerosis and prevalent cardiovascular disease in the elderly: The Rotterdam Study. J Intern Med 1997; 242: 339 - 347.
Booth GL, Wang EE. 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. Canadian Medical Association Journal 2000; 163: 21 - 29.
Zeitlin A, Frishman WH, Chang CJ. The association of vitamin B 12 and folate blood levels with mortality and cardiovascular morbidity incidence in the old old: the Bronx Aging Study. Am J Therap 1997; 4: 275 - 281.
Valmadrid CT, Klein R, Moss SE, Klein BE. The risk of cardiovascular disease mortality associated with microalbuminuria and gross proteinuria in persons with older-onset diabetes mellitus. Arch Intern Med 2000; 160: 1093 - 1100.
Shlipak MG, Simon JA, Grady D, Lin F, Wenger NK, Furberg CD, for the Heart and Estrogen/progestin Replacement Study (HERS) Investigators. Renal insufficiency and cardiovascular events in postmenopausal women with coronary heart disease. J Am Coll Cardiol 2001; 38: 705 - 711.
Tracy RP, Lemaitre RN, Psaty BM, et al. Relationship of C-reactive protein to risk of cardiovascular disease in the elderly. Results from the Cardiovascular Health Study and the Rural Health Promotion Project. Arterioscler Thromb Vasc Biol 1997; 17: 1121 - 1127.
Strandberg TE, Tilvis RS. C-reactive protein, cardiovascular risk factors, and mortality in a prospective study in the elderly. Arterioscler Thromb Vasc Biol 2000; 20: 1057 - 1060.
Tracy RP. Hemostatic and inflammatory markers as risk factors for coronary disease in the elderly. Am J Geriatr Cardiol 2002; 11: 93-100, 107.
Lemaitre RN, Furberg CD, Newman AB, et al. Time trends in the use of cholesterol-lowering agents in older adults. The Cardiovascular Health Study. Arch Intern Med 1998; 158: 1761 - 1768.
MacMahon S, Rodgers A. The effects of blood pressure reduction in older patients: an overview of five randomized controlled trials in elderly hypertensives. Clin Exp Hypertens 1993; 15: 967 - 978.
SHEP Cooperative Research Group. 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). JAMA 1991; 265: 3255 - 3264.
MRC Working Party. Medical Research Council trial of treatment of hypertension in older adults: principal results. Br Med J 1992; 304: 405 - 412.
Staessen JA, Fagard R, Thijs L, et al., for the Systolic Hypertension - Europe (Syst-Eur) Trial Investigators. Morbidity and mortality in the placebo-controlled European Trial on Isolated Systolic Hypertension in the Elderly. Lancet 1997; 260: 757 - 764.
Soons KR, Little DN, Harvey J. Cholesterol screening in the elderly: changing attitudes. Gerontol 1995; 41: 57 - 62.
Lave JR, Ives DG. Participation in health promotion programs by the rural elderly. Am J Prey Med 1995; 11: 46 - 53.
Dellasega C, Brown R, White A. Cholesterol-related health behaviors in rural elderly persons. J Gerontol Nurs 1995; 21: 6 - 12.
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Wenger, N.K. (2003). Risk Factors and the Prevention of Heart Disease. In: Edwards, N.M., Maurer, M.S., Wellner, R.B. (eds) Aging, Heart Disease, and Its Management. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-357-6_10
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