Skip to main content
SpringerLink
Log in

Coronary Heart Disease and Stroke

  • Chapter
  • First Online:
Drug Therapy for the Elderly

  • 1902 Accesses

Abstract

Although at declining incidence, cardiovascular diseases still represent the leading causes of death in the Western world, and myocardial infarction occupies the largest share within these deaths. In 2006, 26% of all 2,426,264 deaths in the United States resulted from cardiac diseases, 23% from malignant diseases; 6% were caused by cerebrovascular diseases. Cardiac deaths had a male/female ratio of 1.5. From 1999 to 2006, there was a decline of the total annual death rate from cardiac disease from 260 to 211 per 100,000 inhabitants. This rate is 207 at age 55–64 years and rises to 1,383 at age 75–84 years and even to 4,480 at age 85+ years (Heron et al. 2009). This indicates that although cardiac diseases as a major cause of death are on the decline, the immense increase at higher age is an important feature of aging societies. The life expectancy at birth in 2006 was 75 years for males, 80 years for females, with the difference mainly reflecting the underrepresentation of women in the incidence of cardiac disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Adams HP Jr, del Zoppo G, Alberts MJ et al (2007) Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 38:1655–1711

    Article  PubMed  Google Scholar 

  • Adams RJ, Albers G, Alberts MJ et al (2008) Update to the AHA/ASA recommendations for the prevention of stroke in patients with stroke and transient ischemic attack. Stroke 39:1647–1652

    Article  PubMed  Google Scholar 

  • Amarenco P, Bogousslavsky J, Callahan A 3rd et al (2006) Highdose atorvastatin after stroke or transient ischemic attack. N Engl J Med 355:549–559

    Article  PubMed  CAS  Google Scholar 

  • Aronow WS, Ahn C (1996) Risk factors for new coronary events in a large cohort of very elderly patients with and without coronary artery disease. Am J Cardiol 77:864–866

    Article  PubMed  CAS  Google Scholar 

  • Bach RG, Cannon CP, Weintraub WS et al (2005) The effect of routine, early invasive management on outcome for elderly patients with non-ST-segment elevation acute coronary syndromes. Ann Intern Med 141:186–195

    Google Scholar 

  • Baigent C, Keech A, Kearney PM et al (2005) Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 366(9493):1267–1278

    Article  PubMed  CAS  Google Scholar 

  • Boersma E, Harrington RA, Moliterno DJ et al (2002) Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-analysis of all major randomised clinical trials. Lancet 359(9302):189–198

    Article  PubMed  CAS  Google Scholar 

  • Cholesterol Treatment Trialists’ CTT Collaboration, Baigent C, Blackwell L et al (2010) Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 376:1670–1681

    Article  PubMed  CAS  Google Scholar 

  • COMMIT Collaborative Group (2005) Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: randomized placebo-controlled trial. Lancet 366:1622–1632

    Article  Google Scholar 

  • Döser S, Marz W, Reinecke MF et al (2004) Empfehlungen zur Statintherapie im Alter: Daten und Consensus. Internist (Berl) 45:1053–1062

    Article  Google Scholar 

  • Fibrinolytic Therapy Trialists’ (FTT) Collaborative Group (1994) Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1,000 patients. Lancet 343(8893):311–322

    Google Scholar 

  • Grundy SM, Cleeman JI, Merz CNB et al (2004) Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation 110:227–239

    Article  PubMed  Google Scholar 

  • Heart Protection Study Collaborative Group (2002) MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 360:7–22

    Article  Google Scholar 

  • Heron MP, Hoyert DL, Murphy SL, Xu JQ, Kochanek KD, Tejada-Vera B (2009) Deaths: final data for 2006. National vital statistics reports, vol 57, no 14. National Center for Health Statistics, Hyattsville

    Google Scholar 

  • Krumholz HM, Radford MJ, Ellerbeck EF et al (1995) Aspirin in the treatment of acute myocardial infarction in elderly Medicare beneficiaries. Patterns of use and outcomes. Circulation 92:2841–2847

    Article  PubMed  CAS  Google Scholar 

  • Kyriakides ZS, Kourouklis S, Kontaras K (2007) Acute coronary syndromes in the elderly. Drugs Aging 24:901–912

    Article  PubMed  CAS  Google Scholar 

  • Lenderink T, Boersma E, Gitt AK et al (2006) Patients using statin treatment within 24 h after admission for ST-elevation acute coronary syndromes had lower mortality than nonusers: a report from the first Euro Heart Survey on acute coronary syndromes. Eur Heart J 27:1799–1804

    Article  PubMed  CAS  Google Scholar 

  • Schuler J, Maier B, Behrens S, Thimme W (2006) Present treatment of acute myocardial infarction in patients over 75 years—data from the Berlin Myocardial Infarction Registry (BHIR). Clin Res Cardiol 95:360–367

    Article  PubMed  Google Scholar 

  • Shepherd J, Blauw GJ, Murphy MB et al (2002) Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet 360:1623–1630

    Article  PubMed  CAS  Google Scholar 

  • Task Force for Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of European Society of Cardiology, Bassand JP, Hamm CW et al (2007) Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J 28:1598–1660

    Article  PubMed  CAS  Google Scholar 

  • The TIME Investigators (2001) Trial of invasive versus medical therapy in elderly patients with chronic symptomatic coronary- artery disease (TIME): a randomised trial. Lancet 358:951–957

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Heidelberg, Maybachstr. 14, Mannheim, 68169, Germany

    Martin Wehling

Authors
  1. Martin Wehling
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Wehling .

Editor information

Editors and Affiliations

  1. Inst. Klinische Pharmakologie, Klinikum Stadt Mannheim gGmbH, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany

    Martin Wehling

Study Acronyms

AIRE

Acute Infarction Ramipril Efficacy Study

COMMIT

Clopidogrel and Metoprolol in Myocardial Infarction Trial

CRUSADE

Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines National Quality Improvement Initiative Database

CURE

Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial

ENHANCE

Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression Study

FTT

Fibrinolytic Therapy Trialists

HERS

Heart and Estrogen/Progestin Replacement Study

HOPE Studie

Heart Outcomes Prevention Study

HPS

Heart Protection Study

MADIT-II

Multicenter Automatic Defibrillator Implantation Trial II

MIRACL

Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering Study

PROSPER

Prospective Study of Pravastatin in the Elderly at Risk

SAVE

Survival and Ventricular Enlargement Study

SPARCL

Stroke Prevention by Aggressive Reduction in Cholesterol Level Study

TACTICS-TIMI-18

Treat Angina with Aggrastat and Determine Cost of Therapy with an Invasive Conservative Strategy

WHI Studie

Women’s Health Initiative Study

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Wien

About this chapter

Cite this chapter

Wehling, M. (2013). Coronary Heart Disease and Stroke. In: Wehling, M. (eds) Drug Therapy for the Elderly. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0912-0_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-0912-0_8

  • Published:

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-0911-3

  • Online ISBN: 978-3-7091-0912-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation