How to prevent cardiovascular diseases in old age?

Cardiovascular diseases, particularly in developed countries, have long been recognised as the leading cause of morbidity and mortality. With rising life expectancy and an ageing population, it is critical to focus on detecting and preventing cardiovascular disease in the elderly. Based on the findings of a review conducted by Wafik Farah Andrawes et al. and published in Drugs Ageing in 2005, this article aims to investigate the importance of cardiovascular preventive measures in individuals aged 65 years and older.

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Identifying Prevention Target Areas

The review emphasises stroke, coronary artery disease, and heart failure as the primary targets for cardiovascular prevention in the elderly. Effective prevention strategies can reduce the occurrence and severity of these conditions significantly. Here are some key findings about each condition’s preventive measures:

Stroke Avoidance:

  • Antihypertensive therapy has been shown to be effective in the primary prevention of fatal or nonfatal stroke, particularly in hypertensive and high-risk patients over the age of 60.
  • Reduced systolic blood pressure is also important in the secondary prevention of stroke.
  • In elderly patients with nonvalvular atrial fibrillation, adjusted warfarin treatment with an INR target of 2 to 3 can prevent ischemic stroke.
  • Antiplatelet agents are advised for elderly patients suffering from non-embolic strokes.

Preventing Coronary Artery Disease:

  • Several trials have shown that statins, antithrombotic agents, beta-adrenoceptor antagonists, and ACE inhibitors are effective in primary or secondary cardiovascular prevention in elderly people with ischemic heart disease.
  • Statins, in particular, have been shown to be beneficial in high-risk elderly subjects as young as 82 years old.
  • Carotid endarterectomy, a surgical procedure, is recommended in elderly patients with carotid artery stenosis greater than 70%, with better outcomes than in younger patients.
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Heart Failure Avoidance:

Antihypertensive therapy and influenza vaccination have been identified as effective preventive measures for elderly heart failure.

Changes in Lifestyle for Cardiovascular Health

In addition to medical interventions, lifestyle changes play an important role in the prevention of cardiovascular disease in old age. The following lifestyle modifications are suggested:

  • Smoking Cessation: Regardless of age, quitting smoking is critical for lowering the risk of cardiovascular events. To quit smoking, smokers should be encouraged and supported.
  • Regular Physical Activity: As tolerated, regular physical activity can improve cardiovascular health and overall well-being. As appropriate for their abilities, older adults should aim for a combination of aerobic exercise, strength training, and balance exercises.
  • Healthy Diet: A nutritious and balanced diet is essential for maintaining cardiovascular health. Seniors should eat a variety of fruits and vegetables, whole grains, lean proteins, and healthy fats while limiting salt, sugar, and processed foods.
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