Levine Barbara S, Kannel William B
Department of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA, USA.
Prog Cardiovasc Nurs. 2003 Summer;18(3):135-40. doi: 10.1111/j.0889-7204.2003.01947.x.
Evidence from epidemiologic studies indicates that the same factors that are associated with increased risk of coronary heart disease (CHD) in middle-aged people are relevant in older adults (i.e., those aged >or=65). The relative risk associated with some risk factors decreases with advancing age but this is offset by greater incidence of CHD among older adults. A growing body of evidence from clinical trials indicates that risk factor modification in older adults reduces CHD risk as effectively as it does in middle-aged adults. Multivariable risk assessment can be used to effectively target intervention to those at significant risk for an initial CHD event and to avoid over-treatment. It is important to appreciate that the average remaining life expectancy after achieving 80 years is about 8 years.
流行病学研究证据表明，与中年人冠心病（CHD）风险增加相关的相同因素在老年人（即年龄≥65岁者）中也具有相关性。一些风险因素相关的相对风险会随着年龄增长而降低，但这被老年人中冠心病更高的发病率所抵消。来自临床试验的越来越多的证据表明，老年人中风险因素的改善与中年人一样能有效降低冠心病风险。多变量风险评估可用于有效地将干预目标对准首次发生冠心病事件的高风险人群，并避免过度治疗。必须认识到，达到80岁后的平均剩余预期寿命约为8年。
