Kannel W B
Cardiovasc Clin. 1992;22(2):9-22.
The major risk factors apply in the elderly as well as the young, including hypertension, dyslipidemia, impaired glucose tolerance, physical indolence, and [table: see text] cigarette smoking. These risk factors are highly prevalent in the elderly and are not inevitable consequences of aging and genetic makeup. With aging, there is a longer exposure to risk factors and diminished capacity to cope with them, resulting in a doubled incidence of cardiovascular sequelae at any level of risk factors compared with younger candidates for cardiovascular disease. The predisposing modifiable risk factors for coronary disease, stroke, cardiac failure, and peripheral arterial disease are virtually the same in younger and older candidates for cardiovascular disease. Multivariate cardiovascular risk profiles predict cardiovascular disease as efficiently in the elderly as in the young. There is also evidence that recurrent cardiovascular events are influenced by the same risk factors that predispose to initial events. Although proof of the efficacy of modifying risk factors in older persons is limited to hypertension control, recent declines in coronary and stroke mortality in the United States have included the elderly. This justifies extrapolations of data from the middle aged until sorely needed data become available on the efficacy of modifying risk factors in the elderly.
主要危险因素在老年人和年轻人中都适用，包括高血压、血脂异常、糖耐量受损、身体怠惰以及吸烟。这些危险因素在老年人中非常普遍，并非衰老和基因构成的必然结果。随着年龄增长，接触危险因素的时间更长，应对这些危险因素的能力下降，导致在任何危险因素水平下，心血管后遗症的发生率与年轻的心血管疾病患者相比都增加了一倍。年轻和老年心血管疾病患者中，冠心病、中风、心力衰竭和外周动脉疾病的可改变的易患危险因素实际上是相同的。多变量心血管风险概况在老年人中预测心血管疾病的效率与年轻人相同。也有证据表明，复发性心血管事件受与引发初始事件相同的危险因素影响。虽然改变老年人危险因素有效性的证据仅限于高血压控制，但美国近期冠心病和中风死亡率的下降也包括了老年人。这证明了从中年人数据进行外推是合理的，直到获得关于改变老年人危险因素有效性的迫切需要的数据。
