Prevention of cardiovascular disease among the elderly.

Cardiovascular diseases are a major cause of mortality, morbidity and disability of the elderly in both developed and developing countries. Their prevention has two aims: to add life to years and years to life. Observational studies suggest that the risk factors for these diseases in the middle-aged predict their incidence and the mortality due to them among the elderly. Direct evidence on the effectiveness of prevention by controlling these risk factors in the elderly, however, is still largely lacking or inconclusive. Nevertheless, the recent falling mortality trends in several countries indicate that deaths due to cardiovascular diseases can decrease rapidly also among the elderly, although the causes of the trends are not yet all clear. The very large cross-national differences in mortality from coronary heart disease and cerebrovascular diseases are a challenge for the wider application of preventive measures now. For the control of some risk factors, particularly of high blood pressure, further research focused on the elderly is urgently needed.