Kannel W B
Department of Preventive Medicine and Epidemiology, Evans Memorial Research Foundation, Boston University School of Medicine, Boston, Massachusetts, USA.
Coron Artery Dis. 1997 Aug-Sep;8(8-9):565-75.
Scepticism about the relevance of preventive measures against cardiovascular disease in the elderly is unjustified because there is evidence that it is possible to assuage the ravages of a lifetime of exposure to risk factors, even beginning late in life. Declines in cardiovascular mortality have occurred in the elderly as well as in the middle-aged. Risk factors that influence the occurrence of cardiovascular disease in the elderly are much the same as those that operate in middle age. The potential and demonstrated benefits of correcting the major cardiovascular risk factors in the older adult are at least as great as for the middle-aged. multivariate risk assessment facilitates the cost-effective targeting of the elderly for treatment. The correction of hypertension and dyslipidemia have been shown to reduce cardiovascular morbidity and mortality in both middle-aged and elderly age-groups. The efficacies of other measures such as lowering homocysteine and fibrinogen levels, quitting smoking, exercising or weight reduction, are not established but nevertheless such measures appear to be warranted.
对老年人采取心血管疾病预防措施的相关性持怀疑态度是没有道理的,因为有证据表明,即使在生命后期开始,也有可能减轻一生暴露于风险因素所造成的损害。老年人以及中年人的心血管死亡率都有所下降。影响老年人心血管疾病发生的风险因素与中年人的大致相同。在老年人中纠正主要心血管风险因素的潜在益处和已证实的益处至少与中年人一样大。多变量风险评估有助于以具有成本效益的方式确定老年人的治疗目标。已证明纠正高血压和血脂异常可降低中年人和老年人的心血管发病率和死亡率。降低同型半胱氨酸和纤维蛋白原水平、戒烟、锻炼或减重等其他措施的疗效尚未确定,但这些措施似乎是有必要的。