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Secondary prevention of coronary heart disease in the elderly

Kimberly A Dornbrook-Lavender1, Mary T Roth, John A Pieper

  • 1Division of Pharmacotherapy, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. kim_dornbrook@yahoo.com

The Annals of Pharmacotherapy
|November 25, 2003
PubMed

Insights

Pharmacologic agents like aspirin, beta-blockers, lipid-lowering drugs, and ACE inhibitors effectively prevent recurrent coronary heart disease (CHD) in older adults. These treatments offer significant benefits for elderly patients aged 65 and above.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Pharmacology

Background:

  • Coronary heart disease (CHD) is a primary cause of death and disability in individuals over 65.
  • The aging US population increases the number of older adults eligible for secondary prevention of CHD.
  • Pharmacologic interventions offer significant opportunities to reduce recurrent cardiovascular events in established CHD.

Purpose of the Study:

  • To review literature supporting the use of key medications for secondary prevention of CHD in the elderly.
  • To evaluate the efficacy of aspirin, beta-blockers, lipid-lowering agents, and ACE inhibitors in patients aged 65 years and older.

Main Methods:

  • A comprehensive MEDLINE search was conducted from 1990 to May 2003.
  • Key search terms included "coronary heart disease," "secondary prevention," and "elderly."
  • Primary and tertiary literature on the specified pharmacologic agents in the elderly was reviewed.

Main Results:

  • Pharmacologic agents demonstrate considerable potential for reducing recurrent CHD events in older adults.
  • Evidence supports the use of aspirin, beta-blockers, lipid-lowering agents, and ACE inhibitors for secondary CHD prevention.
  • Benefits observed in the elderly are comparable to, and sometimes exceed, those in younger populations.

Conclusions:

  • Aspirin, beta-blockers, lipid-lowering agents, and ACE inhibitors are effective for secondary CHD prevention in individuals aged 65 and older.
  • These medications should be prescribed to elderly patients unless contraindicated.
  • Further research is needed to fully elucidate benefits in the very elderly (>/=75 years).
Abstract

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