Epidemiological considerations in the prevention of coronary heart disease among the elderly

Coronary heart disease is a major health problem among the elderly, the importance of which increases with the rising proportion of old people. The significance of traditional cardiovascular risk factors has been documented in younger age groups, and it seems they are effective at least in 'young' elderly people (aged between 65 and 80 years), whereas their role is less well known in people over 80 years because other end-points such as stroke and cancer become increasingly important and coronary heart disease cannot be considered in isolation. Pharmacological treatment of hypertensive elderly patients can reduce the incidence of strokes significantly, but reduction of coronary heart disease incidence is less clear. There are many uncertainties relating to lipid-lowering medication in old people. Nonpharmacological means (modest lifestyle, healthy diet and regular exercise) are unlikely to be of harm in the prevention of coronary heart disease in the elderly.