[Management of cardiovascular risk in the elderly patient]

The management of cardiovascular risk in elderly patients should take into account the complexity that characterizes them, including physiological changes, comorbidities, as well as the individual's life expectancy. Up to 70-75 years old the guideline for the cardiovascular risk management is well structured. If the estimated risk is determined by using the "SCORE" model or cardiovascular prevention algorithm, the treatment is based on the importance of the risk. Recommendations beyond 75 years of age are not as clear. Although, we have a growing number of studies used to treat older patients, there are only a few recommendations for extreme old ages. The major modifiable risk factors are smoking, hypertension, dyslipidaemia, diabetes, and obesity. For cardiovascular events the impact of the risk factors changes with age and influence the therapeutic management of the risk factors. Some interventions beneficial to young patients may be deleterious to the elderly. In addition, it is better defined for elderly patients with few comorbidities, and greater than 10 years life expectancy, because it tends to model the guidelines known to patients who are younger than 70 years old. This is not true for other patient profiles where only a few recommendations can guide us for optimal care.