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Coronary heart disease in the elderly.

R F Gillum1, M Feinleib

  • 1National Center for Health Statistics, Hyattsville, MD 20782.

Comprehensive Therapy
|August 1, 1988
PubMed
Summary

Coronary heart disease (CHD) mortality in older adults has decreased, but its prevalence and healthcare utilization have increased. This highlights the urgent need for enhanced prevention strategies in the elderly population.

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Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Public Health

Background:

  • Coronary heart disease (CHD) remains a leading cause of death in individuals aged 65 and older.
  • While CHD mortality rates have declined since 1968, self-reported CHD prevalence has risen in this demographic.
  • Significant geographic variations in CHD mortality among the elderly have been observed.

Purpose of the Study:

  • To analyze trends in Coronary Heart Disease (CHD) mortality, morbidity, and healthcare utilization among the elderly population (≥65 years).
  • To assess changes in death rates, prevalence, hospitalizations, surgical procedures, and healthcare expenditures related to CHD in older adults.
  • To emphasize the need for improved prevention strategies based on current trends.

Main Methods:

  • Analysis of national mortality data for CHD deaths in persons aged 65 and older.
  • Examination of self-reported CHD prevalence data in the elderly population.
  • Review of hospitalization rates for acute myocardial infarction (MI), including case fatality rates.
  • Assessment of trends in the utilization of coronary artery bypass surgery and coronary arteriography.
  • Analysis of physician office visit data and healthcare expenditures for heart disease care in the elderly.

Main Results:

  • CHD was the leading cause of death in 1984 for those ≥65 years, with rates increasing with age and higher in men.
  • Since 1968, CHD death rates have declined across age, sex, and race groups, but self-reported prevalence has increased, particularly with age.
  • Hospitalization rates for acute MI have increased since 1970, while fatality rates have decreased. Utilization of revascularization procedures has dramatically increased.
  • Elderly individuals made millions of physician visits for chronic CHD, contributing significantly to healthcare costs.

Conclusions:

  • Despite declining mortality rates, the increasing prevalence and healthcare utilization for CHD in the elderly underscore a critical need for intensified prevention efforts.
  • The data suggests a growing burden of chronic CHD in the aging population, necessitating proactive public health interventions.
  • Further research and targeted interventions are required to mitigate the rising impact of CHD on the elderly's quality of life and healthcare system.

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