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Published on: September 26, 2018
Review on the management of cardiovascular risk factors in the elderly
Magali González-Colaço Harmand1,2, María Del Mar García-Sanz3, Antònia Agustí4
1Department of Internal Medicine-Geriatric Medicine, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
Insights
Managing cardiovascular risk factors (CVRF) in older adults is crucial for preventing disease and functional decline. Comprehensive geriatric assessment is recommended due to limited high-quality studies on CVRF management in the elderly.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Cardiovascular risk factors (CVRF) are highly prevalent in the elderly.
- These factors contribute to cardiovascular disease and functional decline, impacting quality of life.
- Effective management strategies for CVRF in this demographic are essential.
Purpose of the Study:
- To conduct a comprehensive review of current evidence on managing CVRF in the elderly population.
- To identify and assess the quality of studies focusing on cardiovascular health in older adults.
Main Methods:
- Systematic literature search across PubMed, Clinicaltrials.org, and Embase.
- Inclusion of clinical trials, observational studies, reviews, and guidelines involving the elderly.
- Studies were screened, duplicates removed, and assessed using the GRADE methodology.
Main Results:
- A total of 136 studies were identified covering risk factors like sedentary lifestyle, smoking, obesity, hypertension, diabetes, dyslipidemia, and alcohol use.
- Results were categorized into diagnostic, preventive, and treatment recommendations based on study quality.
- A significant limitation identified was the scarcity of high-quality studies specifically targeting elderly populations.
Conclusions:
- The lack of robust evidence in elderly populations limits definitive recommendations for CVRF management.
- Comprehensive geriatric assessment is highlighted as the optimal approach for tailoring treatment plans.
- This approach considers individual baseline status and comorbidities for effective CVRF management in older adults.
Abstract:
Cardiovascular risk factors (CVRF) are very prevalent in the elderly population and in addition to predisposing to cardiovascular disease they are related to functional decline, which limits the quality of life in this population. The objective of this work is to offer a review of the current evidence in the management of CVRF in the elderly population. The search strategy was executed in PubMed, Clinicalstrials.org and Embase, to search for clinical trials, observational cohort or cross-sectional studies, reviews, and clinical practice guidelines focused or including elderly population. The results provided were refined after reading the title and abstract, as well as elimination of duplicates, and were finally identified and assessed following the GRADE methodology. A total of 136 studies were obtained for all predefined risk factors, such as sedentary lifestyle, smoking, obesity and metabolic syndrome, hypertension, diabetes mellitus, dyslipidemia and alcohol. We described the results of the studies identified and assessed according to their methodological quality in different recommendation sections: diagnostic and prevention, intervention, or treatment in the elderly population. As the main limitation to the results of this review, there is the lack of quality studies whose target population is elderly patients. This issue limits the recommendations that can be made in this population. Due to this reason, comprehensive geriatric assessment seems the best tool currently available to implement the most appropriate treatment plans based on the baseline situation and comorbidity of each elderly patient.
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