Assessing Cardiovascular Risk in Geriatric Patients Without Atherosclerotic Cardiovascular Disease.

Area of Science:

• Gerontology
• Cardiovascular Medicine
• Public Health

Background:

• Age is a primary risk factor for atherosclerotic cardiovascular disease (ASCVD).
• Nearly all individuals aged 70 and older exceed conventional 10-year ASCVD risk thresholds.
• ASCVD risk modifiers like malnutrition, polypharmacy, and comorbidities are crucial considerations in older adults.

Purpose of the Study:

• To estimate the 10-year ASCVD risk in apparently healthy elderly individuals (aged 70+).
• To characterize this population using biochemical and clinical indicators.
• To evaluate the prevalence of ASCVD risk modifiers in this demographic.

Main Methods:

• The study enrolled 253 apparently healthy elderly individuals (70+ years) without established ASCVD.
• The Systemic Coronary Risk Estimation 2-Older Persons (SCORE2-OP) model was used to assess 10-year ASCVD risk.
• Biochemical and clinical indicators were evaluated to characterize the participants.

Main Results:

• 16.2% were high risk, and 83.8% were very high risk for ASCVD; no participants had low risk.
• The median 10-year ASCVD risk was 23%, with risk significantly increasing with age (75+ years).
• Age (≥75 years) was strongly associated with very high ASCVD risk (C-statistic 0.92, PPV 99%, NPV 52%).

Conclusions:

• Elderly individuals without established ASCVD are a heterogeneous group, with most at very high risk.
• Age and hypertension are the predominant contributors to ASCVD risk in this population.
• Malnutrition, polypharmacy, and multimorbidity are frequently observed ASCVD risk modifiers.