© 2005 by BMJ Publishing Group & British Cardiac Society
EDUCATION IN HEART
Coronary disease
Secondary prevention of coronary heart disease in the elderly
Correspondence to:
Correspondence to:
Professor Christopher J Bulpitt
Care of the Elderly, Division of Medicine, Imperial College School of Medicine, Du Cane Road, London W12 0HS, UK; c.bulpitt@imperial.ac.uk
Keywords: coronary heart disease; elderly
| The first 150 words of the full text of this article appear below. |
An American Heart Association scientific statement on secondary prevention of coronary heart disease (CHD) in the elderly pointed out that at necropsy 50% of elderly women and 70–80% of elderly men have obstructive coronary artery disease.1 Moreover, in the USA, the prevalence of CHD over the age of 75 years is 2.2% for men and 1.3% for women. This sizeable problem has been addressed in other reviews; however, they often consider the elderly as all those over 65 years of age and tend to conclude that the secondary prevention of CHD should be the same as in the young and middle aged. These reviews often ignore the fact that the benefit:risk ratio does change with every decade of life. For example, with aspirin both the absolute benefits and absolute risks are greater at age 60–69 than age 50–59. Moreover, although there is an extensive literature suggesting, for example,
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