Many doctors wrongly — and dangerously — assume it’s too late to prevent heart attacks in older people, but seniors still need to practice heart attack prevention.
Americans are living longer than ever, and senior citizens are now the fastest growing segment of the population. The leading cause of death in this group is heart disease. So you might assume doctors actively look for ways to lower heart attack risk factors in patients who are in their 60s, 70s, and beyond. Unfortunately for many older Americans, that’s not the case.
Doctors often figure it’s too late for elders to take action that could prevent heart attacks, according to researchers from the University of Alberta and the University of British Columbia. But after analyzing the best available evidence about cardiovascular risk reduction in older people, the research team found that assumption is wrong.
"Some assume elderly individuals may not have the life expectancy to derive benefit from preventive cardiovascular therapy; however, their baseline level of risk, and subsequent relative risk reduction with appropriate therapy, may actually be higher than in younger patients," said researcher Michelle M. Graham, MD, professor in the division of cardiology at the Mazankowski Alberta Heart Institute and the University of Alberta.
Graham and colleagues found the top strategies for preventing cardiovascular events in older adults include keeping blood pressure at a healthy level and using statin therapy to lower high cholesterol and reduce the risk of heart attack and stroke.
The researchers recommend doctors monitor elder patients for possible side effects of statins, such as muscle pain and diabetes. However, they noted there’s no evidence older people experience these side effects any more often than young patients.
It’s also important for doctors to be on the lookout for possible interactions between statins and other drugs older folks may be taking, according to the research team. And older patients should be advised about over-the-counter supplements that can interact with statins, too.
When it comes to keeping a senior’s blood pressure at a healthy level to lower the risk of cardiovascular events, the best target blood pressure for older people should be individualized according to each patient, Graham and her colleagues noted.
The research team found that using antiplatelet therapy – which includes blood thinners like aspirin – to prevent a first heart attack isn’t always a good idea in seniors because any benefits often outweigh potential risks, such as bleeding in the stomach.
The study results also showed lifestyle changes can reduce the risk of cardiovascular disease and heart attacks in older people. Bottom line: You are never too old to get healthier by stopping smoking, maintaining a normal body weight, and being as physically active as possible.
“Primary prevention of cardiovascular disease can improve health and reduce future healthcare costs,” Graham said. “Prevention of a first cardiovascular event in elderly patients should be individualized based on consideration of the current evidence, as well as goals of therapy, functionality and/or frailty, comorbidities, and concomitant medications.”
Nobody can avoid getting older, and it’s a fact that age does raise the odds for heart disease, the American Heart Association points out. But proactively reducing risk factors when possible and managing any other health problems you have can help you live longer and healthier.
The American Heart Association’s How to Help Prevent Heart Disease at Any Age guide offers more information on heart healthy strategies for every period of life, including the senior years.
March 03, 2020
Christopher Nystuen, MD, MBA