Risk Modification in the Elderly

  • James A. Schoenberger
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 76)


The epidemiology of the atherosclerotic diseases has recently been comprehensively reviewed [1]. The many studies reported in this chapter underscore the concept that there are easily identified characteristics (risk factors) which place individuals and whole populations at increased risk of developing premature atherosclerosis. The major risk factors that can be lessened are elevated blood pressure, elevated serum cholesterol, and cigarette smoking [2]. The roles of physical inactivity, obesity, excess alcohol consumption, and psychosocial factors are less certain. Factors associated with an increased risk, such as age, gender, and family background, are not susceptible to intervention. Implicit in the risk factor concept is the hope that reduction of the level of risk will result in an improved outlook not only for the individual but for whole populations treated by public health measures.


Serum Cholesterol American Heart Association Systolic Hypertension Lipid Research Clinic Risk Modification 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Atherosclerosis Study Group, Kannel WB, Doyle JT, Ostfeld AM, et al. Optimal resources for primary prevention of atherosclerotic diseases. Circulation 70:157A-205A, 1984.CrossRefGoogle Scholar
  2. 2.
    American Heart Association. Risk factors and coronary disease: A statement for physicians. Circulation 62:455A, 1980.Google Scholar
  3. 3.
    National Heart Lung and Blood Institute. Fact Book for Fiscal year 1982. Washington, D.C.: Department of Healthand Human Services, U.S. Public Health Service.Google Scholar
  4. 4.
    National Heart, Lung and Blood Institute. Proceedings of the conference on the decline in coronary heart disease mortality. NIH Publication No. 79–1610, 1979, Department of Health and Human Services, Public Health Service, Washington, D.C.Google Scholar
  5. 5.
    Goldman L and Cook F. The decline in ischemic heart disease mortality rates. An analysis of the comparative effects of medical interventions and changes in lifestyle. Ann Int Med 101:825–836, 1984.PubMedCrossRefGoogle Scholar
  6. 6.
    American Heart Association. Coronary Risk Handbook. Dallas: AHA, 1973.Google Scholar
  7. 7.
    American Heart Association. Stroke Risk Handbook. Dallas: AHA, 1974.Google Scholar
  8. 8.
    American Heart Association. Risk factors in stroke. A statement for physicians by the subcommittee on risk factors and stroke of the stroke council. Dallas, 1985.Google Scholar
  9. 9.
    The Working Group on Hypertension in the Elderly. Statement on hypertension in the elderly. JAMA 256:70–74, 1986.CrossRefGoogle Scholar
  10. 10.
    Curb JD, Borhani NO, Entwisle G, et al. Isolated systolic hypertension in 14 communities. Amer J Epidemiol 121:362–370, 1985.CrossRefGoogle Scholar
  11. 11.
    Kannel WB. Implications of Framingham study data for treatment of hypertension: Impact of other risk factors. In JH Laragh, FR Buhler and DW Seldin (eds), Frontiers in Hypertension Research. New York: Spring-Verlag, 1981, pp 17–21.CrossRefGoogle Scholar
  12. 12.
    Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension; III. Influence of age, diastolic pressure and prior cardiovascular disease. Further analysis of side effects. Circulation 45:991–1004, 1972.CrossRefGoogle Scholar
  13. 13.
    Report of the Management Committee. The Australian therapeutic trial in mild hypertension. Treatment of mild hypertension in the elderly. Med J Australia 68:396–402, 1981.Google Scholar
  14. 14.
    Hypertension Detection and Follow-up Program Cooperative Study Group: Five-year findings of the hypertension detection and follow-up program. II. Mortality by race, sex and age. JAMA 242:2572–2577, 1979.CrossRefGoogle Scholar
  15. 15.
    Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly Trial. Lancet I:1349–1354 1985.Google Scholar
  16. 16.
    Abernathy J, Borhani NO, Hawkins CM, et al. Systolic blood pressure as an independent predictor of mortality in the hypertension detection and follow-up program. Am J Prey Med 2:123–132, 1986.Google Scholar
  17. 17.
    Hulley SB, Furberg CD, Gurland B, et al. Systolic Hypertension in the Elderly program (SHEP): Antihypertensive efficacy of Chlorthalidone. Am J Cardiol 56:913–920, 1985.PubMedCrossRefGoogle Scholar
  18. 18.
    The 1984 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Int Med 144:1045–1057, 1984.CrossRefGoogle Scholar
  19. 19.
    Schoenberger JA. Epidemiology of systolic and diastolic systemic blood pressure elevation in the elderly. Am J Cardiol 57:45C-51C, 1986.CrossRefGoogle Scholar
  20. 20.
    The Lipid Research Clinics Population Studies Data Book, Lipid Metabolism Branch, Division of Heart and Vascular Diseases, National Heart, Lung and Blood Institute: The prevalence study, Vol. 1. NIH Publication 80–1527.Google Scholar
  21. 21.
    Joint Statement of the Nutrition Committee and the Council in Arteriosclerosis of the American Heart Association: Recommendations for the treatment of hyperlipidemia in adults. Arteriosclerosis 4:445A-468A, 1984.Google Scholar
  22. 22.
    Tyroler HA. Total serum cholesterol and ischemic heart disease risk in clinical trials and observational studies. Amer J Prey Med 1:18–24, 1985.Google Scholar
  23. 23.
    The Lipid Research Clinics Coronary Primary Prevention Trial Results: I. Reduction in incidence of coronary heart disease. JAMA 251:351–364, 1984.CrossRefGoogle Scholar
  24. 24.
    National Institutes of Health Consensus Development Conference Statement: Lowering blood cholesterol to prevent heart disease. vol 5, no 7, 1985.Google Scholar
  25. 25.
    Hoy JM, Gregg RE, and Brewer HB. An approach to the management of hyperlipoproteinemia. JAMA 255:512–521, 1986.CrossRefGoogle Scholar
  26. 26.
    Report of the Surgeon General. The health consequences of smoking: Cardiovascular disease. Rockville, MD.: U.S. Department of Health and Human Services, Office on Smoking and Health, 1983.Google Scholar
  27. 27.
    Ravenholt RT. Tobacco’s impact on twentieth-century U.S. mortality patterns. Am J Prey Med 1:4–17, 1985.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1987

Authors and Affiliations

  • James A. Schoenberger

There are no affiliations available

Personalised recommendations