PRIMARY PREVENTION OF CARDIOVASCULAR-DISEASE IN OLDER-PEOPLE

Cardiovascular disease is the leading cause of death, morbidity and di sability in older people. Strategies for cardiovascular disease preven tion and intervention in older people are similar to those available f or younger ages. The population strategy for primary prevention is bro ad ranging from food and tobacco policy legislation and media communic ation to simple and direct advice delivered by all health workers. Hig h risk strategies for reducing elevated levels of the major cardiovasc ular risk factors such as hypertension and hypercholesterolemia in old er populations indicate that gains in life expectancy are greatest whe re absolute risk is highest and the intervention is the cheapest avail able. Non-pharmacological treatment, in particular dietary therapy, is recommended as the first line of treatment for both raised blood pres sure and blood cholesterol. Because of the high excess mortality assoc iated with smoking, even a brief advice package associated with modest success is cost effective in older people. Health policy for older pe ople should be directed towards the overall goal of maintenance of aut onomy and should include prevention, treatment and rehabilitation of c ardiovascular disease as part of a comprehensive program for the preve ntion and control of all diseases.