“High Risk” Factors and Atherosclerotic Cardiovascular Diseases in the Aged

Abstract

The association between the socalled "high risk" factors -hypercholesterolemia, hypertension, diabetes -and atherosclerotic cardiovascular diseases (ACVD) was studied in 509 subjects over 60 years of age. The correlation between these factors (especially their cumulation) and the prevalence of clinically evident ACVD was statistically significant. Nevertheless, in comparison to the high prevalence of atherosclerosis in these groups of elderly subjects, the prevalence of cumulation of two or even three of these atherogenic factors was relatively so low that their atherogenic importance appeared questionable. This fact may be of great importance in the strategy for prevention of myocardial infarction and cerebrovascular accidents in these age groups.It has been firmly established in clinical as well as in epidemiologic studies that certain factors enhance the development of atherosclerotic cardiovascular diseases (ACVD) (1). Among these so-called "high risk" factors, hypercholesterolemia, hypertension, cigarette smoking and diabetes mellitus seem t o be the most important (2). The great majority of these studies concerned young and middle-aged subjects whose ages ranged from 30 to 60 years.This retrospective cross-sectional study was conducted for the purpose of finding out whether such an association between these factors and ACVD exists in subjects over the age of 60, in whom the prevalence and incidence of either coronary or cerebral atherosclerosis might be expected to be much higher. MATERIAL AND METHODSWe recently reported our study on the relationship of one of these factors, serum cholesterol concentration, to ACVD in the aged (3). The material and methods were

Relationship of Age and Biomedical Risk Factors to Progression of Coronary Artery Disease*

“…Smoking (not age-related) was associated with progression of disease in the younger sample but not in the older sample. In general, these results substantiate the recent findings of a significant positive correlation between traditional biomedical risk factors and the prevalence of atherosclerotic cardiovascular disease in the aged (12)(13).…”

Coronary Heart Disease and the Ischemic Demise of a Beloved Fictional Hero: Hercule Poirot of Agatha Christie Fame

“…It is interesting to note that when the novels were written (1940s), tobacco smoking, physical inactivity, and diet had still not been identified as cardiovascular risk factors, whereas by the time the last Poirot book, Curtain (1975), was published, several epidemiologic studies had begun demonstrating these factors in the development of atherosclerotic disease. 11 Although Poirot had always been "extremely fussy about his health: distrusting draughts, wrapping up his neck in silk and wool, showing a horror of getting his feet damp, and taking his temperature and retiring to bed at the least suspicion of a chill" (Curtain: The Last Case of Hercule Poirot), the Belgian investigator contributed to his own demise, once stating in a letter to Hastings of his refusal to take medication during the most recent heart attack. From this, we can assume that Poirot essentially committed suicide by way of his voluntary, therapeutic noncompliance.…”