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at time of writing, Fellow of Cardiovascular Therapeutics, Division of Pharmacotherapy, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC; now, Consultant Pharmacist, PPD Medical Communications, Durham, NC
Dean and Professor, College of Pharmacy, The University of New Mexico Health Sciences Center, Albuquerque, NM
Assistant Professor, Division of Pharmacotherapy, School of Pharmacy, University of North Carolina at Chapel Hill
Reprints: Kimberly A Dornbrook-Lavender PharmD BCPS, PPD Medical Communications, 2655 Meridian Parkway, Durham, NC 27713-2203, kim_dornbrook{at}yahoo.com
OBJECTIVE: To review relevant literature supporting the
use of antihypertensive agents, lipid-lowering agents (i.e., statins), and
aspirin therapy for the primary prevention of coronary heart disease (CHD) in
an elderly patient population (age 
65 y).
DATA SOURCES: A MEDLINE search (1988–January 2003) was conducted.
STUDY SELECTION AND DATA EXTRACTION: Primary and tertiary literature involving the uses of antihypertensives, statins, and aspirin therapy in the elderly were reviewed.
DATA SYNTHESIS: Mortality due to CHD in the US population has decreased 40–50% over the last 30 years; however, CHD remains the leading cause of morbidity and mortality in elderly persons. As the population continues to age, the number of older adults eligible for primary prevention will rise. The American Heart Association clinical practice guidelines for the primary prevention of CHD were updated in 2002; however, they are based on findings from clinical trials that enrolled predominantly middle-aged white men. The recommendations for elderly individuals are predominantly extrapolated from subgroup analyses of randomized clinical trials or cohort studies. This literature suggests that elderly persons are candidates for primary prevention measures and experience reductions in coronary events when treated with appropriate therapies.
CONCLUSIONS: Data suggest that use of antihypertensives,
statins, and aspirin therapy in the elderly appears effective to an extent
similar to, and often greater than, that observed in younger patients. We
believe these agents should be prescribed to all appropriate high-risk elderly
patients. Ongoing and future studies will more clearly elucidate the benefits
of primary prevention therapy, particularly in persons 75 years of
age.
Key Words: aspirin, coronary heart disease, elderly, hypertension, statins
Published Online, October 1, 2003. www.theannals.com, DOI 10.1345/aph.1D025
THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-03-035-H01
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