Cardiovascular Health and Healthy Aging

Abstract

Cardiovascular disease (CVD) is common in the general population, affecting most individuals over the age of 60. It currently represents over half of all noncommunicable diseases worldwide and is the leading global cause of death, accounting for over 17.3 million deaths per year. The lifetime incidence of CVD is high, as demonstrated by the Framingham Heart Study, where the estimated lifetime risk of developing coronary heart disease (CHD) alone at age 40 was 48.6% for men and 31.7% for women. The demographic shift in aging, coupled with increased survival with CVD, has resulted in an increase in the old and oldest old with chronic CVD-related conditions. Cardiovascular diseases are highly responsible for disability in those ≥ age 75. Coronary heart disease represents approximately one-third to one-half of all CVD cases. There are many lifestyle factors that have contributed to an increasing CVD disease burden, including poor diet, tobacco smoking, elevated body mass index (BMI), hypertension, glucose intolerance, and physical inactivity. Though not a modifiable risk factor, age alone outranks hyperlipidemia, hypertension, and smoking as a clinical predictor of CVD events and is the strongest determinant of heart disease and stroke in several risk factor algorithms. As such, older adults experience the greatest burden of CVD. Although occult CVD and CVD-related events increase with advancing age, subclinical CVD, such as atherosclerosis, is present for years prior to diagnosis. Thus, the prevention and slowing of CVD progression from middle age to old age are of utmost importance in promoting healthy aging.

There are many reasons why CVD affects older persons at a disproportionate rate. The continuum from risk factor(s) to tissue damage is a simplified albeit important context, for illustrating CVD disease with aging.