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Risk Factors for Atherosclerosis in the Elderly

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Principles and Practice of Geriatric Surgery

Abstract

Coronary artery disease (CAD), peripheral arterial disease (PAD), atherothrombotic brain infarction (ABI), and extracranial carotid arterial disease (ECAD) are more common in old individuals than in middle-aged ones. CAD is the leading cause of death in old persons, especially those with PAD, ABI, or ECAD. This chapter discusses risk factors for CAD, PAD, ABI, and ECAD in old persons.

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References

  1. Jajich CL, Ostfield AM, Freeman DH Jr (1984) Smoking and coronary heart disease mortality in the elderly. JAMA 252:2831–2834

    Article  PubMed  CAS  Google Scholar 

  2. Siegel D, Kuller L, Lazarus NB et al (1987) Predictors of cardiovascular events and mortality in the systolic hypertension in the elderly program pilot project. Am J Epidemiol 126:385–399

    PubMed  CAS  Google Scholar 

  3. Kannel WB, Vokonas PS (1986) Primary risk factors for coronary heart disease in the elderly: the Framingham study. In: Wenger NK, Furberg CD, Pitt B (eds) coronary heart disease in the elderly. Elsevier, New York, pp 60–92

    Google Scholar 

  4. Benfante R, Reed D, Frank J (1991) Does cigarette smoking have an independent effect on coronary heart disease incidence in the elderly? Am J Public Health 81:897–899

    Article  PubMed  CAS  Google Scholar 

  5. LaCroix AZ, Lang J, Scherr P et al (1991) Smoking and mortality among older men and women in three communities. N Engl J Med 324:1619–1625

    Article  PubMed  CAS  Google Scholar 

  6. Aronow WS, Ahn C (1996) Risk factors for coronary events in a large cohort of very elderly patients with and without coronary artery disease. Am J Cardiol 77:864–866

    Article  PubMed  CAS  Google Scholar 

  7. Aronow WS, Ahn C, Kronzon I et al (1991) Congestive heart failure, coronary events and atherothrombotic brain infarction in elderly blacks and whites with systemic hypertension and with and without echocardiographic and electrocardiographic evidence of left ventricular hypertrophy. Am J Cardiol 67:295–299

    Article  PubMed  CAS  Google Scholar 

  8. Hermanson B, Omenn GS, Kronmal RA et al (1988) Beneficial six-year outcome of smoking cessation in older men and women with coronary artery disease: results from the CASS registry. N Engl J Med 319:1365–1369

    Article  PubMed  CAS  Google Scholar 

  9. Ness J, Aronow WS, Ahn C (2000) Risk factors for peripheral arterial disease in an academic hospital-based geriatrics practice. J Am Geriatr Soc 48:312–314

    PubMed  CAS  Google Scholar 

  10. Aronow WS, Sales FF, Etienne F et al (1988) Prevalence of peripheral arterial disease and its correlation with risk factors for peripheral arterial disease in elderly patients in a long-term health care facility. Am J Cardiol 62:644–646

    Article  PubMed  CAS  Google Scholar 

  11. Kannel WB, McGee DL (1985) Update on some epidemiologic features of intermittent claudication: the Framingham study. J Am Geriatr Soc 33:13–18

    PubMed  CAS  Google Scholar 

  12. Pomrehn P, Duncan B, Weissfeld L et al (1986) The association of dyslipoproteinemia with symptoms and signs of peripheral arterial disease: the Lipid Research Clinics Program Prevalence Study. Circulation 73(Suppl I):100–107

    Google Scholar 

  13. Beach KW, Brunzell JD, Strandness DE Jr (1982) Prevalence of severe arteriosclerosis obliterans in patients with diabetes mellitus: relation to smoking and form of therapy. Arteriosclerosis 2:275–280

    Article  PubMed  CAS  Google Scholar 

  14. Reunanen A, Takkunen H, Aromaa A (1982) Prevalence of intermittent claudication and its effect on mortality. Acta Med Scand 211:249–256

    Article  PubMed  CAS  Google Scholar 

  15. Ness J, Aronow WS, Newkirk E, McDanel D (2005) Prevalence of symptomatic peripheral arterial disease, modifiable risk factors, and appropriate use of drugs in the treatment of peripheral arterial disease in older persons seen in a university general medicine clinic. J Gerontol Med Sci 60A:M255–M257

    Article  Google Scholar 

  16. Murabito JM, Evans JC, Nieto K et al (2002) Prevalence and clinical correlates of peripheral arterial disease in the Framingham Offspring Study. Am Heart J 143:961–965

    Article  PubMed  Google Scholar 

  17. Sukhija R, Yalamanchili K, Aronow WS (2003) Prevalence of left main coronary artery disease, of 3-vessel or 4-vessel coronary artery disease, and of obstructive coronary artery disease in patients with and without peripheral arterial disease undergoing coronary angiography for suspected coronary artery disease. Am J Cardiol 92:304–305

    Article  PubMed  Google Scholar 

  18. Aronow WS, Ahn C, Mercando AD et al (1992) Prognostic significance of silent ischemia in elderly patients with peripheral arterial disease with and without previous myocardial infarction. Am J Cardiol 69:137–139

    Article  PubMed  CAS  Google Scholar 

  19. Shinton R, Beevers G (1989) Meta-analysis of relation between cigarette smoking and stroke. Br Med J 298:789–794

    Article  CAS  Google Scholar 

  20. Medical Research Council Working Party (1985) MRC trial of treatment of mild hypertension: principal results. Br Med J Clin Res 291:97–104

    Article  Google Scholar 

  21. Wolf PA, D’Agostino PS, Kannel WB et al (1988) Cigarette smoking as a risk factor for stroke: the Framingham study. JAMA 259:1025–1029

    Article  PubMed  CAS  Google Scholar 

  22. Rodgers RL, Meyer JS, Judd BW et al (1985) Abstention from cigarette smoking improves cerebral perfusion among elderly chronic smokers. JAMA 253:2970–2974

    Article  Google Scholar 

  23. Aronow WS, Ahn C, Gutstein H (1996) Risk factors for new atherothrombotic brain infarction in 664 older men and 1488 older women. Am J Cardiol 77:1380–1383

    Google Scholar 

  24. Aronow WS, Ahn C, Schoenfeld MR (1993) Risk factors for extracranial internal or common carotid arterial disease in elderly patients. Am J Cardiol 71:1479–1481

    Article  PubMed  CAS  Google Scholar 

  25. Candelise L, Bianchi F, Galligoni F et al (1984) Italian multicenter study on reversible cerebral ischemic attacks. III. Influence of age and risk factors on cerebrovascular atherosclerosis. Stroke 15:379–382

    Article  PubMed  CAS  Google Scholar 

  26. Crouse JR III, Toole JF, McKinney WM (1987) Risk factors for extracranial carotid artery atherosclerosis. Stroke 18:990–996

    Article  PubMed  CAS  Google Scholar 

  27. Tell GS, Howard G, McKinney WM et al (1989) Cigarette smoking cessation and extracranial carotid atherosclerosis. JAMA 261:1178–1180

    Article  PubMed  CAS  Google Scholar 

  28. Bots ML, Breslau BJ, Briet E et al (1992) Cardiovascular determinants of carotid artery disease: the Rotterdam Elderly Study. Hypertension 19:717–720

    Article  PubMed  CAS  Google Scholar 

  29. Tell GS, Polak JF, Ward BJ et al (1994) Relation of smoking with carotid artery wall thickness and stenosis in older adults: the Cardiovascular Health Study. Circulation 90:2905–2908

    Article  PubMed  CAS  Google Scholar 

  30. Benowitz NL (1997) Treating tobacco addiction: nicotine or no nicotine. N Eng J Med 337:1230–1231

    Article  CAS  Google Scholar 

  31. Hurt RD, Sachs DPL, Glover ED et al (1997) A comparison of sustained-release buproprion and placebo for smoking cessation. N Eng J Med 337:1195–1202

    Article  CAS  Google Scholar 

  32. Frishman WH, Mitta W, Kupersmith A, Ky T (2006) Nicotine and non-nicotine smoking cessation pharmacotherapies. Cardiol in Rev 14:57–73

    Article  Google Scholar 

  33. Tonnesen P, Fryd V, Hansen M et al (1988) Effect of nicotine chewing gum in combination with group counseling on the cessation of smoking. N Eng J Med 318:15–18

    Article  CAS  Google Scholar 

  34. Chobanian AV, Bakris GL, Black HR, Joint National Committee et al (2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289:2560–2572

    Article  PubMed  CAS  Google Scholar 

  35. Aronow WS, Kronzon I (1991) Prevalence of coronary risk factors in elderly blacks and whites. J Am Geriatr Soc 39:567–570

    PubMed  CAS  Google Scholar 

  36. Ness MG, JN AWS (1999) Drug treatment of hypertension in older persons in an academic hospital-based geriatrics practice. J Am Geriatr Soc 47:597–599

    PubMed  Google Scholar 

  37. Applegate WB, Rutan GH (1992) Advances in management of hypertension in older persons. J Am Geriatr Soc 40:1164–1174

    PubMed  CAS  Google Scholar 

  38. Frishman WH, Sokol S, Aronson M et al (1998) Risk factors for cardiovascular and cerebrovascular diseases and dementia in the elderly: findings from the Bronx Longitudinal Aging Study. Curr Probl Cardiol 23:1–68

    Article  PubMed  CAS  Google Scholar 

  39. Amery A, Birkenhager W, Brixko P et al (1985) Mortality and morbidity results from the European Working Party on Hypertension in Elderly Trial. Lancet 1:1349–1354

    Article  PubMed  CAS  Google Scholar 

  40. Dahlof B, Lindholm LH, Hansson L et al (1991) Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP Hypertension). Lancet 338:1281–1285

    Article  PubMed  CAS  Google Scholar 

  41. SHEP Cooperative Research Group (1991) Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 265:3255–3264

    Article  Google Scholar 

  42. MRC Working Party (1992) Medical Research Council Trial on treatment of hypertension in older adults: principal results. Br Med J 304:405–412

    Article  Google Scholar 

  43. Staessen JA, Fagard R, Thijs L et al (1997) Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. Lancet 350:757–764

    Article  PubMed  CAS  Google Scholar 

  44. Aronow WS, Ahn C, Mercando AD et al (1994) Effect of propranolol versus no antiarrhythmic drug on sudden cardiac death, total cardiac death, and total death in patients ≥62 years of age with heart disease, complex ventricular arrhythmias, and left ventricular ejection fraction ≥40%. Am J Cardiol 74:267–270

    Article  PubMed  CAS  Google Scholar 

  45. Hunt SA, Abraham WT, Chin MH et al (2005) ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult-summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). Developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation. Endorsed by the Heart Rhythm Society. Circulation 112:e154–e235

    Article  PubMed  Google Scholar 

  46. Aronow WS (2006) Epidemiology, pathophysiology, prognosis, and treatment of systolic and diastolic heart failure. Cardiol Rev 14:108–124

    Article  PubMed  Google Scholar 

  47. Cleland JG, Tendera M, Adamus J et al (2006) The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J 27:2257–2259

    Article  CAS  Google Scholar 

  48. Yusuf S, Pfeffer MA, Swedberg K et al (2003) Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved trial. Lancet 362:777–781

    Article  PubMed  CAS  Google Scholar 

  49. Aronow WS, Kronzon I (1993) Effect of enalapril on congestive heart failure treated with diuretics in elderly patients with prior myocardial infarction and normal left ventricular ejection fraction. Am J Cardiol 71:602–604

    Article  PubMed  CAS  Google Scholar 

  50. MERIT-HF Study Group (1999) Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 353:2001–2007

    Article  Google Scholar 

  51. Packer M, Coats AJS, Fowler MB et al (2001) Effect of carvedilol on survival in chronic heart failure. N Engl J Med 344:651–658

    Article  Google Scholar 

  52. Flather MD, Shibata MC, Coats AJS et al (2005) Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 26:215–225

    Article  PubMed  CAS  Google Scholar 

  53. Aronow WS, Ahn C, Kronzon I (1997) Effect of propranolol versus no propranolol on total mortality plus nonfatal myocardial infarction in older patients with prior myocardial infarction, congestive heart failure, and left ventricular ejection fraction ≥40% treated with diuretics plus angiotensin-converting-enzyme inhibitors. Am J Cardiol 80:207–209

    Article  PubMed  CAS  Google Scholar 

  54. American Diabetes Association (2003) Treatment of hypertension of adults with diabetes. Diabetes Care 26(Suppl 1):580–582

    Google Scholar 

  55. Smith SC Jr, Allen J, Blair SN et al (2006) ACC/AHA guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation 113:2363–2372

    Article  PubMed  Google Scholar 

  56. HOPE (Heart Outcomes Prevention Evaluation) Study Investigators (2000) Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 342:145–153

    Article  Google Scholar 

  57. Aronow WS, Ahn C, Kronzon I (2001) Effect of beta blockers alone, of angiotensin-converting enzyme inhibitors alone, and of beta blockers plus angiotensin-converting enzyme inhibitors on new coronary events and on congestive heart failure in older persons with healed myocardial infarcts and asymptomatic left ventricular systolic dysfunction. Am J Cardiol 88:1298–1300

    Article  PubMed  CAS  Google Scholar 

  58. Aronow WS, Ahn C (2002) Incidence of new coronary events in older persons with prior myocardial infarction and systemic hypertension treated with beta blockers, angiotensin-converting enzyme inhibitors, diuretics, calcium antagonists, and alpha blockers. Am J Cardiol 89:1207–1209

    Article  PubMed  CAS  Google Scholar 

  59. Mehler PS, Coll JR, Estacio R et al (2003) Intensive blood pressure control reduces the risk of cardiovascular events in patients with peripheral arterial disease and type 2 diabetes. Circulation 107:753–756

    Article  PubMed  Google Scholar 

  60. Garland C, Barrett-Connor E, Suarez L et al (1983) Isolated systolic hypertension and mortality after age 60 years: a prospective population-based study. Am J Epidemiol 118:365–376

    PubMed  CAS  Google Scholar 

  61. Coope J, Warrender TS (1986) Randomised trial of treatment of hypertension in elderly patients in primary care. Br Med J 293:1145–1151

    Article  CAS  Google Scholar 

  62. Beckett NS, Peters R, Fletcher AE et al (2008) Treatment of hypertension in patients 80 years of age or older. N Engl J Med 358:1887–1898

    Article  PubMed  CAS  Google Scholar 

  63. Stokes J III, Kannel WB, Wolf PA et al (1987) The relative importance of selected risk factors for various manifestations of cardiovascular disease among men and women from 35 to 64 years old: 30 years of follow-up in the Framingham study. Circulation 75(Suppl V):V65–V73

    PubMed  Google Scholar 

  64. Aronow WS, Frishman WH (2006) Effects of antihypertensive drug treatment on cognitive function and the risk of dementia. Clin Geriatr 114:25–28

    Google Scholar 

  65. Applegate WB, Miller ST, Elam JT et al (1992) Nonpharmacologic intervention to reduce blood pressure in older patients with mild hypertension. Arch Intern Med 152:1162–1166

    Article  PubMed  CAS  Google Scholar 

  66. Aronow WS, Frishman WH (2004) Treatment of hypertension and prevention of ischemic stroke. Curr Cardiol Rep 6:124–129

    Article  PubMed  Google Scholar 

  67. Lavie CJ, Ventura HO, Messerli FH (1994) Left ventricular hypertrophy in the elderly. Cardiol Elder 2:362–369

    Google Scholar 

  68. Ruben S, Espeland MA, Ryu J et al (1988) Individual variation in susceptibility to extracranial carotid atherosclerosis. Arteriosclerosis 8:389–397

    Article  Google Scholar 

  69. Aronow WS, Kronzon I, Schoenfeld MR (1995) Left ventricular hypertrophy is more prevalent in patients with systemic hypertension with extracranial carotid arterial disease than in patients with systemic hypertension without extracranial carotid arterial disease. Am J Cardiol 76:192–193

    Article  PubMed  CAS  Google Scholar 

  70. Kannel WB, Dannenberg AL, Levy D (1987) Population implications of electrocardiographic left ventricular hypertrophy. Am J Cardiol 60:85I–93I

    Article  PubMed  CAS  Google Scholar 

  71. Aronow WS, Koenigsberg M, Schwartz KS (1989) Usefulness of echocardiographic and electrocardiographic left ventricular hypertrophy in predicting new cardiac events and atherothrombotic brain infarction in elderly patients with systemic hypertension or coronary artery disease. Am J Noninvasive Cardiol 3:367–370

    Google Scholar 

  72. Kahn S, Frishman WH, Weissman S et al (1996) Left ventricular hypertrophy on electrocardiogram: prognostic implications from a 10 year cohort study of older subjects: a report from the Bronx Longitudinal Aging Study. J Am Geriatr Soc 44:524–529

    PubMed  CAS  Google Scholar 

  73. Levy D, Garrison RJ, Savage DD et al (1989) Left ventricular mass and incidence of coronary heart disease in an elderly cohort: the Framingham Heart Study. Ann Intern Med 110:101–107

    PubMed  CAS  Google Scholar 

  74. Aronow WS, Koenigsberg M, Schwartz KS (1988) Usefulness of echocardiographic left ventricular hypertrophy in predicting new coronary events and atherothrombotic brain infarction in patients over 62 years of age. Am J Cardiol 61:1130–1132

    Article  PubMed  CAS  Google Scholar 

  75. Aronow WS, Ahn C, Kronzon I et al (1997) Association of plasma renin activity and echocardiographic left ventricular hypertrophy with frequency of new coronary events and new atherothrombotic brain infarction in older persons with systemic hypertension. Am J Cardiol 79:1543–1545

    Article  PubMed  CAS  Google Scholar 

  76. Bikkina M, Levy D, Evans JC et al (1994) Left ventricular mass and risk of stroke in an elderly cohort: the Framingham Heart Study. JAMA 272:33–36

    Article  PubMed  CAS  Google Scholar 

  77. Aronow WS, Ahn C, Kronzon I et al (1997) Association of extracranial carotid arterial disease, prior atherothrombotic brain infarction, systemic hypertension, and left ventricular hypertrophy with the incidence of new atherothrombotic brain infarction at 45 month follow-up of 1482 older patients. Am J Cardiol 79:991–993

    Article  PubMed  CAS  Google Scholar 

  78. Aronow WS (1992) Left ventricular hypertrophy. J Am Geriatr Soc 40:71–80

    PubMed  CAS  Google Scholar 

  79. Dahlof B, Pennert K, Hansson L (1992) Reversal of left ventricular hypertrophy in hypertensive patients: a meta-analysis of 109 treatment studies. Am J Hypertens 5:95–110

    PubMed  CAS  Google Scholar 

  80. Levy D, Solomon M, D’Agostino RB et al (1994) Prognostic implications of baseline electro-cardiographic features and their serial changes in subjects with left ventricular hypertrophy. Circulation 90:1786–1793

    Article  PubMed  CAS  Google Scholar 

  81. Koren MJ, Devereux RB, Casale PN et al (1991) Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 114:345–352

    PubMed  CAS  Google Scholar 

  82. Wachtell K, Okin PM, Olsen MH et al (2007) Regression of electrocardiographic left ventricular hypertrophy during antihypertensive therapy and reduction in sudden cardiac death. The LIFE Study. Circulation 116:700–705

    Article  PubMed  Google Scholar 

  83. Castelli SP, Wilson PWF, Levy D, Anderson K (1989) Cardiovascular risk factors in the elderly. Am J Cardiol 63:12H–19H

    Article  PubMed  CAS  Google Scholar 

  84. Wong ND, Wilson PWF, Kannel WB (1991) Serum cholesterol as a prognostic factor after myocardial infarction: the Framingham study. Ann Intern Med 115:687–693

    PubMed  CAS  Google Scholar 

  85. Benfante R, Reed D (1990) Is elevated serum cholesterol level a factor for coronary heart disease in the elderly? JAMA 263:393–396

    Article  PubMed  CAS  Google Scholar 

  86. Rubin SM, Sidney S, Black DM et al (1990) High blood cholesterol in elderly men and the excess risk for coronary heart disease. Ann Intern Med 113:916–920

    PubMed  CAS  Google Scholar 

  87. Zimetbaum P, Frishman WH, Ooi WL et al (1992) Plasma lipids and lipoproteins and the incidence of cardiovascular disease in the very elderly: the Bronx Aging Study. Arterioscler Thromb 12:416–423

    Article  PubMed  CAS  Google Scholar 

  88. Corti M-C, Guralnik JM, Salive ME et al (1995) HDL cholesterol predicts coronary heart disease mortality in older persons. JAMA 274:539–544

    Article  PubMed  CAS  Google Scholar 

  89. Miettinen TA, Pyorala K, Olsson AG et al (1997) Cholesterol-lowering therapy in women and elderly patients with myocardial infarction or angina pectoris. Findings from the Scandinavian Simvastatin Survival Study (4S). Circulation 96:4211–4218

    Article  PubMed  CAS  Google Scholar 

  90. Sacks FM, Pfefer MA, Moye LA et al (1996) The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 335:1001–1009

    Article  PubMed  CAS  Google Scholar 

  91. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group (1998) Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 339:1349–1357

    Article  Google Scholar 

  92. Heart Protection Study Collaborative Group (2002) MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20, 536 high-risk individuals: a randomised placebo-controlled trial. Lancet 360:7–22

    Article  Google Scholar 

  93. Cannon CP, Braunwald E, McCabe CH et al (2004) Comparison of intensive and moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 350:1495–1504

    Article  PubMed  CAS  Google Scholar 

  94. LaRosa JC, Grundy SM, Waters DD et al (2005) Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Eng J Med 352:1425–1435

    Article  CAS  Google Scholar 

  95. Aronow WS, Ahn C (2002) Incidence of new coronary events in older persons with prior myocardial infarction and serum low-density lipoprotein cholesterol ≥125 mg/dL treated with statins versus no lipid-lowering drug. Am J Cardiol 89:67–69

    Article  PubMed  CAS  Google Scholar 

  96. Nissen SE, Tuzcu EM, Schoenhagen P et al (2004) Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis. A randomized controlled trial. JAMA 291:1071–1080

    Article  PubMed  CAS  Google Scholar 

  97. Grundy SM, Cleeman JI, Merz CN et al (2004) Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 110:227–239

    Article  PubMed  Google Scholar 

  98. Aronow WS, Ahn C (1994) Correlation of serum lipids with the presence or absence of coronary artery disease in 1793 men and women aged ≥62 years. Am J Cardiol 73:702–703

    Article  PubMed  CAS  Google Scholar 

  99. Lavie CJ, Milani RV (1991) National Cholesterol Education Program’s recommendations and implications of “missing” high-density lipoprotein cholesterol in cardiac rehabilitation programs. Am J Cardiol 68:1087–1088

    Article  PubMed  CAS  Google Scholar 

  100. Fowkes FGR, Housley E, Riemersma RA et al (1992) Smoking, lipids, glucose intolerance, and blood pressure as risk factors for peripheral atherosclerosis compared with ischemic heart disease in the Edinburgh Artery Study. Am J Epidemiol 135:331–340

    PubMed  CAS  Google Scholar 

  101. Aronow WS, Ahn C (1994) Correlation of serum lipids with the presence or absence of atherothrombotic brain infarction and peripheral arterial disease in 1834 men and women aged ≥62 years. Am J Cardiol 73:995–997

    Article  PubMed  CAS  Google Scholar 

  102. Criqui MH, Browner D, Fronek A et al (1989) Peripheral arterial disease in large vessels is epidemiologically distinct from small vessel disease: an analysis of risk factors. Am J Epidemiol 129:1110–1119

    PubMed  CAS  Google Scholar 

  103. Aronow WS, Ahn C (2002) Frequency of new coronary events in older persons with peripheral arterial disease and serum low-density lipoprotein cholesterol ≥125 mg/dl treated with statins versus no lipid-lowering drug. Am J Cardiol 90:789–791

    Article  PubMed  CAS  Google Scholar 

  104. Aronow WS, Nayak D, Woodworth S, Ahn C (2003) Effect of simvastatin versus placebo on treadmill exercise time until the onset of intermittent claudication in older patients with peripheral arterial disease at 6 months and at 1 year after treatment. Am J Cardiol 92:711–712

    Article  PubMed  CAS  Google Scholar 

  105. Mohler ER III, Hiatt WR, Creager MA (2003) Cholesterol reduction with atorvastatin improves walking distance in patients with peripheral arterial disease. Circulation 108:1481–1486

    Article  PubMed  CAS  Google Scholar 

  106. Mondillo S, Ballo P, Barbati R et al (2003) Effects of simvastatin on walking performance and symptoms of intermittent claudication in hypercholesterolemic patients with peripheral vascular disease. Am J Med 114:359–364

    Article  PubMed  CAS  Google Scholar 

  107. Wolf PA (1999) Cerebrovascular disease in the elderly. In: Tresch DD, Aronow WS (eds) Cardiovascular disease in the elderly patient. Marcel Dekker, New York, pp 125–147

    Google Scholar 

  108. Iso H, Jacobs DR Jr, Wentworth D et al (1989) Serum cholesterol levels and six year mortality from stroke in 350, 977 men screened for the Multiple Risk Factor Intervention trial. N Engl J Med 320:904–910

    Article  PubMed  CAS  Google Scholar 

  109. Bihari-Varga M, Szekely J, Gruber E (1981) Plasma high density lipoproteins in coronary, cerebral and peripheral vascular disease: the influence of various risk factors. Atherosclerosis 40:337–345

    Article  PubMed  CAS  Google Scholar 

  110. Crouse JR III, Byington RP, Hoen HM et al (1997) Reductase inhibitor monotherapy and stroke prevention. Arch Intern Med 157:1305–1310

    Article  PubMed  CAS  Google Scholar 

  111. Sever PS, Dahlof B, Poulter NR et al (2003) Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial – Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet 361:1149–1158

    Article  PubMed  CAS  Google Scholar 

  112. Aronow WS, Ahn C, Gutstein H (2002) Incidence of new atherothrombotic brain infarction in older persons with prior myocardial infarction and serum low-density lipoprotein cholesterol ≥125 mg/dL treated with statins versus no lipid-lowering drug. J Gerontol Med Sci 57A:M333–M335

    Article  CAS  Google Scholar 

  113. Aronow WS, Ahn C, Gutstein H (2002) Reduction of new coronary events and of new atherothrombotic brain infarction in older persons with diabetes mellitus, prior myocardial infarction, and serum low-density lipoprotein cholesterol ≥125 mg/dL treated with statins. J Gerontol Med Sci 57A:M747–M750

    Article  CAS  Google Scholar 

  114. Amarenco P, Goldstein LB, Szarek M et al (2007) Effects of intense low-density lipoprotein cholesterol reduction in patients with stroke or transient ischemic attack. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Trial. Stroke 38:3198–3204

    Article  PubMed  CAS  Google Scholar 

  115. Warshafsky S, Packard D, Marks SJ et al (1999) Efficacy of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors for prevention of stroke. J Gen Intern Med 14:763–774

    Article  PubMed  CAS  Google Scholar 

  116. O’Leary DH, Anderson KM, Wolf PA et al (1992) Cholesterol and carotid atherosclerosis in older persons: the Framingham study. Ann Epidemiol 2:147–153

    Article  PubMed  Google Scholar 

  117. Salonen R, Seppanen K, Raurmaa R et al (1988) Prevalence of carotid atherosclerosis and serum cholesterol levels in eastern Finland. Arteriosclerosis 8:788–792

    Article  PubMed  CAS  Google Scholar 

  118. Blankenhorn DH, Selzer RH, Crawford DW et al (1993) Beneficial effects of colestipol-niacin therapy on the common carotid artery: two and four year reduction of intima-media thickness measured by ultrasound. Circulation 88:20–28

    Article  PubMed  CAS  Google Scholar 

  119. Furberg CD, Adams HP, Applegate WB et al (1994) Effect of lovastatin on early carotid atherosclerosis and cardiovascular events. Circulation 90:1679–1687

    Article  PubMed  CAS  Google Scholar 

  120. Crouse JR III, Byington RP, Bond MG et al (1995) Pravastatin, lipids and atherosclerosis in the carotid arteries (PLAC-II). Am J Cardiol 75:455–459

    Article  PubMed  Google Scholar 

  121. Ravipati G, Aronow WS, Ahn C et al (2006) Incidence of new stroke or new myocardial infarction or death in patients with severe carotid arterial disease treated with and without statins. Am J Cardiol 98:1170–1171

    Article  PubMed  CAS  Google Scholar 

  122. Vokonas PS, Kannel WB (2008) Epidemiology of coronary heart disease in the elderly. In: Aronow WS, Fleg JL, Rich MW (eds) Cardiovascular disease in the elderly, 4th edn. Informa Healthcare, New York, pp 215–241

    Chapter  Google Scholar 

  123. Sukhija R, Aronow WS, Kakar P et al (2006) Relation of microalbuminuria and coronary artery disease in patients with and without diabetes mellitus. Am J Cardiol 98:279–281

    Article  PubMed  CAS  Google Scholar 

  124. Ravipati G, Aronow WS, Ahn C et al (2006) Association of hemoglobin A1c level with the severity of coronary artery disease in patients with diabetes mellitus. Am J Cardiol 97:968–969

    Article  PubMed  CAS  Google Scholar 

  125. DeLuca AJ, Kaplan S, Aronow WS et al (2006) Comparison of prevalence of unrecognized myocardial infarction and of silent myocardial ischemia detected by a treadmill exercise sestamibi stress test in patients with versus without diabetes mellitus. Am J Cardiol 98:1045–1046

    Article  PubMed  Google Scholar 

  126. Aronow WS, Ahn C, Weiss MB, Babu S (2007) Relation of increased hemoglobin A1c levels to severity of peripheral arterial disease in patients with diabetes mellitus. Am J Cardiol 99:1468–1469

    Article  PubMed  CAS  Google Scholar 

  127. Barrett-Connor E, Khaw K-T (1988) Diabetes mellitus: an independent risk factor for stroke. Am J Epidemiol 128:116–123

    PubMed  CAS  Google Scholar 

  128. Bogousslavsky J, Regli F, Van Melle G (1985) Risk factors and concomitants of internal carotid arterial occlusion or stenosis: a controlled study of 159 cases. Arch Neurol 42:864–867

    Article  PubMed  CAS  Google Scholar 

  129. Kannel WB, Cupples LA, Ramaswami R et al (1991) Regional obesity and risk of cardiovascular disease. J Clin Epidemiol 44:183–190

    Article  PubMed  CAS  Google Scholar 

  130. Folsom AR, Kaye SA, Sellers TA et al (1993) Body fat distribution and 5 year risk of death in older women. JAMA 269:483–487

    Article  PubMed  CAS  Google Scholar 

  131. Paffenbarger RS Jr, Hyde RT, Wing AL et al (1986) Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med 314:605–613

    Article  PubMed  Google Scholar 

  132. Wenger NK (1994) Physical inactivity as a risk factor for coronary heart disease in the elderly. Cardiol Elder 2:375–379

    Google Scholar 

  133. Paffenbarger RS Jr, Wing AL (1967) Characteristics in youth predisposing to fatal stroke in later years. Lancet 1:753–754

    Article  PubMed  Google Scholar 

  134. Williams MA, Maresh CM, Aronow WS et al (1984) The value of early outpatient cardiac exercise programs for the elderly in comparison with other selected age groups. Eur Heart J 5(Suppl E):113–115

    Article  PubMed  Google Scholar 

  135. Aronow WS, Ahn C, Gutstein H (2002) Prevalence and incidence of cardiovascular disease in 1160 older men and 2464 older women in a long-term health care facility. J Gerontol Med Sci 57A:M45–M46

    Article  Google Scholar 

  136. Gillum RF (1988) Stroke in blacks. Stroke 19:1–9

    Article  PubMed  CAS  Google Scholar 

  137. Aronow WS (1992) Prevalence of atherothrombotic brain infarction, coronary artery disease and peripheral arterial disease in elderly blacks, Hispanics and whites. Am J Cardiol 70:1212–1213

    Article  PubMed  CAS  Google Scholar 

  138. Aronow WS, Ahn C, Schoenfeld M et al (1992) Extracranial carotid arterial disease: a prognostic factor for atherothrombotic brain infarction and cerebral transient ischemic attack. N Y State J Med 92:424–425

    PubMed  CAS  Google Scholar 

  139. Hertzer NR, Beven EG, Young JR et al (1984) Coronary artery disease in peripheral vascular patients: a classification of 1000 coronary angiograms and results of surgical management. Ann Surg 199:223–233

    Article  PubMed  CAS  Google Scholar 

  140. Smith GD, Shipley MJ, Rose G (1990) Intermittent claudication, heart disease risk factors and mortality: the Whitehall study. Circulation 82:1925–1931

    Article  PubMed  CAS  Google Scholar 

  141. Criqui MH, Langer RD, Fronek A et al (1992) Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med 326:381–386

    Article  PubMed  CAS  Google Scholar 

  142. Vogt MT, Cauley JA, Newman AB et al (1993) Decreased ankle/arm blood pressure index and mortality in elderly women. JAMA 270:465–469

    Article  PubMed  CAS  Google Scholar 

  143. Newman AB, Tyrrell KS, Kuller LH (1997) Mortality over four years in SHEP participants with a low ankle-arm index. J Am Geriatr Soc 45:1472–1478

    PubMed  CAS  Google Scholar 

  144. Chimowitz MI, Mancini GBJ (1992) Asymptomatic coronary artery disease in patients with stroke: prevalence, prognosis, diagnosis and treatment. Stroke 23:433–436

    Article  PubMed  CAS  Google Scholar 

  145. Aronow WS, Ahn C, Schoenfeld MR et al (1993) Prognostic significance of silent myocardial ischemia in patients >61 years of age with extracranial internal or common carotid arterial disease with and without previous myocardial infarction. Am J Cardiol 71:115–117

    Article  PubMed  CAS  Google Scholar 

  146. Aronow WS, Schoenfeld MR (1992) Forty-five month follow-up of extracranial carotid arterial disease for new coronary events in elderly patients. Coron Artery Dis 3:249–251

    Article  Google Scholar 

  147. Aronow WS, Gutstein H, Hsieh FY (1989) Risk factors for thromboembolic stroke in elderly patients with chronic atrial fibrillation. Am J Cardiol 63:366–367

    Article  PubMed  CAS  Google Scholar 

  148. Aronow WS, Ahn C (1994) Prevalence of coexistence of coronary artery disease, peripheral arterial disease, and atherothrombotic brain infarction in men and women ≥62 years of age. Am J Cardiol 74:64–65

    Article  PubMed  CAS  Google Scholar 

  149. Ness J, Aronow WS (1999) Prevalence of coexistence of coronary artery disease, ischemic stroke, and peripheral arterial disease in older persons, mean age 80 years, in an academic hospital-based geriatrics practice. J Am Geriatr Soc 47:1255–1256

    PubMed  CAS  Google Scholar 

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Aronow, W.S., Frishman, W.H. (2011). Risk Factors for Atherosclerosis in the Elderly. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6999-6_51

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