Cardiovascular disease (CVD) remains the global leader in mortality, claiming an estimated 17.9 million lives annually—nearly twice as many as cancer. As our population ages, the stakes only get higher. By 2030, 20% of the world’s population will be 65 or older, and for those over 70, the prevalence of CVD jumps to a staggering 70%.
Managing heart health in older adults isn’t just about following standard guidelines; it’s about navigating a unique set of physiological and pharmacological challenges.
The challenge: scarcity of evidence
One of the biggest hurdles in cardiovascular care for older populations is the “evidence gap”. Patients aged 75 and older are frequently underrepresented in major clinical trials. Because they often have complex comorbidities, frailty, or significant disabilities, they are excluded from the very studies that dictate our clinical recommendations.
This leaves clinicians in a delicate position: we know CVD is partially preventable, yet we must manage it in a population where age-related changes to organ systems make every pharmacological intervention a higher risk.
Assessing risk
In younger patients, risk assessment is often straightforward. In older adults, we need tools that account for the nuances of aging. Here are some of the key algorithms currently used to help quantify risk:
- Framingham Risk Score (FRS): The traditional standard for predicting 10-year risk.
- PREVENT™ Equations: Specifically designed to predict risk across a broad age range.
- ASCVD Risk Estimator Plus: A common tool for evaluating atherosclerotic coronary artery disease risk.
- QRISK®3: Helps identify patients at highest risk of heart attack or stroke.
- SCORE2-OP: Calibrated specifically for individuals aged 70–89 to improve risk estimation in older populations.
Safe medication use
Assessing the risk factors—like hypertension, diabetes, and smoking—is only the first step. The real “how-to” in older adults involves safe medication management. Age-related shifts in renal and hepatic function mean that “standard” doses can quickly lead to complications. The goal is to maximize the protective benefits of CVD therapy without compromising the patient’s overall quality of life.
Want to learn more?
Identifying risk is one thing; managing it safely in a complex older patient is another.
Ready to sharpen your strategy for geriatric heart health? Take our free 15-minute course, CVD Risk in Older Adults: Strategies for Safer Medication Use, to learn practical, evidence-based approaches for this high-risk population.