Primary prevention of Cardiovascular Diseases among the Middle aged and the Elderly

Abstract

Aim: To define the best practice guidelines for primary prevention of cardiovascular diseases in middle age individuals as well as the elderly. Study design and Methodology: Narrative review study for RCT, clinical trials and systematic review studies published in English language from 2003-2018; in middle age individuals as well as the elderly. Search was conducted in Pubmed and Google Chrome. Terms used for searching were (best practice guidelines) and (primary prevention of cardio-vascular disease). Results: The total number of study search items was 2020 studies and after filtering them, the matching studies were 70: 38 studies were excluded whereas 32 studies were included. Six studies were about statins therapy in primary prevention of CVD in the elderly. Five studies were about statin benefits for primary prevention of cardiovascular disease in middle age individuals. Nine studies were about non-statin therapy. Five studies were about blood pressure control and primary prevention of cardiovascular disease. Seven studies were about aspirin for primary prevention of cardiovascular disease in diabetics. Conclusion: Statins are beneficial for primary prevention of cardiovascular disease in middle age individuals as well as the elderly who had dyslipidemia or were diabetic aged 40-75 years, or 10-years CVD risk =>7.5% according to AHA/ACC, or =>10% in accordance with the guidelines for both NICE and USPSTF. There is no definite evidence for non-statin therapy benefit for primary prevention of CVD but it can be used in hypercholesterolemia patients or high CVD risk patients who do not tolerate statins or have not responded to the maximum dose of statins. There was no evidence for aspirin benefit in primary prevention of CVD in diabetics. Immediate blood pressure control is important in the primary prevention of CVD in hypertensive patients with high cardiovascular risk. Key words: Cardiovascular diseases, middle aged, elderly