Traditional Risk Factors and Subclinical Disease Measures as Predictors of First Myocardial Infarction in Older Adults

Abstract

IN MIDDLE-AGED adults, the major risk factors for a first myocardial infarction (MI) have been well characterized and include smoking, diabetes, lipid levels, and systolic and diastolic blood pressures.^1-6 Drug treatment of hypertension and hyperlipidemia is known to reduce the risk of first coronary events.^7,8 For several major risk factors in older adults, however, both the levels of risk and the benefits of intervention are in general less clearly established. While the benefits of the treatment of high blood pressure are clear,^9,10 the risks associated with elevated levels of cholesterol and the potential benefits of therapy in older adults remain controversial.^11-14