Risk Factors for Coronary Atherosclerosis in the Elderly

To determine the importance of traditional risk factors for coronary artery disease (CAD) in the elderly, the authors studied 64 consecutive patients with angiographically normal or near-normal coronary arteries and 64 patients with CAD. All patients were greater than or equal to sixty years old. The risk factors studied were male sex, hypertension, diabetes mellitus, hypercholesterolemia, cigarette smoking, sedentary life-style, and family history. The prevalence of these risk factors in the two groups of patients was compared. The results suggest that in persons greater than or equal to 60 years old, male sex and cigarette smoking continue to remain risk factors for CAD. Since most of the patients with diabetes and hypertension were on medical management for their condition, the authors' findings also suggest that diabetes mellitus, even under treatment, remains an important risk factor for CAD in the elderly but controlled hypertension does not. Other traditional risk factors (hypercholesterolemia, sedentary life-style, and family history) do not discriminate individuals with moderate to severe CAD from those with normal or near-normal coronary arteries in persons greater than or equal to sixty years old.