The Middle-Aged and Older American: Wrong Prototype for a Preventive Polypill?

Editorials15 March 2005The Middle-Aged and Older American: Wrong Prototype for a Preventive Polypill?Cynthia Mulrow, MD, MSc, Deputy Editor and William Kussmaul, MD, Associate EditorCynthia Mulrow, MD, MSc, Deputy EditorSearch for more papers by this author and William Kussmaul, MD, Associate EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-6-200503150-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Any way you look at them, the numbers are staggering. In the coming year, about 1.2 million Americans will have a first or recurrent coronary attack and about 700 000 will have a new or recurrent stroke (1). Most Americans older than age 35 years have 1 or more vascular risk factors. More than one third of them have hypercholesterolemia (2). One fifth of adult Americans smoke, and most have inactive lifestyles (3). One third have high blood pressure, more than 30% are obese, and nearly 10% have diabetes (4).Americans have a dizzying array of options available to reduce vascular ...References1. American Heart Association. Heart Disease and Stroke Statistics–2004 Update. Dallas, TX: American Heart Assoc; 2003. Google Scholar2. Ford ES, Mokdad AH, Giles WH, Mensah GA. Serum total cholesterol concentrations and awareness, treatment, and control of hypercholesterolemia among US adults: findings from the National Health and Nutrition Examination Survey, 1999 to 2000. Circulation. 2003;107:2185-9. [PMID: 12719276] CrossrefMedlineGoogle Scholar3. National Vital Statistics System. Centers for Disease Control and Prevention, National Center for Health Statistics. Hyattsville, Maryland. Accessed at www.cdc.gov/nchs/nvss.htm in January 2005. Google Scholar4. Health, United States, 2004. Hyattsville, MD: National Center for Health Statistics; 2004. Google Scholar5. Volpe M, Alderman MH, Furberg CD, Jackson R, Kostis JB, Laragh JH, et al. Beyond hypertension toward guidelines for cardiovascular risk reduction. Am J Hypertens. 2004;17:1068-74. [PMID: 15533736] CrossrefMedlineGoogle Scholar6. Grundy SM, Cleeman JI, Merz CN, Brewer HB, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004;110:227-39. [PMID: 15249516] CrossrefMedlineGoogle Scholar7. National Institute of Health. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). NIH Pub. No. 01-3670. Bethesda, MD: National Heart, Lung, Blood and Tissue Institute. 2001: 40 pages. Google Scholar8. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ. 2003;326:1419. [PMID: 12829553] CrossrefMedlineGoogle Scholar9. Vasan RS, Sullivan LM, Wilson PW, Sempos CT, Sundstrom J, Kannel WB, et al. Relative importance of borderline and elevated levels of coronary heart disease risk factors. Ann Intern Med. 2005;142:393-402. LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Disclosures: None disclosed.Corresponding Author: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.Current Author Addresses: Dr. Mulrow: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.Dr. Kussmaul: Hahnemann University Hospital, 227 North Broad Street, Suite 200, Philadelphia, PA 19107. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRelative Importance of Borderline and Elevated Levels of Coronary Heart Disease Risk Factors Ramachandran S. Vasan , Lisa M. Sullivan , Peter W.F. Wilson , Christopher T. Sempos , Johan Sundström , William B. Kannel , Daniel Levy , and Ralph B. D'Agostino Metrics Cited byPrescribing trend in cardiovascular patients at Ethiopian university hospital: The number of medications and implication on the clinical improvementUncontrolled Hypertension in Uganda: A Comparative Cross-Sectional StudyCombination pharmacotherapy to prevent cardiovascular disease: present status and challengesChapter 63 The future of stroke prevention by risk factor modificationCombination Pharmacotherapy for Cardiovascular DiseaseCombination Pharmacotherapy and Public Health Research Working Group*Prospects and possible pitfalls of a preventive Polypill: confessions of a health promotion convertThe Role of SERMs in the Management of Postmenopausal Women 15 March 2005Volume 142, Issue 6Page: 467-468KeywordsBlood pressureExerciseHealth surveysMedical risk factorsMorbidityObesityVascular diseases ePublished: 15 March 2005 Issue Published: 15 March 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...