title: Cardiovascular risk management in community-dwelling elderly: opportunities for prevention.
abstract: BACKGROUND
  There is little information on the prevalence of hypertension and other modifiable cardiovascular risk factors in community-dwelling elderly in the Netherlands and the potential impact of improving antihypertensive treatment on major cardiovascular events.
  
  
  METHODS
  Cross-sectional analysis of Dutch community-dwelling subjects aged 70-78 years without dementia who were included in the cluster randomized preDIVA trial (Prevention of Dementia by Intensive Vascular care).
  
  
  METHODS
  The prevalence of hypertension and other cardiovascular risk factors are described for participants with and without a history of cardiovascular disease (CVD). Projected benefits of blood pressure decrease are calculated using data from a meta-analysis and a large national registry.
  
  
  RESULTS
  Of 3534 subjects, more than one-third (n = 1230, 35.2%) have a history of cardiovascular disease. Overall, 63% of subjects have two or more cardiovascular risk factors amenable to treatment. Systolic blood pressure (SBP) is ≥160 mmHg in 37% of patients with CVD, of which 28% is untreated. In subjects without a history of CVD, 41% have a SBP ≥ 160 mmHg of which 52% is untreated. A 5-15 mmHg decrease in SBP is projected to prevent 12-32% of coronary heart disease and 16-41% of strokes, respectively. This corresponds with 14-38 prevented cases within 2 years in our intervention group (n = 1895).
  
  
  CONCLUSIONS
  Hypertension and other cardiovascular risk factors are very common in elderly subjects. Current (primary and secondary) prevention programmes appear insufficient. Improved antihypertensive treatment has the potential to prevent a substantial proportion of strokes and coronary heart disease in this population.
authors.affiliation: University of Amsterdam, Amsterdam, The Netherlands. s.a.ligthart@amc.nl
authors.forename: Suzanne A
authors.initials: SA
authors.lastname: Ligthart
authors.forename: Edo
authors.initials: E
authors.lastname: Richard
authors.forename: Willem A
authors.initials: WA
authors.lastname: van Gool
authors.forename: Eric P
authors.initials: EP
authors.lastname: Moll van Charante
mesh_terms: D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D003153:Community Health Services; D003430:Cross-Sectional Studies; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D057187:Independent Living; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011322:Primary Prevention / Q000379:methods*; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents