title: [The guideline 'Cardiovascular risk management' is too simplified for elderly care].
abstract: In the 2011 revision of the multidisciplinary guideline 'Cardiovascular Risk Management', the new age category '70-year olds' was added to the risk chart. Virtually all people aged 70 years and over have a 10-year risk of cardiovascular mortality and morbidity that exceeds 20%, and are therefore eligible for preventive medication when lifestyle changes fail. In view of the attenuating predictive value of classic risk factors with age, the authors of this commentary discuss the lack of a more age-differentiated approach for older persons. They underline the importance of including differences in the levels of vulnerability in older patients when making medication decisions. The risk of undue medicalisation of a large segment of the population is discussed. Alternative approaches are conveyed: the use of age-dependent thresholds for different risk categories, the use of relative risk charts, and the search for better risk markers in (very) old age.
authors.affiliation: Leids Universitair Medisch Centrum, afd. Public Health en Eerstelijnsgeneeskunde, Leiden, the Netherlands. w.de_ruijter@lumc.nl
authors.forename: Wouter
authors.initials: W
authors.lastname: de Ruijter
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D006801:Humans; D017410:Practice Guidelines as Topic; D012308:Risk Management
chemical_list: D000959:Antihypertensive Agents; D002317:Cardiovascular Agents