Introduction: Guidelines for the management of vascular disease recommend treatment of modifiable risk factors in all age groups. It is unclear whether risk factors for vascular disease are increasing in prevalence in community living older people and how rates of end-organ disease parallel changes in these risk factors. Our aim is to compare the burden of vascular disease and its risk factors in community-dwelling older people over 10 years of follow-up.
Methods: In 2002, 104 community-dwelling people aged 65 and over (median 70 range 65–83) underwent clinical history and physical examination. Identical protocol was repeated 10 years later.
Results: Reported smoking status was comparable between baseline and follow-up (current; 8 versus 7%, past; 65 versus 63%), there was no difference in the proportion at each time point of older people consuming alcohol. There was a significant increase in BMI [median BMI (IQ range) 26 (24, 29) versus 27 (24, 31); P = 0.02] Rates of hypertension and diabetes had significantly increased (hypertension 32 versus 51%; P = 0.005) (diabetes 4 versus 15%; P = 0.005) nevertheless rates of ischaemic heart disease, cerebro- and peripheral vascular disease had not significantly increased. Hyperlipidaemia rates had significantly decreased (35 versus 16%; P = 0.003) in line with an increase in prescription of HMG co-A reductase inhibitors (20 versus 50%; P < 0.001). The number of individuals taking antihypertensives (46 versus 68%; P = 0.001) and any cardioactive medication (49 versus 71%; P = 0.001) had increased. The use of ACE inhibitors and calcium antagonists had significantly increased with a non-significant decrease in beta-blockers.
Conclusion: Over the last decade modifiable risk factors for vascular disease have increased in a community cohort of older people. Effective management of these risk factors might account for the stable rates of age-related end-organ vascular disease.