Aging

Cardiac Risk Increases With Age

The risk for heart disease increases with advancing age.¹¹⁵ This increase is even sharper in women,¹¹⁵ who generally present with heart disease at an older age than men.⁹ CHD is responsible for 84% of deaths among people ≥65 years old.¹¹⁶ The risk for heart failure also increases as people age,¹ and heart failure is the leading cause of hospitalization among that age group.⁸⁵

The prevalence of obstructive coronary disease is relatively low in premenopausal women but increases substantially after age 50 (Table 5).¹⁴

Table 5. Prevalence of Obstructive Coronary Disease in Women by Age¹⁴

Age, Years	Prevalence
<35	~5%
35-44	14%
45-54	29%
55-64	48%
65-74	65%
≥75	79%

Unfortunately, few clinical studies of cardiovascular disease prevention include elderly women, especially those older than 80 years, in whom such disease is common.¹¹⁷

Late-Life Depression and Heart Disease

• Depressed elderly patients are significantly more likely to have hypertension and heart disease than their nondepressed counterparts.¹¹⁸
• Depression has been associated with poor cardiac disease outcomes.¹¹⁸
• Elderly patients with atherosclerosis are more likely to be depressed.¹¹⁹
• A strong relationship has been observed between severe coronary and aortic calcification and depressive disorders.¹¹⁹
• In a large study (N=93,676), depression was an independent predictor of cardiovascular death in postmenopausal women with no history of CVD.¹²⁰

Given the association between depression and poor medical outcomes in heart disease among older women, this population should be appropriately screened and treated for depressive disorders as necessary.¹¹⁸