Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2017; 5(9): 349-359
Published online Sep 16, 2017. doi: 10.12998/wjcc.v5.i9.349
Primary prevention of cardiovascular disease in older adults in China
Jian Yong, Dong Lin, Xue-Rui Tan
Jian Yong, Dong Lin, Xue-Rui Tan, First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Author contributions: Tan XR designed, critically revised and approved the manuscript; Yong J and Lin D conducted the literature reviews, drafted and finalised the manuscript.
Conflict-of-interest statement: The authors state no conflict of interest and have received no payment in the preparation of this manuscript. This paper has been written upon an invitation of the journal editor to the corresponding author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Xue-Rui Tan, MD, PhD, Department of Cardiology, First Affiliated Hospital of Shantou University Medical College, No. 22 Xinling Road, Shantou 515041, Guangdong Province, China.
Telephone: +86-754-8825218 Fax: +86-754-88259850
Received: January 28, 2017
Peer-review started: February 6, 2017
First decision: May 11, 2017
Revised: May 22, 2017
Accepted: June 12, 2017
Article in press: June 13, 2017
Published online: September 16, 2017

Over the past two decades, the percentage of Chinese who is 60 years or older has increased from 5.2% in 1995 to 10.5% in 2015. Approximately 16% of the population in China was 60 years old and above in 2015. Since 1990, cardiovascular disease (CVD) has been the leading cause of death in China. Cardiovascular medications of older adults are usually more complicated than younger age groups due to polypharmacy, the presence of comorbidities and more susceptible to treatment-related adverse outcomes. Therefore, effective primary prevention of CVD for older adults is important in sustaining the health of older adults and reducing the burden of the healthcare system. Proper management of CVD-related risk factors, such as hypertension, dyslipidemia, diabetes and obesity, can remarkably reduce risks of CVDs in older Chinese. These risk factors can be modified by managing blood pressure, glucose and lipids via lifestyle modifications or receiving medications. Smoking cessation, healthy diets, strict alcohol intake and moderate physical exercise are examples of recommended lifestyle changes for remarkably recovering health conditions of older adults who have hypertension, dyslipidemia, obesity, diabetes or complications. Treatment prescriptions of older adults, in general, are recommended to be individualized and to be initiated at a low dose. The future directions for better primary CVD prevention in older adults include establishing guidelines for primary prevention of CVD for different older adults and further research on better management strategies of CVD risks for elderly Chinese.

Keywords: Cardiovascular disease, Primary prevention, Adults, China, Aged

Core tip: Cardiovascular disease (CVD) is the leading cause of death in China. More than half of the Chinese ≥ 60 years old have been exposed to at least one risk factor for CVD. This review aims to highlight the primary CVD prevention in Chinese who are 60 years old and above. The management of common risk factors and future directions of primary CVD prevention for elderly population are described in this review.