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Women and Heart Disease > Special Issues

Aging

Cardiac Risk Increases With Age

The risk for heart disease increases with advancing age, and women generally present with heart disease at an older age than men. CHD is responsible for 84% of deaths among people

65 years old.¹²⁹ The risk for heart failure also increases as people age,² and heart failure is the leading cause of hospitalization among that age group.¹⁰⁵

The prevalence of obstructive coronary disease is relatively low in premenopausal women but increases substantially after age 50 (Table 10).¹³⁰

Table 10. Prevalence of Obstructive Coronary Disease in Women by Age¹³⁰

Unfortunately, few clinical studies of cardiovascular disease prevention include elderly women, especially those older than 80, in whom such disease is common.⁵⁴ Research should include more diverse subpopulations of women so that prevention guidance can be more effectively tailored for different patients.

Late-Life Depression and Heart Disease

Depressed elderly patients are significantly more likely to have hypertension and heart disease than their nondepressed counterparts.¹³¹
Depression has been associated with poor cardiac disease outcomes.¹³¹
Elderly patients with atherosclerosis are more likely to be depressed.¹³²
A strong relationship has been observed between severe coronary and aortic calcification and depressive disorders.¹³²
In a large study, depression was an independent predictor of cardiovascular death in postmenopausal women with no history of CVD.¹³³

Given the association between depression and heart disease in older women, this population should be appropriately screened and treated for depressive disorders.