Age, established vascular disease, frailty and life expectancy influence the presentation and management described in this passage.
Age and presentation
•
In developed countries, prevalence rises almost exponentially with age, although atherosclerosis is not considered part of normal ageing.
•
Frail patients frequently present with advanced multisystem arterial disease and multiple other comorbidities.
Treatment considerations
•
The passage states that statins have no role in primary prevention of atherosclerotic disease in people over 75 years.
•
In established vascular disease, statins reduce cardiovascular events but do not reduce overall mortality.
•
In frail patients with extensive disease and limited life expectancy, surgical risks may outweigh benefits; symptomatic care alone should then be offered.