Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Life Expectancy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,675 records · Page 93Linked to original sources
PubMed2003

Causes of death between 1911-1950 in a Swedish province with a population characterized by longevity.

AIMS: Life expectancy in Sweden is among the highest in the world, and the province of Halland has the highest life expectancy in Sweden today. In an earlier paper the authors reported that life expectancy in the province of Halland in the south-west of the country was approx. 3.5 years above the national average between 1911 and 1950. The aim of this study was to explore the influence of different causes of death on life expectancy in Sweden and the distribution of these causes of death in Halland compared with Sweden as a whole during the same period of time. METHOD: Causes of death between 1911 and 1950 in the whole of Sweden and in Halland were obtained from the archives of Statistics Sweden. A trend analysis was performed on the impact of the various causes of death on life expectancy in Sweden. Calendar year, age, and sex were controlled for in a Poisson model. The distribution and incidence of the most frequent causes of death were compared between Halland and Sweden as a whole. RESULTS: The decreasing mortality risk due to infectious diseases and the simultaneous increase in the risk of mortality from tumours and circulatory diseases contributed most to the change in life expectancy in Sweden. In Halland there was a lower mortality risk in the seven most important causes of death, which accounted for approx 80% of all deaths during the study period. CONCLUSIONS: The lower mortality risk from infectious diseases mostly favoured the improvement in life expectancy in Halland up to the mid-1930s. Thereafter, a low mortality risk from tumours and particularly circulatory diseases gained increasing importance although there was always a difference in favour of Halland from the beginning of the study period. Thus, the positive trend in life expectancy that favours Halland today seems to have existed for a long period of time.

Cause of Death↗
PubMed2001

New African American life tables from 1935-1940 to 1985-1990.

New life tables for African Americans are presented from 1935 through 1990. They are based on a historical series of vital statistics data on deaths that have been corrected for age misreporting, on reconstructed population counts that have been adjusted for census underenumeration, and on births that have been corrected for underregistration. The new life tables show rapid mortality declines for both African American males and females from 1935 to 1950, and relatively steady reductions thereafter for females. The smaller declines in male mortality in young adulthood and middle age since the 1950s have led to exceptionally high ratios of male to female mortality at these ages. Corrections for census undercounts lead to higher values of life expectancy than in official life tables, but to less improvement over time. Official estimates of life expectancy at age 65 appear to be about 10% too high around 1940 but only about 1.5% too high in the late 1980s.

Adolescent↗
PubMed2004

Intensive lifestyle changes or metformin in patients with impaired glucose tolerance: modeling the long-term health economic implications of the diabetes prevention program in Australia, France, Germany, Switzerland, and the United Kingdom.

BACKGROUND: In the Diabetes Prevention Program (DPP), interventions with metformin (plus standard lifestyle advice) or intensive lifestyle changes (ILC) reduced the risk of developing type 2 diabetes mellitus (DM) by 31% and 58%, respectively, versus control (standard lifestyle advice only) in patients with impaired glucose tolerance (IGT). OBJECTIVE: The goal of this study was to establish whether implementing the active treatments used in the DPP would be cost-effective in Australia, France, Germany, Switzerland, and the United Kingdom. METHODS: A Markov model simulated 3 states-IGT, type 2 DM, and deceased-using probabilities from the DPP and published data. Country-specific direct costs were used throughout. RESULTS: Assuming only within-trial effects and costs of interventions, both metformin and ILC improved life expectancy versus control. Mean improvements in nondiscounted life expectancy were 0.11 and 0.22 years for metformin and ILC, respectively. Both interventions were associated with cost savings versus control in all countries except the United Kingdom, where a small increase in costs was observed in both intervention arms. When a lifetime effect of interventions was assumed, incremental improvements in life expectancy were 0.35 and 0.90 years for metformin and ILC, respectively. Results were sensitive to probabilities of developing type 2 DM, the projected long-term duration of effect of interventions after the 3-year trial period, the relative risk of mortality for type 2 DM compared with IGT, and the costs of implementing the interventions. CONCLUSIONS: Based on probabilities from the DPP and published data, in this model analysis, incorporation of the DPP interventions into clinical practice in 5 developed countries was projected to lead to an increase in DM-free years of life, improvements in life expectancy, and either cost savings or minor increases in costs compared with standard lifestyle advice in a population with IGT. Thus, financial constraints should not prevent the implementation of DM prevention programs.

Adult↗
PubMedDate not supplied

Biological age--what is it and can it be measured?

Biological age is a concept used loosely and with little objectivity to describe a shortfall between a population cohort average life expectancy and the perceived life expectancy of an individual of the same age. Many biomarkers decline roughly linearly with age with a slope of <1% per annum. The use of a battery of 16 biomarkers is described as a method of calculating an individual biological age. They include: the concentration of prostacyclin in fibroblasts, cell membrane viscosity, the electroretinogram, baroreflex regulation of the heart rate, the concentration of lymphocytes, leucocyte density and velocity, grip strength, cells of the corneal endothelium and the buccal epithelium, neck muscle mobility, and vital capacity. Although not subjected to a prospective validation, the method might provide an objective approach to this widely used concept.

Aged↗
PubMed2004

The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%.

OBJECTIVE: Although the Polypill concept (proposed in 2003) is promising in terms of benefits for cardiovascular risk management, the potential costs and adverse effects are its main pitfalls. The objective of this study was to identify a tastier and safer alternative to the Polypill: the Polymeal. METHODS: Data on the ingredients of the Polymeal were taken from the literature. The evidence based recipe included wine, fish, dark chocolate, fruits, vegetables, garlic, and almonds. Data from the Framingham heart study and the Framingham offspring study were used to build life tables to model the benefits of the Polymeal in the general population from age 50, assuming multiplicative correlations. RESULTS: Combining the ingredients of the Polymeal would reduce cardiovascular disease events by 76%. For men, taking the Polymeal daily represented an increase in total life expectancy of 6.6 years, an increase in life expectancy free from cardiovascular disease of 9.0 years, and a decrease in life expectancy with cardiovascular disease of 2.4 years. The corresponding differences for women were 4.8, 8.1, and 3.3 years. CONCLUSION: The Polymeal promises to be an effective, non-pharmacological, safe, cheap, and tasty alternative to reduce cardiovascular morbidity and increase life expectancy in the general population.

Cacao↗
PubMed1994

[Comparison of relative survival vs. classical survival. Apropos of primary bronchial cancer].

The aim of the study is to compare the usefulness of a recent relative survival model versus more classical methods for univariate and multivariate survival analysis, applied to a population of patients with surgically cured non small cell lung cancer, in determination of prognostic factors and appreciation of the exact role of age on survival. We studied 156 patients surgically treated between 1975 and 1988. Both univariate and multivariate analysis were performed, using the actuarial method and the Cox model for crude survival and the additive Hakulinen model (1985) for relative survival (total risk of death equal to natural risk of death in general population plus disease specific risk of death) which is an age-adjusted survival corrected for normal life expectancy. In addition, the loss in life expectancy was also calculated. Our 156 patients (including six females), whose age ranged from 30 to 78 (mean age 59) were almost all current or former smokers (97%) and 63% had clinical trouble. Squamous cell carcinoma was the most common histology (76%) before adenocarcinomas (20%). Pneumonectomy and lobectomy were equally performed. Post surgical TNM staging was stage I = 78 (50.3%), II = 23 (14.8%), IIIa = 44 (28.4%), IIIb = 10 (6.5%). By 31 December 1990, 116 patients had died, 24 were alive and 16 lost to follow-up. In univariate analysis, overall survival is (crude/relative): 1 year (75.8%/77.5%), 2 years (53.8%/56.0%), 5 years (28.7%/32.5%), 10 years (14.4%/18.9%). Univariate prognostic factors are histopathology, surgical procedure and post operative TNM staging. The overall loss in life expectancy is 71.4% (5.5 years of life expectancy vs 19.21). The loss is higher for the younger patients than for the older ones (73% for the 30-49 year old group--59.2% for the more than 70 year old group). In multivariate analysis, prognostic factors are: Cox model: post-surgical TNM staging, histopathology and age (RR = 2.18 [1.13-4.23] for patients over 65); Hakulinen model: TNM staging. In this model, age is no longer a significant prognostic factor. In conclusion, this study confirmed the poor prognosis of NSCLC, even if a curative surgical procedure has been possible, with a 5-year survival of 48% for stage I tumours but only 6% for stage III tumours. The most significant prognostic factor is the post-surgical TNM staging. The relative survival model of Hakulinen dismissed age as a significant prognostic factor.(ABSTRACT TRUNCATED AT 400 WORDS)

Actuarial Analysis↗
PubMed2002

European perspectives on healthy aging in women.

Using data from the 1994 European Community Household Panel, we compare active life expectancy differentials at age 65 years between women and men in 12 European countries. We seek to explain the extent to which differences are a reflection of gender differentials in life expectancy at 65 years or reflect differences in active life expectancy earlier in life. Considerable variation in the gender differentials in both total and active life expectancies at age 65 years exist within Europe, with some countries experiencing 20% lower life expectancy at age 65 years for men compared to women. Some evidence was found to suggest that gender differentials in active life expectancy may continue from younger ages through to later life.

Activities of Daily Living↗
PubMed2003

Kidney transplantation in the elderly: a decision analysis.

Transplantation offers superior life expectancy and quality of life compared with dialysis in young patients with end-stage renal failure. However, the initial risks of mortality and morbidity are high. This study used a decision analysis model to evaluate the costs and benefits of kidney transplantation versus continued dialysis for older patients with renal failure. A decision analytic model comparing cadaveric renal transplantation to continued hemodialysis treatment was developed. The base case considered a theoretical cohort of patients aged 65 yr without known comorbidity or contraindications to transplantation who would have to wait 2 yr for a cadaveric transplant. Separate models were constructed for patients with diabetes or cardiovascular disease and for patients receiving an organ after a variety of wait-list times. Probability, utility, and survival data were obtained from published reports and renal registries. For 65-yr-old patients, quality-adjusted life expectancy increased by 1.1 quality-adjusted life years (QALY) at an incremental cost of $67,778 per QALY. Assuming a 2-yr wait-listed time, transplantation remained economically attractive for 70-yr-old patients (incremental cost effectiveness [ICE], $79,359 per QALY) but was less economically attractive for those over 75 yr of age (ICE, $99,553) or for 70-yr-olds with either cardiovascular disease or diabetes (ICE, $126,751 and $161,090 per QALY, respectively). The analytic results were sensitive only to the time spent waiting for the graft. The cost-effectiveness reduced such that the costs associated with one QALY were in excess of $100,000/yr when the probability of a complication was > or = 50% per 3-mo cycle and when the utility of transplantation fell below 0.62. If available within a timely period, transplantation may offer substantial clinical benefits to older patients at a reasonable financial cost. Prolonged waiting times dramatically decrease the clinical benefits and economic attractiveness of transplantation, suggesting that living donor transplantation may be of particular benefit in this population.

Aged↗
PubMed2004

How much downside? Quantifying the relative harm from tobacco taxation.

OBJECTIVE: To estimate the loss of life expectancy attributable to tobacco taxation (via financial hardship and flow-on health effect) in New Zealand. DESIGN: Data were used on the gradients in life expectancy and smoking by neighbourhood socioeconomic deprivation and survey data on tobacco expenditure. Three estimates were modelled of the percentage of the crude association of neighbourhood deprivation with life expectancy that might be mediated via financial hardship: 100%, 50%, and 25% (best estimate). From this information the impact of tobacco taxation on life expectancy was estimated. MAIN RESULTS: For the total population, the estimated loss of life expectancy due to tobacco tax ranged from 0.005 years to 0.027 years. For people living in the most deprived 30% of neighbourhoods, the range was 0.009 to 0.044 years (that is, 3 to 16 days of lost life expectancy). For the total population the loss of life expectancy attributable to tobacco tax ranged from 119 to 460 times less than that attributable to deprivation. The loss of life expectancy attributable to tobacco tax was 42 to 257 times less than that attributable to smoking. CONCLUSIONS: The estimated harm to life expectancy from tobacco taxation (via financial hardship) is orders of magnitude smaller than the harm from smoking. Although the analyses involve a number of simplistic assumptions, this conclusion is likely to be robust. Policy makers should be reassured that tobacco taxation is likely to be achieving far more benefit than harm in the general population and in socioeconomically deprived populations.

Aged↗
PubMedDate not supplied

Short-term menopausal hormone therapy for symptom relief: an updated decision model.

BACKGROUND: Hormone therapy (HT) provides the most effective relief of menopausal symptoms. This therapy is associated with a decreased risk of osteoporosis and colorectal cancer but increased risks of cardiovascular disease (CVD), venous thrombosis, and breast cancer. Our objective was to identify which women should benefit from short-term HT by exploring the trade-off between symptom relief and risks of inducing disease. METHODS: A Markov model simulates the effect of short-term (2 years) estrogen and progestin HT on life expectancy and quality-adjusted life expectancy (QALE) among 50-year-old menopausal women with intact uteri, using findings from the Women's Health Initiative. Quality-of-life (QOL) utility scores were derived from the literature. We assumed HT-affected QOL only during perimenopause, when it reduced symptoms by 80%. RESULTS: Among asymptomatic women, short-term HT was associated with net losses in life expectancy and QALE of 1 to 3 months, depending on CVD risk. Women with mild or severe menopausal symptoms gained 3 to 4 months or 7 to 8 months of QALE, respectively. Among women at low risk for CVD, HT extended QALE if menopausal symptoms lowered QOL by as little as 4%. Among women at elevated CVD risk, HT extended QALE only if symptoms lowered QOL by at least 12%. CONCLUSIONS: Hormone therapy is associated with losses in survival but gains in QALE for women with menopausal symptoms. Women expected to benefit from short-term HT can be identified by the severity of their menopausal symptoms and CVD risk.

Black or African American↗
PubMed2006

Regional differences in multidimensional aspects of health: findings from the MRC cognitive function and ageing study.

BACKGROUND: Differences in mortality and health experience across regions are well recognised and UK government policy aims to address this inequality. Methods combining life expectancy and health have concentrated on specific areas, such as self-perceived health and dementia. Few have looked within country or across different areas of health. Self-perceived health, self-perceived functional impairment and cognitive impairment are linked closely to survival, as well as quality of life. This paper aims to describe regional differences in healthy life expectancy using a variety of states of health and wellbeing within the MRC Cognitive Function and Ageing Study (MRC CFAS). METHODS: MRC CFAS is a population based study of health in 13,009 individuals aged 65 years and above in five centres using identical study methodology. The interviews included self-perceived health and measures of functional and cognitive impairment. Sullivan's method was used to combine prevalence rates for cognitive and functional impairment and life expectancy to produce expectation of life in various health states. RESULTS: The prevalence of both cognitive and functional impairment increases with age and was higher in women than men, with marked centre variation in functional impairment (Newcastle and Gwynedd highest impairment). Newcastle had the shortest life expectancy of all the sites, Cambridgeshire and Oxford the longest. Centre differences in self-perceived health tended to mimic differences in life expectancy but this did not hold for cognitive or functional impairment. CONCLUSION: Self-perceived health does not show marked variation with age or sex, but does across centre even after adjustment for impairment burden. There is considerable centre variation in self-reported functional impairment but not cognitive impairment. Only variation in self-perceived health relates to the ranking of life expectancy. These data confirm that quite considerable differences in life experience exist across regions of the UK beyond basic life expectancy.

Activities of Daily Living↗
PubMed1993

Survival time after onset of diabetes: 29-year follow-up mortality study in a diabetes cohort from a rural district.

UNLABELLED: In order to evaluate various influences on survival time after onset of diabetes, a 29-year follow-up study was conducted in the 166 diabetic patients who were newly diagnosed between May 1st, 1962, and April 30th, 1963, in the rural district of Neustrelitz. Their mean age at onset was 63 (15-81) years, sex ratio was 2.5 (females: males). 27% of the patients were initially treated with insulin, 73% were on diet alone or on diet plus oral antidiabetic drug. There were 18 drop-outs. Check-up of mortality was performed at 3-year intervals. Shortening of life expectancy was calculated by comparison of their survival time to the life expectancy of the general population of the former German Democratic Republic with reference upon age and sex. RESULTS: Seven out of the remaining 148 study patients (4.7%) with an age at onset between 15 and 60 were alive. 19% of the patients had either reached or exceeded the life expectancy of the general population. The average loss in life expectancy in the decreased patients amounted to 5.3 years in males and to 6.4 years in females. The shortening of life expectancy decreased with increasing age at onset. Both underweight (BMI < 20) and extreme obesity (BMI > 40) were associated with a higher loss in life expectancy (14.7 vs. 10.8 yrs.) Also the survival time was not significantly different in dependence on the nature of treatment and on the circumstances of detection of the disease. CONCLUSION: only 19% of diabetic patients may expect a "normal" survival time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

A clinical decision analysis to assess the value of laparoscopic cholecystectomy in the treatment of gallstone disease.

Laparoscopic cholecystectomy has been introduced for gallstone therapy and its use appears currently to be spreading very rapidly. A clinical decision analysis was performed to assess this new technique by quantitative comparison with other therapeutic modalities. A decision tree-based state transition model implemented to simulate a five-year period of follow-up was constructed. Non-surgical treatments were superior to surgical treatments in enhancing both life expectancy and quality-adjusted life expectancy on the basis of the optimal indications; one radiolucent stone < 2 cm for extracorporeal shock-wave lithotripsy and multiple floating stones for oral dissolution therapy respectively, especially in the elderly. Laparoscopic cholecystectomy was superior to open cholecystectomy in enhancing the quality of life for all eligible patients. Sensitivity analysis revealed that a higher incidence of the bile duct injury resulting from laparoscopic cholecystectomy would result in a poorer quality-adjusted life expectancy. The results of the analysis suggest the following. Nonsurgical treatments are acceptable alternatives to surgery on the basis of their optimal indications. Laparoscopic cholecystectomy has an advantage over open cholecystectomy in enhancing the patient's utility, and appears to be an attractive therapeutic modality. A proper training program is necessary to ensure the quality of this procedure in order to maintain its advantage.

Adult↗
PubMed2004

Pricing implications of trends in population mortality and underwriting effectiveness.

Pricing actuaries try to anticipate insured lives mortality rates for decades into the future by considering historic relationships between population and insured lives mortality and trends in population mortality. The degree to which underwriting might decrease insured lives mortality relative to population mortality is of particular importance. A comparison of trends in population and insured mortality is presented to illustrate historic relationships. Two theories for future life expectancy trends are: 1) no foreseeable limit to life expectancy, and 2) life expectancy limited by biological forces. Factors that may increase or decrease the future effectiveness of underwriting are reviewed.

Actuarial Analysis↗
PubMed1991

Development and survival of Anopheles pharoensis and An. multicolor from Faiyum, Egypt.

Adults of Anopheles pharoensis and An. multicolor were held under cycling environmental conditions in the laboratory to examine the duration of the gonotrophic cycles, survival and life expectancy, and to examine the life table characteristics of F1 larvae. The first gonotrophic cycle took 6.14 and 7.37 days for An. pharoensis and An. multicolor, respectively. Subsequent gonotrophic cycles for the 2 species were shorter. Daily survival rates of An. pharoensis and An. multicolor in the laboratory were 0.95 and 0.93, respectively. The parity rate of field-collected females and estimates of the duration of the gonotrophic cycle yielded daily survivorship estimates of 0.89 and 0.80 for An. pharoensis and An. multicolor, respectively. Mean life expectancy at emergence was 19.0 days for An. pharoensis compared with 17.9 days for An. multicolor. Survivorship from egg eclosion to adult emergence and development time were similar for both species. Both the duration of gonotrophic cycles and mean life expectancies indicated that An. pharoensis had a greater potential to serve as a malaria vector than An. multicolor.

Animals↗
PubMed2004

Clopidogrel versus aspirin for secondary prophylaxis of vascular events: a cost-effectiveness analysis.

PURPOSE: Clopidogrel is more effective than aspirin in preventing recurrent vascular events, but concerns about its cost-effectiveness have limited its use. We evaluated the cost-effectiveness of clopidogrel and aspirin as secondary prevention in patients with a prior myocardial infarction, a prior stroke, or peripheral arterial disease. METHODS: We constructed Markov models assuming a societal perspective, and based analyses on the lifetime treatment of a 63-year-old patient facing event probabilities derived from the Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE) trial as the base case. Outcome measures included costs, life expectancy in quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios, and events averted. RESULTS: In patients with peripheral arterial disease, clopidogrel increased life expectancy by 0.55 QALYs at an incremental cost-effectiveness ratio of $25,100 per QALY, as compared with aspirin. In poststroke patients, clopidogrel increased life expectancy by 0.17 QALYs at a cost of $31,200 per QALY. Aspirin was both less expensive and more effective than clopidogrel in post-myocardial infarction patients. In probabilistic sensitivity analyses, our evaluation for patients with peripheral vascular disease was robust. Evaluations of stroke and myocardial infarction patients were sensitive predominantly to the cost and efficacy of clopidogrel, with aspirin therapy more effective and less expensive in 153 of 1000 simulations (15.3%) in poststroke patients and clopidogrel more effective in 119 of 1000 simulations (11.9%) in the myocardial infarction sample. CONCLUSION: Clopidogrel provides a substantial increase in quality-adjusted life expectancy at a cost that is within traditional societal limits for patients with either peripheral arterial disease or a recent stroke. Current evidence does not support increased efficacy with clopidogrel relative to aspirin in patients following myocardial infarction.

Aspirin↗
PubMed2000

World Health Report 2000: the position of Slovak Republic.

The World Health Organization (WHO) published the analysis of the health systems in 191 member states of WHO with important data (mostly for the year 1999) on probability of dying under age 5 years and between ages 15 and 59 years, life expectancy at birth, disability-adjusted life expectancy--DALE which is defined as the expectation of life lived in equivalent full health, responsiveness of health system, fairness of financial contribution and overall health system attainment. The last parameter was based on five weighted components: overall level of population health, health inequalities within the population, level of health system responsiveness, distribution of responsiveness between population and the distribution of health system financial burden within the population. Between 149 countries with more than 1 million inhabitants the rank for Slovakia (30th) is not bad and is close to Croatia and Poland. The estimates of overall health system performance (i.e. how efficiently health systems translate financial expenditure into health) belong to the problematic part of the report:. In this parameter the health system of USA ranks much lower than Turkey or Tunisia and Slovakia ranks lower than Albania. The authors did not take into consideration, that the health of population depends not only on health care and health expenditure but on many other factors, such as life style, nutrition, pollution, etc., which are not influenced by expenditure into health system. (Tab. 2, Fig. 6, Ref. 15.)

Adolescent↗
PubMed2003

The influence of absolute cardiovascular risk, patient utilities, and costs on the decision to treat hypertension: a Markov decision analysis.

OBJECTIVE: To estimate the effectiveness and cost-effectiveness of blood pressure-lowering treatment over a lifetime. DESIGN: Markov decision analysis model comparing treatment and non-treatment of hypertension. PARTICIPANTS: Hypothetical cohorts for 20 different strata of sex, age (30-79 years, in 10-year age bands), and cardiovascular risk (low and high risk). MAIN OUTCOME MEASURES: Life expectancy, and incremental cost : effectiveness ratios for treatment and non-treatment strategies. RESULTS: In terms of life expectancy, blood pressure treatment increased life expectancy in all age, sex, and risk strata, by between 1.6 and 10.3%, compared with a policy of non-treatment. In terms of cost-effectiveness, treatment was more effective, but also cost more than non-treatment for all age, sex, and risk strata except the oldest high-risk men and women. Incremental cost per quality-adjusted life year (QALY) among low-risk groups ranged from pound 1030 to pound 3304. Cost-effectiveness results for low-risk individuals were sensitive to the utility of receiving antihypertensive treatment. Treatment of high-risk individuals was highly cost-effective, such that it was the dominant strategy in the oldest age group, and resulted in incremental costs per QALY ranging from pound 34 to pound 265 in younger age groups. CONCLUSIONS: Policy decisions about which patients to treat depend on whether a life-expectancy or cost-effectiveness perspective is taken. Treatment increases life expectancy in all strata of age, sex, and cardiovascular risk. However, younger individuals stand to gain proportionately more from blood pressure treatment than do the elderly. In terms of cost-effectiveness, patients at high risk of cardiovascular disease are a highly cost-effective group to treat. In patients at lower risk of cardiovascular disease, consideration should be given to issues of patient preference and cost.

Adult↗