Holy water and other stories . . .

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5849 (Published 02 October 2013) Cite this as: BMJ 2013;347:f5849

“Death in old age is inevitable, but death before old age is not,” said Sir Richard Doll, who was active up to his death at 92 years. The trouble is defining the start of old age: 65? 75? Or older still? The authors of a comprehensive study of cardiovascular disease in Europe (European Heart Journal 2013, doi:10.1093/eurheartj/eht356) provide figures for premature mortality based on the first two thresholds. The most recent data show that cardiovascular disease caused almost 1.5 million deaths a year before the age of 75, including more than 710 000 deaths of Europeans aged under 65. More women than men die from cardiovascular causes, but these deaths occur at a later age.

One reason that men get cardiovascular disease earlier than women is that their arteries stiffen faster. This can be measured using the carotid-femoral pulse wave velocity (PWV), as in the Baltimore Longitudinal Study of Aging (Hypertension 2013, doi:10.1161/HYPERTENSIONAHA.113.01445), which obtained two to nine measurements of PWV in 354 men …

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