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September 16, 1992

Exclusion of the Elderly and Women From Coronary TrialsIs Their Quality of Care Compromised?

Author Affiliations

From the Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Ga.

JAMA. 1992;268(11):1460-1461. doi:10.1001/jama.1992.03490110098038

Increasing numbers of elderly individuals have changed not only the profile of the US population, but also the demography of cardiovascular disease. Currently, 13% of the population is older than age 65 years; this percentage is expected to increase to 21%, or 35 million people, by the year 2030. The "oldest old," or those 85 years old or older, number 2.7 million individuals; they constitute the most rapidly growing subgroup among the elderly, with a projected sixfold increase by the year 2030.1 Although studies to guide the therapeutic management of this rapidly growing portion of our population should warrant high priority, the age-based exclusions of contemporary clinical trials limit this process.2 Coronary heart disease increasingly is a disease of and cause of death among the aging population. The majority of US patients with clinical manifestations of coronary heart disease are older than 65 years; more than half of