Targeting vascular risk factors in older adults from polypill to personalized prevention

For many years vascular disease prevention strategies have been focused on reducing undertreatment, often using a “one-size-fits-all” approach to increase patient adherence. Conversely, during recent years an increasing emphasis has been placed on the issue of potential overtreatment, frequently resulting from the same treatment approach in all patients despite significant individual differences in comorbidity and life expectancy. A proposed stratification of antihypertensive and antidiabetic treatment strategies according to patient vulnerability is described, including issues that should be further clarified and possible solutions.