Older adults with an abnormal coronary flow reserve have a near four-fold higher risk of all-cause death compared with those with normal coronary flow, a systematic review has found.

And every 0.1-unit reduction in coronary flow reserve (CFR) upped the likelihood of mortality and major adverse cardiovascular events (MACE), the UK researchers say.

The University College London-led team said their findings should prompt clinicians to measure coronary flow “more routinely” and to target aggressive vascular risk modification interventions accordingly.

In their meta-analysis of 79 studies, they examined data from 60,000 patients (mean age 65) with ischaemic heart disease — all of whom had coronary flow measured — to assess the link between reduced CFR with death and MACE.