Improved Cardiovascular Disease Outcomes in Older Adults.

• Type of Material: Article
• Authors: Daniel E. Forman, University of Pittsburgh Medical Center; Karen Alexander, Duke University Medical Center; Ralph G. Brindis, University of California, San Francisco; Anne B. Curtis, University at Buffalo; Mathew Maurer, Columbia University Medical Center; Michael W. Rich, Washington University in St. Louis; Laurence Sperling, Emory University; Nanette Wenger, Emory University
• Language: English
• Date: 2016
• Publisher: F1000Research
• Publication Version: Final Published Version
• Copyright Statement: © 2016 Forman DE et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.12688/f1000research.7088.1
• Title of Journal or Parent Work: F1000Research
• ISSN: 2046-1402
• Volume: 5
• Grant/Funding Information: Mathew Maurer’s institution, Columbia University Medical Center, receives funding for research and serving on advisory boards and DSMBs from Pfizer Inc., Alnylam Pharmaceuticals Inc., ISIS Pharmaceuticals and Prothena Inc.
• Keywords: Geriatric; HFpEF; Cardiology; Cardiovascular
• Research Categories: Gerontology; Health Sciences, Medicine and Surgery

Abstract

Longevity is increasing and the population of older adults is growing. The biology of aging is conducive to cardiovascular disease (CVD), such that prevalence of coronary artery disease, heart failure, valvular heart disease, arrhythmia and other disorders are increasing as more adults survive into old age.  Furthermore, CVD in older adults is distinctive, with management issues predictably complicated by multimorbidity, polypharmacy, frailty and other complexities of care that increase management risks (e.g., bleeding, falls, and rehospitalization) and uncertainty of outcomes.  In this review, state-of-the-art advances in heart failure, acute coronary syndromes, transcatheter aortic valve replacement, atrial fibrillation, amyloidosis, and CVD prevention are discussed.  Conceptual benefits of treatments are considered in relation to the challenges and ambiguities inherent in their application to older patients.