医学
多药
背景(考古学)
冠状动脉疾病
人口老龄化
重症监护医学
疾病
瓣膜性心脏病
认知功能衰退
多学科方法
人口
心房颤动
多发病率
医疗保健
老年病科
心脏病学
内科学
痴呆
精神科
社会学
古生物学
经济
环境卫生
生物
经济增长
社会科学
作者
Akshay Gaur,Fiona Carr,David Warriner
出处
期刊:Heart
[BMJ]
日期:2024-01-11
卷期号:110 (14): 933-939
被引量:1
标识
DOI:10.1136/heartjnl-2022-322117
摘要
It is estimated that by 2050, 17% of the world’s population will be greater than 85 years old, which, combined with cardiovascular disease (CVD) being the leading cause of death and disability, sets an unprecedented burden on our health and care systems. This perfect storm will be accompanied by a rise in the prevalence of CVD due to increased survival of patients with pre-existing CVD and the incidence of CVD that is associated with the process of ageing. In this review, we will focus on the diagnosis and management of common CVD conditions in old age, namely: heart failure (HF), coronary artery disease (CAD), atrial fibrillation (AF) and valvular heart disease (VHD). Despite limited evidence, clinical guidelines are increasingly considering the complexity of management of these conditions in the older person, which often coexist, for example, AF and HF or CAD and VHD. Furthermore, they, in turn, need specific consideration in the context of comorbidities, polypharmacy, frailty and impaired cognition found in this age group. Hence, the emerging role of the geriatric cardiologist is therefore vital in performing comprehensive geriatric assessment, attending multidisciplinary team meetings and ultimately considering the patient and the sum of their diseases in their totality. There have been recent advances in CVD management but how we apply these to deliver integrated care to the elderly population is key. This review article aims to bring together emerging studies and guidelines on assessment and management of CVD in the elderly, summarising latest definitions, diagnostics, therapeutics and future challenges.
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