For seniors, the single most frequent cause of death is cardiovascular disease. In this age group, the disease causes considerable suffering and disability. Although geriatric heart disease treatments continue to improve, the rapid increase in our aging population presents many public health challenges.
It’s important, however, to distinguish between heart disease (conditions affecting the heart) and cardiovascular disease (conditions affecting the coronary veins and arteries).
Although most people may be familiar with terms like myocardial infarction (heart attack), atherosclerosis (blocked veins and arteries) and stroke, heart diseases vary greatly in their nature and causes.
Complications and Qualifications
Because heart conditions have many causes, this makes both their prevention and treatment challenging for physicians. To make things more complicated, cardiologists view diastolic and systolic heart conditions (two types of left-sided or left-ventricle heart failure) as separate entities to be handled with differing approaches.
It’s essential to note that the aging process, above other factors, brings about changes in both the anatomy and functioning of the entire cardiovascular system. When discussing treatments, however, half the challenge lies in identifying the causes of the illness.
Geriatric Heart Disease Treatments in Berkeley Heights
Heart Failure and Related Disorders
In treating heart failure and related disorders, approaches include diuretics (for management of systolic heart failure), ACE inhibitors (angiotensin-converting-enzyme inhibitors for treating high blood pressure and heart failure), inotropes (dioxin to treat systolic heart failure), beta-blockers and spironolactone. Doctors often rely on spironolactone to treat older patients who are allergic to ACE inhibitors.
Myocardial Infarction
The choice of treatments for seniors with myocardial infarction is limited because they have been excluded from most clinical trials. For example, thrombolysis — treatment to dissolve clots in blood vessels — is less commonly used for elderly patients. The reason? Seniors are more likely to experience adverse effects from it. Instead, doctors prefer to prescribe aspirin as a course of treatment. That said, beta-blockers have proved effective in lowering the mortality rates of patients of all ages. Note that ACE inhibitors are only given to elderly patients whose blood pressures are stable.
Angina (Severe Chest Pain)
Angina (severe chest pain) afflicts some 16% of seniors. It presents difficulties in diagnosis because patients who suffer from angina in their 60s tend to adopt sedentary lifestyles. This results in the serious under-diagnosis of angina for patients in their 80s. Still, taking into account individual adverse drug effects, the same standard treatment applies to all ages. This can mean minimally invasive surgical procedures to open up blocked coronary arteries, such as percutaneous transluminal coronary angioplasty.
Arrhythmias
Arrhythmias affect about one in 20 seniors. Atrial fibrillation (irregular beating of the atria or top chamber of the heart) is a type of arrhythmia. In the most severe cases, this condition may bring about heart failure. When arrhythmias first appear, many doctors prescribe blood thinners and also medication to slow the heart rate. In tertiary stages of the condition, doctors may resort to electro-cardioversion, electrical shocks to the heart to re-establish regular rhythm. Control with digoxin is also another option, sometimes used with a beta-blocker. Another approach to treatment is anti-coagulation medication such as aspirin or warfarin. Note, however, that anticoagulation medication may result in excess bleeding. Thus, doctors refrain from prescribing it for patients who are prone to falls.
Hypertension or High Blood Pressure
Hypertension or high blood pressure increases with age. Above age 65, systolic blood pressure levels tend to rise. Generally, isolated systolic hypertension is common in geriatric patients. Thus, high blood pressure poses a very serious health threat to seniors. In fact, it puts seniors at major risk for strokes, heart failure, coronary artery disease and peripheral vascular disease.
Studies show that seniors may not be the only ones at risk of developing isolated systolic hypertension. Younger patients also face risks of developing the condition. Therefore, the medications used to treat high blood pressure in younger patients may also be effective in the oldest patients. That said, lifestyle changes to reduce high blood pressure — a diet low in salt, exercise, and stress reduction — apply to any age. As with virtually all heart problems, the presence of diabetes mellitus complicates both the disease and treatment. So, the effective prevention, treatment, and management of diabetes is important to heart health.
David York Agency Supports New Research for Geriatric Heart Disease Treatments
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