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Reviews the best therapies and surgical techniques available to provide quality care for the elderly cardiac patient and of those areas that require further research. The authors detail preventive therapies and the cardiovascular syndromes that disproportionately afflict the older individual, including arrhythmias (particularly atrial fibrillation), syncope, heart failure (particularly diastolic heart failure), and ischemic heart disease. They also delineate the surgical management of the heart patient with discussions of postoperative management and its complications and of specific surgical procedures such as coronary artery bypass grafting, valve surgery, pacemaker and defibibrillators, and surgical management of heart failure.
This book synthesizes the major research advances in molecular, biochemical and translational aspects of aging and heart failure over the last four decades and addresses future directions in management and drug discovery. It presents clinical issues and molecular mechanisms related to heart failure, including the changing demographics in the aging population with heart failure; hypertension and prevention of diastolic heart failure in the aging population; polypharmacy and adverse drug reactions in the aging population with heart failure; changes in the heart that accompany advancing age from humans to molecules; aging-associated alterations in myocardial inflammation and fibrosis and aging-related changes in mitochondrial function and implications for heart failure therapy. The book succinctly summarizes the large volume of data on these key topics and highlights novel pathways that need to be explored. Featuring contributions from leading clinician-scientists, Aging and Heart Failure: Mechanisms and Management is an authoritative resource on the major clinical issues in heart failure therapy in the elderly for cardiologists, gerontologists and internists.
A panel of clinicians, researchers, and leaders in the field review and discuss the latest findings on the pathophysiology, diagnosis, and management of cardiovascular disease in the older patient. The authors explain the physiological changes associated with the normal aging process that may lead to the development of disease, to adverse consequences once disease develops, and which alter the risk-benefit equation for medical and other interventions designed to diagnose, assess, and treat cardiovascular disease. The focus is on particularly common syndromes in the elderly, including cardiac failure with normal ejection fraction, isolated systolic hypertension, and atrial fibrillation. Wherever possible, the authors take an evidence-based approach to recommendations and rely heavily on prospective clinical trials.
The population is aging, and most cardiovascular diseases are more common in older people. Older people often present atypically, have multiple co-morbidities, and are vulnerable to therapeutic delays or errors. The healthcare needs of the elderly differ from those of younger patients and are more complex, related to the physical and psychological changes associated with ageing and other disease processes in the elderly population. In addition, the response to treatment may alter with ageing, yet many elderly patients with cardiovascular disease are not looked after by specialists. Cardiovascular Disease in the Elderly provides user-friendly advice in a field that has limited evidence but contributes significantly to the workload not only of cardiologists but also of elderly care physicians and general practitioners. It reflects current UK and international guidelines and provides key evidence based references. Wherever possible, published guidelines are incorporated to ensure the book reflects current recommended management. It indicates where practice differs from that of younger adults, and provides guidance on the ethical and clinical dilemmas particular to the elderly. The handbook covers many aspects of cardiovascular disease in the elderly and focuses on common problems, including heart failure, atrial fibrillation and isolated systolic hypertension.
Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data-including population surveys, cohort studies, disease registries, administrative health data, and vital statistics-contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels. The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.
This book aims to clarify the potential association between frailty and cardiovascular disease in older people. Covering the biological as well as the clinical point of view, it allows researchers and clinicians to discover the significance of this topic. The contributions cover the most important aspects in the potential relationship between frailty and cardiovascular disease. In particular, authoritative authors in this field have clarified the definition and the epidemiology of frailty and cardiovascular disease in older people. A large part of the volume is dedicated to the biological mechanisms of frailty and cardiovascular disease, trying to find those in common between these two conditions. Since this book is dedicated to both researchers and clinicians, we have proposed some chapters to the importance of comprehensive geriatric assessment in the evaluation and treatment of cardiovascular diseases and frailty. In this regard, the importance of geriatric evaluation in cardiac surgery for older people is well covered. Finally, the importance of cardiac rehabilitation and physical exercise is summarized, being, actually, the most important treatments for both frailty and cardiovascular disease. Written by many well-known and widely published experts in their respective fields, this book will appeal to a wide readership such as researchers in the field and clinicians, especially suited in geriatric medicine and cardiology who, every day, face frail older patients.
Heart failure is effectively a disease of older people. Eighty percent of patients are over 65 years old, and the majority of these are over 75. This figure is likely to increase significantly in the next two decades. The prognosis is worse than that of most cancers and heart failure is the commonest reason for hospital admission in the over 65s. The problems associated with treating heart failure in older patients are more diverse and complex than in those who are younger. The diagnosis in older patients is easily overlooked and as they were excluded from most heart failure treatment trials there has been a reluctance to treat them optimally (fewer than 20% are prescribed conventional medicines). They have multiple co-morbidities which are poorly managed, they are repeatedly hospitalised, and suffer social isolation. These important age-related treatment and management problems have been largely ignored and this book aims to redress the balance. It provides a concise, comprehensive account of the epidemiology, pathogenesis, diagnosis, treatment, management and end-of-life care of elderly patients with heart failure, based on published studies. A Practical Guide to Heart Failure in Older People is essential reading for geriatricians, cardiologists, general hospital physicians, family practitioners and specialist nurses. • Specifically addresses the particular needs of the elderly, a largely ignored group who constitute the majority of patients with heart failure • Presents a concise yet comprehensive account of the evidence relating to the diagnosis, treatment and management of heart failure in this population • Improves awareness of the various roles within the management team
Aging Issues in Cardiology provides an overview of the practical clinical areas involved in managing cardiovascular disease in the elderly. This volume will be useful to any physician managing the cardiovascular health of elderly individuals. Topics covered include: -Delirium in Elderly Cardiac Patients, -Depression, - Pharmacologic Issues, - Primary Prevention, - Syncope, - Heart Failure, - Coronary Revascularization.
This book focuses specifically on the management of cardiovascular disease in elderly patients with particular frailties and in the “oldest old”. It is clearly explained how treatment in these patients differs from that in patients in their seventies who respond well to therapies and do not present frailties or organ failures. Although not young, the latter patients can be treated almost like any other patient, according to established guidelines. In contrast, the frail, compromised elderly and the oldest old require specific measures that target their needs, including with respect to underlying renal conditions. The book considers all those pathologies that have a high prevalence in the general population, explaining advanced treatment concepts and all aspects of assessment. Key clinical points are highlighted, and the text is supplemented with numerous informative figures and tables. The authors are respected experts, for the most part geriatric physicians, and the book is especially addressed to cardiologists, who may lack the described targeted information and treatment tools.