Geriatric Cardiology Section, University of Pittsburgh Medical Center, Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
Karen Alexander
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
Ralph G. Brindis
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA
Anne B. Curtis
Department of Medicine, University at Buffalo, Buffalo, New York, USA
Mathew Maurer
Department of Medicine, Columbia University Medical Center, New York, USA
Michael W. Rich
Washington University School of Medicine, St Louis, MO, USA
Laurence Sperling
Emory University School of Medicine and Rollins School of Public Health, Emory University, Atlanta, GA, USA
Nanette K. Wenger
Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, USA
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.
