Complexities in Geriatric Cardiology:Clinical Dilemmas and Gaps in Evidence
Nikolaos Theodorakis1
Christos Hitas2
Georgia Vamvakou2
Sofia Kalantzi3
Aikater-ini Spyridaki3
Zoi Kollia4
Georgios Feretzakis5
Maria Nikolaou2
1.Department of Cardiology,Sismanogleio-Amalia Fleming General Hospital,14 25is Martiou Str.,15127 Melissia,Greece;Geriatric Outpatient Clinic,Sismanogleio-Amalia Fleming General Hospital,14 25is Martiou Str.,15127 Melis-sia,Greece;School of Medicine,National and Kapodistrian University of Athens,75 Mikras Asias,11527 Athens,Greece2.Department of Cardiology,Sismanogleio-Amalia Fleming General Hospital,14 25is Martiou Str.,15127 Melissia,Greece;Geriatric Outpatient Clinic,Sismanogleio-Amalia Fleming General Hospital,14 25is Martiou Str.,15127 Melis-sia,Greece3.Geriatric Outpatient Clinic,Sismanogleio-Amalia Fleming General Hospital,14 25is Martiou Str.,15127 Melis-sia,Greece;Department of Internal Medicine,Sismanogleio-Amalia Fleming General Hospital,14 25is Martiou Str.,15127 Melissia,Greece4.Geriatric Outpatient Clinic,Sismanogleio-Amalia Fleming General Hospital,14 25is Martiou Str.,15127 Melis-sia,Greece5.School of Science and Technology,Hellenic Open University,18 Aristotelous Str.,26335 Patras,Greece
摘要：Cardiovascular diseases(CVD)are undoubtedly the leading cause of morbidity and mortality in the elderly.Population aging is a global phenomenon.In developed countries,by the year 2050 one in four people will be aged 65+years.This ongoing growth of the aging population leads to an increasing burden of CVD.The management of CVD in geriatric pa-tients requires specific considerations.Aging is associated with complex pathophysiology due to decreased organ reserve,which is clinically described as frailty.Additionally,the aging population is extremely heterogenous and frequently characterized by a combination of unique features,including atypical disease presentation,multimorbidity,polypharmacy,altered pharmacokinet-ics,cognitive impairment,renal impairment,dysautonomia,elevated risk of falls,sarcopenia,and frailty.Furthermore,signific-ant gaps in evidence exist largely due to the limited representation of the very elderly,and especially frail patients,in random-ized controlled trials.When combined with issues related to life expectancy,goals of care,bioethics,and patients'preferences,these factors pose intricate challenges for healthcare providers.This literature review summarizes selected clinical scenarios that often introduce dilemmas in the management of elderly patients in cardiology practice,emphasizing the intersection of geriatric medicine and cardiology.These include blood pressure management,management of dyslipidemia,anticoagulation in atrial fib-rillation,medical and device treatment of heart failure,antiplatelet and interventional management of acute coronary syndromes,and peri-procedural considerations in severe aortic stenosis.The above will provide guidance for clinical practice,as well as im-plications for health policies and future research in the field of geriatric cardiology.
机标关键词：clinicalgapscardiologycomplexitiesdilemmasevidencegeriatric
论文发表日期：2025-01-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：20( 190-209 )