Califf Robert M, Alexander Karen P
Duke Clinical Research Institute, Box 17969, Durham, NC 27715, USA.
Postgrad Med. 2002 Dec;112(6 Suppl Heart):6-11. doi: 10.3810/pgm.12.2002.suppl24.125.
The "graying of America" is resulting in an exponential increase in the number of very elderly patients presenting with cardiovascular disease. Despite the availability of many effective cardiovascular therapeutics, elderly cardiac patients are treated less aggressively and receive less evidence-based care. This phenomenon can be attributed to factors that include underrepresentation of older patients in clinical trials, age-related treatment biases, and potential reluctance of the elderly to consider aggressive treatment. All these factors are remediable. Action to increase evidence-based use of treatments in the elderly should result in both the prolongation of life and compaction of morbidity in our growing elderly population. Inaction will surely result in increased health burdens for these patients and on society as a whole. Therefore, although treatments must continue to be applied to individuals based on their preferences, the evidence for these treatments must not summarily discriminate on the basis of age.
“美国的老龄化”导致患有心血管疾病的高龄患者数量呈指数级增长。尽管有许多有效的心血管治疗方法，但老年心脏病患者接受的治疗不够积极，且较少接受循证护理。这种现象可归因于多种因素，包括老年患者在临床试验中的代表性不足、与年龄相关的治疗偏见，以及老年人可能不愿考虑积极治疗。所有这些因素都是可以纠正的。采取行动增加老年人循证治疗的使用，应能延长我们不断增长的老年人口的寿命，并减少发病率。不作为肯定会给这些患者以及整个社会带来更大的健康负担。因此，尽管必须继续根据个人偏好为其提供治疗，但这些治疗的证据绝不能基于年龄进行一概而论的歧视。
