University of Auckland Waikato Hospital, Hamilton, New Zealand.
Curr Opin Cardiol. 2010 Jul;25(4):335-9. doi: 10.1097/HCO.0b013e328338bcab.
Women and older patients with cardiovascular disease are frequently underinvestigated and are less likely to receive evidence-based treatments than younger male counterparts. A lack of sex and age-specific clinical trial evidence is frequently cited for this practice. This manuscript reviews the currently available evidence base in the management of both groups presenting with ischaemic heart disease and heart failure.
Registry data in both women and older patients confirm that these groups receive suboptimal care in the management of ischaemic heart disease and heart failure. A number of recent trials, including several meta-analyses, do not support this practice and suggest that, with the possible exception of implantable cardiac defibrillator implantation in females, both women and elderly patients derive similar benefit to younger males in the management of risk factors, symptomatic ischaemic heart disease and heart failure.
Pending sex and age-specific trials to address in particular not only outcomes but dosing and complications, women and elderly patients should receive similar evidence-based treatment of cardiac risk factors, symptomatic ischaemic disease and heart failure to younger males.
与年轻男性患者相比，患有心血管疾病的女性和老年患者通常接受的检查较少，且不太可能接受基于证据的治疗。这种做法通常归因于缺乏针对特定性别和年龄的临床试验证据。本文综述了目前在管理缺血性心脏病和心力衰竭方面，针对这两个群体的现有证据基础。
女性和老年患者的登记数据证实，这些群体在缺血性心脏病和心力衰竭的管理中未得到最佳治疗。一些最近的试验，包括几项荟萃分析，并不支持这种做法，并表明，除了女性植入式心脏除颤器的植入外，女性和老年患者在管理危险因素、有症状的缺血性心脏病和心力衰竭方面与年轻男性患者获益相似。
在特定于性别的试验和特定于年龄的试验确定了不仅是结局，还包括剂量和并发症之前，女性和老年患者应接受与年轻男性患者相似的基于证据的心脏危险因素、有症状的缺血性疾病和心力衰竭的治疗。
