Forman Daniel E, Alexander Karen, Brindis Ralph G, Curtis Anne B, Maurer Mathew, Rich Michael W, Sperling Laurence, Wenger Nanette K
Geriatric Cardiology Section, University of Pittsburgh Medical Center, Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
F1000Res. 2016 Jan 28;5. doi: 10.12688/f1000research.7088.1. eCollection 2016.
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.
寿命在延长，老年人的人口数量在增长。衰老生物学易引发心血管疾病（CVD），随着越来越多的成年人步入老年，冠状动脉疾病、心力衰竭、心脏瓣膜病、心律失常及其他疾病的患病率也在上升。此外，老年人的心血管疾病具有独特性，管理问题因多重疾病、多种药物治疗、身体虚弱及其他护理复杂性而变得复杂，这些因素增加了管理风险（如出血、跌倒和再次住院）以及结果的不确定性。在本综述中，将讨论心力衰竭、急性冠状动脉综合征、经导管主动脉瓣置换术、心房颤动、淀粉样变性和心血管疾病预防方面的最新进展。会结合治疗应用于老年患者时所固有的挑战和不确定性来考虑治疗的理论益处。
