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走向老年医学方法治疗高龄心血管疾病患者:欧洲老年医学学会心血管医学特别兴趣小组立场声明。

Toward a geriatric approach to patients with advanced age and cardiovascular diseases: position statement of the EuGMS Special Interest Group on Cardiovascular Medicine.

机构信息

Geriatric Intensive Care Medicine, Hypertension Centre, Syncope Unit, University of Florence and Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139, Florence, Italy.

Department of Geriatrics, Ghent University Hospital, and Ghent University, Ghent, Belgium.

出版信息

Eur Geriatr Med. 2020 Feb;11(1):179-184. doi: 10.1007/s41999-019-00267-0. Epub 2019 Dec 14.

Abstract

Cardiovascular diseases (CVD) are highly prevalent in older adults and represent a major geriatric health-care concern. Management of CVD in older patients may be challenging due to specific geriatric issues, such as frailty and multi-morbidity, which may influence patients' outcomes. In this clinical context, diagnostic and therapeutic strategies should target those outcomes that have higher priority in geriatric health care, including disability prevention and quality of life. Older adults with CVD should be offered a reasonably optimized treatment, customized to the individual's frailty level and functional status. Yet, most clinical trials excluded comorbid and frail patients and evidence to support CVD management in this vulnerable population is lacking. Therefore, a geriatric approach is needed in cardiovascular medicine, characterized by a holistic, patient-centered perspective focusing on functional status and quality of life. With a view to promote the geriatric approach in the management of older patients with CVD, the EuGMS Special Interest Group (SIG) on Cardiovascular Medicine was founded in 2018, consisting of a network of geriatricians with an extensive expertise in geriatric cardiovascular medicine. The present position paper aims to present the Cardiovascular SIG and illustrate its main purposes and action programs.

摘要

心血管疾病(CVD)在老年人中高发,是老年医疗保健的主要关注点。由于脆弱和多病共存等特定老年问题,老年患者的 CVD 管理可能具有挑战性,这些问题可能影响患者的预后。在这种临床情况下,诊断和治疗策略应针对老年保健中具有更高优先级的那些预后,包括预防残疾和提高生活质量。应向患有 CVD 的老年人提供合理优化的治疗,根据个体的脆弱程度和功能状态进行定制。然而,大多数临床试验排除了合并症和脆弱患者,并且缺乏支持在这一脆弱人群中进行 CVD 管理的证据。因此,心血管医学需要采用老年医学方法,其特点是采用整体的、以患者为中心的方法,注重功能状态和生活质量。为了在 CVD 老年患者的管理中推广老年医学方法,2018 年成立了欧洲老年医学学会(EuGMS)心血管医学特别兴趣小组(SIG),该小组由具有丰富老年心血管医学专业知识的老年病学家网络组成。本立场文件旨在介绍心血管 SIG,并说明其主要目的和行动计划。

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