Healthcare for Older People, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK.
Institute of Biomedical and Clinical Science, University of Exeter, Exeter UK.
Age Ageing. 2022 Aug 2;51(8). doi: 10.1093/ageing/afac179.
As people age they are at increased risk of cardiovascular disease, the leading cause of mortality and morbidity worldwide. Understanding cardiovascular ageing is essential to preserving healthy ageing and preventing serious health outcomes. This collection of papers published in Age and Ageing since 2011 cover key themes in cardiovascular ageing, with a separate collection on stroke and atrial fibrillation planned. Treating high blood pressure remains important as people age and reduces strokes and heart attacks. That said, a more personalised approach to blood pressure may be even more important as people age to lower blood pressure to tight targets where appropriate but avoid overtreatment in vulnerable groups. As people age, more people experience blood pressure drops on standing (orthostatic hypotension), particularly as they become frail. This can predispose them to falls. The papers in this collection provide an insight into blood pressure and orthostatic hypotension. They highlight areas for further research to understand blood pressure changes and management in the ageing population. Inpatient clinical care of older people with heart attacks differs from younger people in UK national audit data. People aged over 80 had improved outcomes in survival after heart attack over time, but had lower rates of specialist input from cardiology compared with younger people. This may partly reflect different clinical presentations, with heart attacks occurring in the context of other health conditions, frailty and multimorbidity. The care and outcomes of acute and chronic cardiovascular disease are impacted by the frailty and health status of an individual at baseline. The research included in this collection reinforces the wide variations in the ageing population and the necessity to focus on the individual needs and priorities, and provide a person-centred multidisciplinary approach to care.
随着年龄的增长，人们患心血管疾病的风险增加，心血管疾病是全球死亡和发病的主要原因。了解心血管衰老对于保持健康衰老和预防严重健康后果至关重要。自 2011 年以来，《Age and Ageing》杂志上发表的这组论文涵盖了心血管衰老的关键主题，计划单独出版一组关于中风和心房颤动的论文。随着人们年龄的增长，治疗高血压仍然很重要，因为它可以降低中风和心脏病发作的风险。也就是说，随着人们年龄的增长，采取更个性化的血压治疗方法可能更为重要，以便在适当的情况下将血压降至严格目标，但避免在脆弱人群中过度治疗。随着人们年龄的增长，更多的人会出现站立时血压下降（直立性低血压），尤其是在身体虚弱的情况下。这会使他们更容易摔倒。本论文集中的论文提供了对血压和直立性低血压的深入了解。它们突出了进一步研究的领域，以了解衰老人群中的血压变化和管理。在英国国家审计数据中，老年人心肌梗死患者的住院临床护理与年轻人不同。随着时间的推移，80 岁以上的人心肌梗死后的生存结果有所改善，但与年轻人相比，接受心脏病学专业治疗的比例较低。这可能部分反映了不同的临床表现，心肌梗死发生在其他健康状况、虚弱和多病共存的背景下。急性和慢性心血管疾病的护理和结局受到个体基线时的虚弱和健康状况的影响。本论文集中的研究进一步证实了衰老人群的广泛差异，有必要关注个体的需求和优先事项，并提供以个人为中心的多学科护理方法。
