Townsend Nick, Timmis Adam, Erglis Andrejs, Miličić Davor, Perrone-Filardi Pasquale, Weidinger Franz, Guzik Tomasz, Gale Chris P
School for Policy Studies, University of Bristol, UK.
European Heart Agency, European Society of Cardiology, Brussels, Belgium.
Lancet Reg Health Eur. 2025 Aug 21;56:101372. doi: 10.1016/j.lanepe.2025.101372. eCollection 2025 Sep.
The ageing population in Europe is contributing to a growing proportion of older people affected by cardiovascular disease (CVD). Older adults account for most of the CVD burden and face unique challenges, complicated by age-related physiological changes and comorbidities. Older patients are underrepresented in clinical trials, leading to scientific and clinical equipoise, and inequities in care. Managing CVD in this age group is complex. Despite the availability of guideline-directed therapies, older adults often do not receive optimal treatment due to the complexity of their conditions and are at higher risk of complications. Strategies for the treatment and management of CVD in older individuals should be driven by patient centred outcomes relating to functional capacity and quality of life. Social and economic factors, such as financial limitations and isolation, further exacerbate age-related CVD inequalities and highlight the need for a holistic approach to care. To address this challenge, The Lancet Regional Health-Europe convened experts to evaluate the current state of knowledge on inequalities and disparities in cardiovascular health among older adults and propose recommendations to address these disparities. This Series paper aims to explore inequalities in, and the escalating burden of, CVD for older adults, with a focus on treatment, prevention, and strategies to support their physical and mental well-being.
欧洲人口老龄化导致受心血管疾病（CVD）影响的老年人比例不断上升。老年人占CVD负担的大部分，面临着独特的挑战，这些挑战因与年龄相关的生理变化和合并症而变得更加复杂。老年患者在临床试验中的代表性不足，导致科学和临床平衡以及护理方面的不平等。在这个年龄组中管理CVD很复杂。尽管有指南指导的治疗方法，但由于病情复杂，老年人往往无法获得最佳治疗，并且并发症风险更高。老年人心血管疾病的治疗和管理策略应以与功能能力和生活质量相关的以患者为中心的结果为导向。社会和经济因素，如经济限制和孤立，进一步加剧了与年龄相关的心血管疾病不平等，并凸显了采取整体护理方法的必要性。为应对这一挑战，《柳叶刀-欧洲区域健康》召集专家评估老年人心血管健康不平等和差异的现有知识状况，并提出解决这些差异的建议。本系列文章旨在探讨老年人心血管疾病的不平等现象及其不断升级的负担，重点关注治疗、预防以及支持他们身心健康的策略。
