Heart Disease Care in an Aging Population

The American Heart Association released a 31-page scientific statement offering expert insight into heart disease treatment for an aging US population. 

Considering Age-Related Changes – Cardiovascular changes that occur with normal aging make diagnosing and treating heart disease more complex: large arteries become stiffer, the heart muscle pumps less effectively, and blood vessels are less flexible and less able to respond to changes in the heart’s oxygen needs.

Here are some considerations AHA highlights: 

  • ACS is more likely to occur without chest pain in older adults, presenting with symptoms such as shortness of breath, fainting, or sudden confusion.
  • Measuring levels of circulating troponin is standard to diagnose heart attacks in younger people, but troponin levels may already be higher in older people. Evaluating the rise and fall patterns of troponin may be more appropriate. 
  • Although many clinicians avoid cardiac rehab for frail patients, these are the patients who often benefit the most.
  • Older adults are vulnerable to complications when transferred to outpatient centers; ensuring medications and other therapies are continued among these patients is particularly important. 

Quality of Life Emphasis – The authors note that the goals of care for older people with ACS should extend beyond clinical outcomes like bleeding, stroke, or another heart attack. Goals focused on quality of life may be more important to the patient, placing emphasis on concrete metrics such as pain relief and days spent at home.

The Takeaway

With the US facing an aging population, the AHA’s latest scientific statement provides timely information on the diagnosis and management of ACS in adults over 75. The organization emphasizes clinical considerations for age-related changes and the importance of prioritizing quality of life.

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