Cardiovascular disease in the elderly: proceedings of the European Society of Cardiology - Cardiovascular Round Table
Lettino, Maddalena; Mascherbauer, Julia; Nordaby, Matias; Ziegler, André; Collet, Jean Philippe; Derumeaux, Geneviève; Hohnloser, Stefan H.; Leclercq, Christophe; O'neill, Deirdre E.; Visseren, Frank; Weidinger, Franz; Richard-Lordereau, Isabelle
(2022) European journal of preventive cardiology, volume 29, issue 10, pp. 1412 - 1424
(Article)
Abstract
The growing elderly population worldwide represents a major challenge for caregivers, healthcare providers, and society. Older patients have a higher prevalence of cardiovascular (CV) disease, high rates of CV risk factors, and multiple age-related comorbidities. Although prevention and management strategies have been shown to be effective in older people, they
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continue to be under-used, and under-studied. In addition to hard endpoints, frailty, cognitive impairments, and patients' re-assessment of important outcomes (e.g. quality of life vs. longevity) are important aspects for older patients and emphasize the need to include a substantial proportion of older patients in CV clinical trials. To complement the often skewed age distribution in clinical trials, greater emphasis should be placed on real-world studies to assess longer-term outcomes, especially safety and quality of life outcomes. In the complex environment of the older patient, a multidisciplinary care team approach with the involvement of the individual patient in the decision-making process can help optimize prevention and management strategies. This article aims to demonstrate the growing burden of ageing in real life and illustrates the need to continue primary prevention to address CV risk factors. It summarizes factors to consider when choosing pharmacological and interventional treatments for the elderly and the need to consider quality of life and patient priorities when making decisions.
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Keywords: Anticoagulant, Antiplatelet, Coronary revascularization, Older people, Primary prevention, Risk assessment, Epidemiology, Cardiology and Cardiovascular Medicine, Journal Article
ISSN: 2047-4873
Publisher: SAGE Publications Ltd
Note: Funding Information: M.N.: employment with Boehringer Ingelheim International J.-P.C.: Grants or contracts from Bristol-Myers Squibb, Medtronic, and Pfizer; and honoraria from Abbott, AstraZeneca, Boston Scientific, and Sanofi. G.D.: institutional grants to INSERM (RHU CARMMA) from Agence Nationale pour la Recherche (ANR). S.H.H.: consulting fees from Bristol-Meyers Squibb, Pfizer, Boehringer Ingelheim, Bayer, and Daiichi Sankyo; and honoraria from Bristol-Meyers Squibb, Pfizer, Boehringer Ingelheim, Bayer, and Daiichi Sankyo. D.E.O.: honoraria from Servier Canada. F.V.: research funding from Amgen. I.R.-L.: employment with and stock options from Amgen. And all other authors have no conflict of interest to declare. Publisher Copyright: © 2022 Published on behalf of the European Society of Cardiology.
(Peer reviewed)