Aging And Heart Failure

This book synthesizes the major research advances in molecular, biochemical and translational aspects of aging and heart failure over the last four decades and addresses future directions in management and drug discovery. It presents clinical issues and molecular mechanisms related to heart failure, including the changing demographics in the aging population with heart failure; hypertension and prevention of diastolic heart failure in the aging population; polypharmacy and adverse drug reactions in the aging population with heart failure; changes in the heart that accompany advancing age from humans to molecules; aging-associated alterations in myocardial inflammation and fibrosis and aging-related changes in mitochondrial function and implications for heart failure therapy. The book succinctly summarizes the large volume of data on these key topics and highlights novel pathways that need to be explored. Featuring contributions from leading clinician-scientists, Aging and Heart Failure: Mechanisms and Management is an authoritative resource on the major clinical issues in heart failure therapy in the elderly for cardiologists, gerontologists and internists.

Reviews the best therapies and surgical techniques available to provide quality care for the elderly cardiac patient and of those areas that require further research. The authors detail preventive therapies and the cardiovascular syndromes that disproportionately afflict the older individual, including arrhythmias (particularly atrial fibrillation), syncope, heart failure (particularly diastolic heart failure), and ischemic heart disease. They also delineate the surgical management of the heart patient with discussions of postoperative management and its complications and of specific surgical procedures such as coronary artery bypass grafting, valve surgery, pacemaker and defibibrillators, and surgical management of heart failure.

Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.

A panel of clinicians, researchers, and leaders in the field review and discuss the latest findings on the pathophysiology, diagnosis, and management of cardiovascular disease in the older patient. The authors explain the physiological changes associated with the normal aging process that may lead to the development of disease, to adverse consequences once disease develops, and which alter the risk-benefit equation for medical and other interventions designed to diagnose, assess, and treat cardiovascular disease. The focus is on particularly common syndromes in the elderly, including cardiac failure with normal ejection fraction, isolated systolic hypertension, and atrial fibrillation. Wherever possible, the authors take an evidence-based approach to recommendations and rely heavily on prospective clinical trials.

Heart failure is effectively a disease of older people. Eighty percent of patients are over 65 years old, and the majority of these are over 75. This figure is likely to increase significantly in the next two decades. The prognosis is worse than that of most cancers and heart failure is the commonest reason for hospital admission in the over 65s. The problems associated with treating heart failure in older patients are more diverse and complex than in those who are younger. The diagnosis in older patients is easily overlooked and as they were excluded from most heart failure treatment trials there has been a reluctance to treat them optimally (fewer than 20% are prescribed conventional medicines). They have multiple co-morbidities which are poorly managed, they are repeatedly hospitalised, and suffer social isolation. These important age-related treatment and management problems have been largely ignored and this book aims to redress the balance. It provides a concise, comprehensive account of the epidemiology, pathogenesis, diagnosis, treatment, management and end-of-life care of elderly patients with heart failure, based on published studies. A Practical Guide to Heart Failure in Older People is essential reading for geriatricians, cardiologists, general hospital physicians, family practitioners and specialist nurses. • Specifically addresses the particular needs of the elderly, a largely ignored group who constitute the majority of patients with heart failure • Presents a concise yet comprehensive account of the evidence relating to the diagnosis, treatment and management of heart failure in this population • Improves awareness of the various roles within the management team

This issue of Heart Failure Clinics examines co-morbidities in patients with heart failure. Topics include hypertension, diabetes, pulmonary disorders, cardiorenal syndrome, anemia, depression, atrial fibrillation, obesity and cardiac cachexia, peripheral vascular disease, rheumatologic disorders, co-morbidities and polypharmacy, coronary artery disease, and clinical trials.

The population is aging, and most cardiovascular diseases are more common in older people. Older people often present atypically, have multiple co-morbidities, and are vulnerable to therapeutic delays or errors. The healthcare needs of the elderly differ from those of younger patients and are more complex, related to the physical and psychological changes associated with ageing and other disease processes in the elderly population. In addition, the response to treatment may alter with ageing, yet many elderly patients with cardiovascular disease are not looked after by specialists. Cardiovascular Disease in the Elderly provides user-friendly advice in a field that has limited evidence but contributes significantly to the workload not only of cardiologists but also of elderly care physicians and general practitioners. It reflects current UK and international guidelines and provides key evidence based references. Wherever possible, published guidelines are incorporated to ensure the book reflects current recommended management. It indicates where practice differs from that of younger adults, and provides guidance on the ethical and clinical dilemmas particular to the elderly. The handbook covers many aspects of cardiovascular disease in the elderly and focuses on common problems, including heart failure, atrial fibrillation and isolated systolic hypertension.