Hearts and bodies change with age, heart disease treatments may need to change

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In a new statement from the American Heart Association, scientists found for people ages 75 and older, age-related changes in general health and in the heart and blood vessels require consideration and likely modifications in how heart attacks and heart disease are treated.

The new statement highlights recent evidence to help clinicians better care for patients over age 75. According to the statement, 30-40% of people hospitalized with the acute coronary syndrome (ACS) are age 75 or older.

ACS includes heart attack and unstable angina (heart-related chest pain).

The statement is an update of a 2007 American Heart Association statement on the treatment of heart attacks in the elderly.

Cardiovascular changes that occur with normal aging make ACS more likely and may make diagnosing and treating it more complex:

large arteries become stiffer; the heart muscle often works harder but pumps less effectively; blood vessels are less flexible and less able to respond to changes in the heart’s oxygen needs, and there is an increased tendency to form blood clots.

Sensory decline due to aging may also alter hearing, vision and pain sensations. Kidney function also declines with age, with more than one-third of people ages 65 and older having chronic kidney disease.

These changes should be considered when diagnosing and treating ACS in older adults.

As people age, they are often diagnosed with health conditions that may be worsened by ACS or may complicate existing ACS.

As these chronic conditions are treated, the number of medications prescribed may result in unwanted interactions or medications that treat one condition may worsen another.

Researchers suggest that an individualized and patient-centered approach to ACS care, considering coexisting conditions and the need for input from multiple specialists, is best for older adults.

Ideally, the multidisciplinary teams caring for older adults with ACS include cardiologists, surgeons, geriatricians, primary care clinicians, nutritionists, pharmacists, cardiac rehabilitation professionals, social workers, nurses and family members.

In addition, people with cognitive difficulties and limited mobility may benefit from a simplified medication schedule, with fewer doses per day and 90-day supplies of medications so fewer refills are necessary.

Monitoring symptom burden, functional status and quality of life during post-discharge follow-up are important to provide insight into how the patient is progressing relative to their goals of care and gauging potential for improvement.

If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.

For more information about health, please see recent studies that olive oil may help you live longer, and Vitamin C linked to lower risk of heart failure.

The study was conducted by Abdulla A. Damluji et al and published in Circulation.

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