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Heart in the elderly (views and considerations at the turn of the centuries)
Insights
Cardiovascular diseases are a major cause of death in the elderly. Atherosclerosis, a key contributor, is preventable through lifestyle changes and medical interventions, emphasizing early primary prevention for better heart health.
Area of Science:
- Gerontology
- Cardiology
- Preventive Medicine
Background:
- The global elderly population is rapidly increasing, presenting significant healthcare challenges.
- Cardiovascular diseases, particularly coronary heart disease, are the leading cause of mortality in older adults, accounting for approximately 50% of deaths.
- Aging itself does not significantly impair cardiac function; disease, primarily atherosclerosis, is the main culprit.
Purpose of the Study:
- To highlight that atherosclerosis is a preventable disease, not an inevitable part of aging.
- To emphasize the critical role of primary prevention in managing cardiovascular risk factors in the elderly.
- To advocate for informed patient participation in preventive health programs.
Main Methods:
- Review of current literature on aging, cardiovascular disease, and atherosclerosis.
- Analysis of the impact of major risk factors (smoking, hypertension, hyperlipidemia, diabetes, obesity, inactivity) on cardiovascular health in the elderly.
- Evaluation of primary and secondary prevention strategies, including lifestyle modifications and pharmacotherapy.
Main Results:
- Atherosclerosis is a preventable disease, and its major risk factors can be managed effectively.
- Early intervention through primary prevention, focusing on hygienic-dietetic measures and medication, is crucial to prevent subclinical disease progression.
- Late-stage interventions for complications like myocardial infarction are only partially successful and not universally accessible.
Conclusions:
- Primary and secondary prevention measures for cardiovascular disease are as vital in the elderly as in younger populations.
- Addressing risk factors early can mitigate the impact of atherosclerosis and improve cardiovascular outcomes in aging individuals.
- Public awareness and active patient involvement are essential for successful preventive healthcare programs in gerontology.
Abstract:
The proportion of elderly people grows rapidly both in Croatia and worldwide, posing great health care, psychological, social, economic and other problems. In the elderly, cardiovascular diseases, especially coronary (ischemic) heart diseases, account for approximately 50% of all deaths. In contrast to previous opinions, recent studies show that aging per se does not substantially diminish the efficacy of heart pump unless affected by diseases, primarily atherosclerosis (atherothrombosis). Atherosclerosis, however, is not an inevitable component of old age, but a disease that can to a great extent be prevented, and hopefully even defeated in the near future. Of paramount importance is elimination of the major risk factors: cigarette smoking, hypertension, hyperlipidemia, diabetes mellitus, obesity, and physical inactivity, preferably in the form of primary prevention, primarily by the hygienic-dietetic measures, and by medication (antihypertensives, hypolipidemics), if necessary. The prevention should be initiated early enough to prevent the development of subclinical forms of the disease, because clinical manifestations (angina pectoris, myocardial infarction, serious ventricular arrhythmias, sudden death) occurring unexpectedly ('like a bolt from the blue') reflect a very advanced coronary disease. The management of these late complications, however admirable it may be (coronary dilatation--stents, coronary surgery, thrombolysis, resuscitation, electrotherapy, etc.), is only partially successful and in fact unavailable to the majority of the population, even in developed countries. Therefore, every individual should be informed about the main characteristics of the issue to be able to take active participation in the programs of primary prevention. Although the relative importance of particular risk factors decreases in old age, these factors are present in a higher number in the elderly which, along with the generally greater mortality rate, points to the need of all measures (primary and secondary) of prevention to be as carefully carried out in the elderly as in younger individuals.