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Cardiovascular research in the elderly: challenges, opportunities, and impact
Robert M Califf1, Karen P Alexander
1Duke Clinical Research Institute, Box 17969, Durham, NC 27715, USA. calif001@mc.duke.edu
Postgraduate Medicine
|August 12, 2009
Summary
Older adults with cardiovascular disease receive less evidence-based care, despite effective treatments. Addressing age-related biases and trial underrepresentation can improve care, prolong life, and reduce morbidity for the growing elderly population.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- The aging population (
- graying of America") is increasing the incidence of cardiovascular disease in very elderly patients.
- Despite effective cardiovascular therapeutics, older adults often receive less aggressive, evidence-based care.
- Factors contributing to this include underrepresentation in clinical trials, age-related treatment biases, and patient reluctance.
Purpose of the Study:
- To highlight the disparities in cardiovascular disease treatment for elderly patients.
- To advocate for increased evidence-based care in this demographic.
- To emphasize the potential benefits of addressing age-related treatment biases.
Main Methods:
- This study is a review and analysis of current treatment paradigms and clinical trial data concerning elderly cardiac patients.
- It examines factors contributing to undertreatment and proposes remediable actions.
Main Results:
- Elderly cardiac patients are frequently undertreated compared to younger counterparts.
- Underrepresentation in clinical trials and age-based biases are significant contributing factors.
- Remediable factors exist to improve care delivery.
Conclusions:
- Aggressive, evidence-based treatment for cardiovascular disease in the elderly is crucial.
- Addressing age-related biases and trial underrepresentation can prolong life and reduce morbidity.
- Healthcare providers must ensure age does not lead to discriminatory treatment decisions.
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