Related Experiment Video
Updated: Dec 7, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Cardiovascular Biomarkers and Imaging in Older Adults: JACC Council Perspectives
Daniel E Forman1, James A de Lemos2, Leslee J Shaw3
1Section of Geriatric Cardiology, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.
Insights
Diagnostic testing for cardiovascular disease in older adults requires careful consideration due to age-related physiological changes. This review highlights limitations and research opportunities for improving cardiovascular care in this population.
Area of Science:
- Cardiology
- Geriatrics
- Diagnostic Testing
Background:
- Older adults are a vulnerable population for cardiovascular disease (CVD).
- Standard CVD management and diagnostic tests validated in younger adults may not directly apply to older adults.
- Aging impacts biology, physiology, and body composition, affecting CVD testing and interpretation.
Purpose of the Study:
- To address the challenges of diagnostic testing for cardiovascular disease in older adults.
- To review key concepts, clinical limitations, and research opportunities in this field.
- To foster a multidisciplinary approach to CVD care in the aging population.
Main Methods:
- A 2-day multidisciplinary workshop was convened by the American College of Cardiology, National Institute on Aging, and American Geriatrics Society.
- The workshop focused on "Diagnostic Testing in Older Adults with Cardiovascular Disease."
- This review summarizes the key discussions and outcomes from the workshop.
Main Results:
- Basic assumptions for biomarker- and imaging-based CVD tests are often unclear in older adults.
- Heterogeneous clinical priorities in older adults can impact the utility of testing data.
- Significant differences exist in how aging affects diagnostic test interpretation.
Conclusions:
- Current diagnostic testing strategies for cardiovascular disease need re-evaluation for older adults.
- There are critical limitations in applying existing tests to this demographic.
- Further research is essential to optimize cardiovascular disease diagnosis and management in the growing older adult population.
Abstract:
Whereas the burgeoning population of older adults is intrinsically vulnerable to cardiovascular disease, the utility of many management precepts that were validated in younger adults is often unclear. Whereas biomarker- and imaging-based tests are a major part of cardiovascular disease care, basic assumptions about their use and efficacy cannot be simply extrapolated to many older adults. Biology, physiology, and body composition change with aging, with important influences on cardiovascular disease testing procedures and their interpretation. Furthermore, clinical priorities of older adults are more heterogeneous, potentially undercutting the utility of testing data that are collected. The American College of Cardiology and the National Institutes on Aging, in collaboration with the American Geriatrics Society, convened, at the American College of Cardiology Heart House, a 2-day multidisciplinary workshop, "Diagnostic Testing in Older Adults with Cardiovascular Disease," to address these issues. This review summarizes key concepts, clinical limitations, and important opportunities for research.
