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Cardiovascular disease in the aged: overview of an autopsy series
S Matsushita1, M Kuroo, T Takagi
1Department of Cardiology, Tokyo Metropolitan Tama Geriatric Hospital, Japan.
Insights
Cardiovascular disease incidence sharply rises in older adults aged 60-75. Focusing prevention and treatment on this demographic is key for better outcomes in aging populations.
Area of Science:
- Gerontology
- Cardiology
- Pathology
Background:
- Cardiovascular diseases (CVD) are a significant health concern in the aging population.
- Autopsy studies provide valuable insights into the prevalence and patterns of CVD in elderly individuals.
Purpose of the Study:
- To analyze the frequency and age-specific incidence of various cardiovascular diseases in the aged.
- To describe the prevalence of ischemic heart disease, valvular heart disease, and aortic aneurysm/dissection.
Main Methods:
- Analysis of 3657 autopsy cases.
- Examination of cardiovascular disease frequency and age-wise incidence.
Main Results:
- Overall cardiovascular disease incidence increases significantly between ages 60 and 75.
- Prevalence of specific conditions: myocardial infarction (19.8%), valvular disease (10.0%), arteriosclerosis obliterans (3.5%), aortic aneurysm/dissection (3.3%).
- Non-ischemic causes of death are common even in advanced coronary sclerosis; management of infections and malignancies is crucial.
Conclusions:
- The 60-75 age group is critical for cardiovascular disease prevention and treatment interventions.
- Valvular heart disease, excluding mitral stenosis, increases with age.
- Aortic aneurysms pose rupture risks regardless of diameter; aortic dissection management is challenging due to rapid progression.
Abstract:
As an overview of cardiovascular disease in the aged, 3657 autopsy cases were analyzed for the frequency and age-wise incidence of cardiovascular disease. The three major categories, ischemic heart disease, valvular heart disease, and aortic aneurysm and dissection were described. 1. The incidence of overall cardiovascular disease increases sharply between the ages of 60 and 75. Prevention and treatment could be effectively directed at this age group. 2. The incidence of organic cardiovascular disease was: myocardial infarction 19.8 percent; valvular disease 10.0 percent; arteriosclerosis obliterans 3.5 percent; aortic aneurysm and dissection 3.3 percent; pericarditis 2.1 percent; cardiomyopathy 1.6 percent; cor pulmonale 1.4 percent; congenital heart disease 0.7 percent; and others 0.8 percent. 3. As coronary sclerosis progresses, death from ischemic heart disease increases; however, 7 out of 10 patients with 3 vessel disease still die of causes other than ischemic heart disease (pneumonia, malignancy etc.). The general management of infection and malignant neoplasms is important in addition to treatment of cardiovascular disease. 4. Except for mitral stenosis, valvular heart disease, the etiology of which is mostly non-rheumatic, increases with advancing age. 5. In aortic aneurysm, the rupture rate is relatively high in the thoracic aorta; however, this may be caused by the successful surgical repair of abdominal aneurysms. An aneurysm below 6 cm in diameter is not absolutely safe from rupture. 6. In aortic dissection, the interval from onset to the death of the patient is often too short to consider surgery.