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[Cardiovascular prevention in old age-Cardiovascular prevention of ageing?]
1Medizinische Klinik für Geriatrie und Altersmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland. ursula.mueller-werdan@charite.de.
Insights
Cardiovascular prevention is highly effective in older adults. Expanding this with geroscience insights to target aging itself may prevent chronic diseases, multimorbidity, and frailty.
Area of Science:
- Gerontology
- Cardiology
- Preventive Medicine
Background:
- Cardiovascular prevention is successful in older adults, reducing major cardiovascular events.
- Gerontology offers new perspectives to expand geriatric disease prevention.
- Aging is a fundamental factor in most adult chronic diseases, with the cardiovascular system as a prototype.
Purpose of the Study:
- To explore expanding cardiovascular prevention strategies by incorporating geroscience insights.
- To propose slowing the aging process as a novel goal for preventing geriatric diseases.
- To investigate how targeting aging can prevent multimorbidity and frailty in older adults.
Main Methods:
- Review of current European Society of Cardiology (ESC) and German Society for Cardiology (DGK) guidelines.
- Analysis of age-stratified and individually adapted preventive measures (lifestyle, psychosocial, risk factors, antithrombotics, disease-specific interventions).
- Consideration of biogerontological approaches, including senolytics and metformin, for slowing biological aging.
Main Results:
- Current guidelines emphasize lifestyle, risk factor management, and disease-specific interventions.
- Biogerontological strategies like senolytics and metformin show potential for future integration.
- Initial clinical studies on senolytics have been reported, indicating emerging therapeutic possibilities.
Conclusions:
- Treating the aging process itself holds promise for preventing chronic diseases, multimorbidity, and frailty in older populations.
- Integrating geroscience into cardiovascular prevention represents a paradigm shift towards proactive healthspan extension.
- Future research should focus on validating and implementing anti-aging interventions in clinical practice.
Abstract:
Cardiovascular prevention is also particularly successful in old people in terms of preventing major cardiovascular events. The concept of prevention of geriatric diseases can, however, be expanded taking the insights of geroscience into consideration, so that slowing the ageing process per se can be set as a new goal: ageing is the pertinent basis of nearly all chronic diseases in adulthood, a line of argument for which the cardiovascular system can serve as a prototype. Consequently, treating ageing can help prevent the typical chronic diseases in old people, i.e. multimorbidity and frailty. According to the current guidelines of the European Society of Cardiology (ESC, Eur Heart J 42:3227-3337, 2021) and the German Society for Cardiology (DGK, https://leitlinien.dgk.org/files/03_pocket_leitlinien_praevention_aktualisiert.pdf ) cardiovascular prevention incorporates age-stratified and individually adapted measures and treatment targets in the domains lifestyle (physical activity, body weight, nutrition), psychosocial factors, cardiovascular risk factors (smoking, blood lipids, blood pressure, diabetes), antithrombotic treatment and disease-specific interventions. From a biogerontological perspective, in the midterm these measures could be supplemented by measures and medicinal treatment strategies to slow the biological ageing process, e.g. with senolytics and metformin. Initial clinical studies using senolytics have already been reported.
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