Management of Cardiovascular Disease in the Elderly

The United States elderly population is expected to grow dramatically over the next several years. In 2016, about 49 million US adults were 65 years or older. By 2060, that number is expected to climb to 98 million ((NCCDPHP) CNCfCDPaHP. Promoting health for older adults 2020 06 16. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/promoting-health-for-older-adults.htm ). Moreover, the >80+ age group is the fastest growing subgroup and projected to increase from 6.4 million in 2016 to 14.6 million by 2040 (US Census Bureau PD. Annual estimates of the resident population for selected age groups by sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010, to July 1, 2016, 2017). Since cardiovascular disease is the most common diagnosis in older patients accounting for one in three deaths, these demographic changes translate to significant burdens in morbidity, mortality, and health care utilization. Cardiovascular disease includes heart diseases such as coronary artery disease, heart failure, and arrhythmias in addition to noncardiac vascular disease. Currently about 121.5 million Americans are living with cardiovascular disease, and prevalence increases with each decade of life. In the age group between 60 and 79 years, about 77.2% of males and 78.2% of females have CVD, and in the 80 years + age group, the percentage increases to 89.3% in males and 91% in females (2020, 141:e1–e458, Circulation). Each year, cardiovascular hospitalizations cost an estimated $213.8 billion dollars ((NCCDPHP) CNCfCDPaHP. Promoting health for older adults 2020 06 16. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/promoting-health-for-older-adults.htm ). The effect/consequences of aging can be challenging to clinicians in providing care to older adults. In this chapter, we review common cardiovascular disease present in elderly patients and its management.