Cardiovascular Disease in Older Adults

Incidence and prevalence of cardiovascular disease (CVD) rise steeply with aging. High mortality and morbidity are common, but so too are greater vulnerabilities to outcomes also related to age, including functional decline, disability, and poor quality of life. Expertise in CVD management for older adults calls for enhanced insights about the distinctive effects of aging on CVD pathophysiology, as well as on geriatric complexities that often confound standard precepts of CVD management. Older patients with CVD are more likely to be contending with multimorbidity, frailty, polypharmacy, cognitive impairment, and idiosyncratic challenges other than just the CVD event. Diagnostics, therapeutics, patient preferences, and decision making must all be reconsidered. This chapter highlights the physiologic effects of aging in respects to CVD and geriatric complexity. Individual CVDs are then reviewed through the lens of age-sensitized insights, and best approaches are presented, which in some instances vary from those endorsed by the guidelines.