Cardiovascular problems in the elderly

Aging is associated with diffuse changes throughout the cardiovascular system that significantly impact the clinical features, management, and prognosis of older patients with cardiovascular disease. As a result of these changes, cardiovascular reserve capacity declines progressively with age, while the incidence and prevalence of cardiovascular diseases increase with age in both men and women. In addition, age-related changes predispose older individuals to specific cardiovascular disorders, including systolic hypertension, non-ST-segment elevation myocardial infarction, heart failure with preserved ejection fraction, aortic stenosis, syncope, atrial fibrillation, and sinoatrial dysfunction. While the management of older patients with cardiovascular disease is generally similar to that in younger patients, prevalent comorbid conditions, quality of life considerations, and personal preferences become increasingly important for ensuring patient-centered care in older adults. This chapter provides an overview of clinically relevant effects of cardiovascular aging and discusses the pathophysiology, diagnosis, and management of cardiovascular conditions commonly encountered in older adults.