Clin-STAR corner: Practice changing advances in cardiology

Although cardiovascular disease is the leading cause of death and major disability in older adults, older patients have been consistently under-represented in most cardiovascular clinical trials. This article summarizes the results of four trials published from 2020 to 2022 with practice-changing implications directly applicable to the care of older adults. The key findings from these trials were that: (1) an initial conservative approach to managing selected patients with stable ischemic heart disease is reasonable, even in the setting of moderate or severe ischemia; (2) empagliflozin is effective in reducing heart failure hospitalizations in patients with heart failure and preserved ejection fraction, with or without diabetes; (3) an individually tailored physical rehabilitation program reduces deconditioning and functional decline in older patients hospitalized with heart failure; and (4) restricting dietary sodium intake to less than 1500 mg/day is unlikely to improve outcomes in most patients with heart failure.