Medikamentöse Therapie kardiologischer Erkrankungen im Alter

2018 ◽  
Vol 143 (04) ◽  
pp. 236-243
Author(s):  
Robert Schwinger
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Elderly Patients ◽  
Coronary Intervention ◽  
The Elderly ◽  
Lipid Lowering ◽  
Lipid Lowering Agents ◽  
Reduced Kidney Function

AbstractElderly people show increased probability to develop atherosclerotic diseases; in consequence heart failure – most often following coronary heart disease – as well as atrial fibrillation is more common. Following guidelines may lead to polypharmacy, i. e. use of more than 5 drugs daily. Thus, drug interactions as well as side effects become more likely; especially in elderly patients reduced kidney function has to be taken into account. Only drugs which have shown to prolong life or to reduce symptoms in controlled clinical trials should be used. There is little evidence to use low dose aspirin or lipid lowering agents in primary prevention especially in elderly. ACE inhibitors, β blocker and MRA are effective to improve symptoms and outcome in HFrEF but not in HFmEF or HFpEF. This also holds true for the elderly. Withdrawal of long term diuretic treatment in the elderly patients may lead to symptoms of heart failure or increase in blood pressure to hypertensive values often. In coronary heart disease ß blocker may be used to control symptoms as well as to reduce the need for coronary intervention following 1 year after myocardial infarction. Because the risk of stroke increases with age more than the risk of bleeding, the absolute benefit of oral anticoagulation in atrial fibrillation patients is highest in the elderly. NOAK appear to be safer and at least as efficacious as warfarin.

scholarly journals Relationship Between a Plant‐Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings From the Women's Health Initiative Prospective Cohort Study

2021 ◽  
Author(s):  
Andrea J. Glenn ◽  
Kenneth Lo ◽  
David J. A. Jenkins ◽  
Beatrice A. Boucher ◽  
Anthony J. Hanley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Postmenopausal Women ◽  
Prospective Cohort ◽  
Health Initiative ◽  
Dietary Portfolio ◽  
Diet Score

Background The plant‐based Dietary Portfolio combines established cholesterol‐lowering foods (plant protein, nuts, viscous fiber, and phytosterols), plus monounsaturated fat, and has been shown to improve low‐density lipoprotein cholesterol and other cardiovascular disease (CVD) risk factors. No studies have evaluated the relation of the Dietary Portfolio with incident CVD events. Methods and Results We followed 123 330 postmenopausal women initially free of CVD in the Women's Health Initiative from 1993 through 2017. We used Cox proportional‐hazard models to estimate adjusted hazard ratios (HRs) and 95% CI of the association of adherence to a Portfolio Diet score with CVD outcomes. Primary outcomes were total CVD, coronary heart disease, and stroke. Secondary outcomes were heart failure and atrial fibrillation. Over a mean follow‐up of 15.3 years, 13 365 total CVD, 5640 coronary heart disease, 4440 strokes, 1907 heart failure, and 929 atrial fibrillation events occurred. After multiple adjustments, adherence to the Portfolio Diet score was associated with lower risk of total CVD (HR, 0.89; 95% CI, 0.83–0.94), coronary heart disease (HR, 0.86; 95% CI, 0.78–0.95), and heart failure (HR, 0.83; 95% CI, 0.71–0.99), comparing the highest to lowest quartile of adherence. There was no association with stroke (HR, 0.97; 95% CI, 0.87–1.08) or atrial fibrillation (HR, 1.10; 95% CI, 0.87–1.38). These results remained statistically significant after several sensitivity analyses. Conclusions In this prospective cohort of postmenopausal women in the United States, higher adherence to the Portfolio Diet was associated with a reduction in incident cardiovascular and coronary events, as well as heart failure. These findings warrant further investigation in other populations.

Abstract 14: Cardiac Biomarkers are Associated With Findings on Brain MRI in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Andreea M Rawlings ◽  
Christie M Ballantyne ◽  
Rebecca F Gottesman ◽  
Ron C Hoogeveen ◽  
Timothy M Hughes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Troponin T ◽  
Brain Mri ◽  
Standard Deviation Increase ◽  
Cortical Volume ◽  
Galectin 3

Background: Cerebrovascular disease is often the consequence of cardiac disease. Our aim was to examine associations of biomarkers of cardiovascular disease, high sensitivity troponin T (hs-cTnT), NT-proBNP, and galectin-3, with cerebrovascular signs: lacunar infarcts, lobar and subcortical microhemorrhages, cortical infarcts, and white matter hyperintensity (WMH) volume. We also examined total cortical and Alzheimer’s Disease (AD) signature region volumes. Methods: We conducted a cross-sectional analysis of 1748 ARIC participants from the 2011-2013 exam who had biomarker measurements, completed a brain MRI, and did not have a clinical history of stroke. We used linear regression to model brain volumes, modeled as Z scores, and logistic regression for all other outcomes; biomarkers were log transformed. We repeated analyses excluding persons with coronary heart disease, atrial fibrillation, and heart failure. Results: The mean age of participants was 76, 62% were female, and 21% were Black. All biomarkers were associated with total cortical volume. Each standard deviation increase in log hs-cTnT was associated with lower total cortical volume (adjusted beta = -0.08, 95% CI: -0.12, -0.05); results for the other biomarkers were similar (Figure). All biomarkers were associated with lobar microhemorrhages. Hs-cTnT and NT-proBNP were associated with WMH volume, but galectin-3 was not. No biomarker was associated with subcortical microhemorrhages or cortical infarcts. Results were similar in persons without coronary heart disease, atrial fibrillation, or heart failure (conditions associated with cerebral thromboembolism). Conclusions: In persons free of clinical cardiovascular disease, biomarkers of cardiac stretch, strain, and fibrosis were associated cerebral small vessel disease and reduced cortical volume, but not in a specific pattern suggestive of AD pathogenesis. This suggests subclinical vascular insults affect brain structure through mixed pathogenic processes.

scholarly journals Association of occupational exposures with cardiovascular disease among US Hispanics/Latinos

Heart ◽  
2018 ◽  
Vol 105 (6) ◽  
pp. 439-448 ◽  
Author(s):  
Catherine M Bulka ◽  
Martha L Daviglus ◽  
Victoria W Persky ◽  
Ramon A Durazo-Arvizu ◽  
James P Lash ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cerebrovascular Disease ◽  
Organic Solvents ◽  
Occupational Exposures ◽  
Latino Workers ◽  
Prevalence Ratios

ObjectiveCardiovascular disease (CVD) is a leading cause of mortality and morbidity in the USA. The role of occupational exposures to chemicals in the development of CVD has rarely been studied even though many agents possess cardiotoxic properties. We therefore evaluated associations of self-reported exposures to organic solvents, metals and pesticides in relation to CVD prevalence among diverse Hispanic/Latino workers.MethodsCross-sectional data from 7404 employed individuals, aged 18–74 years, enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analysed. Participants from four US cities provided questionnaire data and underwent clinical examinations, including ECGs. CVD was defined as the presence of at least one of the following: coronary heart disease, atrial fibrillation, heart failure or cerebrovascular disease. Prevalence ratios reflecting the relationship between each occupational exposure and CVD as well as CVD subtypes were calculated using Poisson regression models.ResultsHispanic/Latino workers reported exposures to organic solvents (6.5%), metals (8.5%) and pesticides (4.7%) at their current jobs. Overall, 6.1% of participants had some form of CVD, with coronary heart disease as the most common (4.3%) followed by cerebrovascular disease (1.0%), heart failure (0.8%) and atrial fibrillation (0.7%). For individuals who reported working with pesticides, the prevalence ratios for any CVD were 2.18 (95% CI 1.34 to 3.55), coronary heart disease 2.20 (95% CI 1.31 to 3.71), cerebrovascular disease 1.38 (95% CI 0.62 3.03), heart failure 0.91 (95% CI 0.23 to 3.54) and atrial fibrillation 5.92 (95% CI 1.89 to 18.61) after adjustment for sociodemographic, acculturation, lifestyle and occupational characteristics. Metal exposures were associated with an almost fourfold (3.78, 95% CI 1.24 to 11.46) greater prevalence of atrial fibrillation. Null associations were observed for organic solvent exposures.ConclusionsOur results suggest that working with metals and pesticides could be risk factors for CVD among Hispanic/Latino workers. Further work is needed to evaluate these relationships prospectively.

Deletion polymorphism of the angiotensin 1-converting enzyme gene in the elderly patients with coronary heart disease

2001 ◽  
Vol 2 (2) ◽  
pp. 58
Author(s):  
B. Bergman-Marković ◽  
Ž. Reiner ◽  
M. Bergovec ◽  
A. Stavljenić-Rukavina ◽  
D. Ivanković ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Elderly Patients ◽  
The Elderly ◽  
Converting Enzyme ◽  
Deletion Polymorphism ◽  
Enzyme Gene

Cost Effectiveness of Intensive Lipid-Lowering Treatment for Patients with Congestive Heart Failure and Coronary Heart Disease in the US

2010 ◽  
Vol 28 (1) ◽  
pp. 47-60 ◽  
Author(s):  
Virginia M. Rosen ◽  
Douglas C.A. Taylor ◽  
Hemangi Parekh ◽  
Ankur Pandya ◽  
David Thompson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Cost Effectiveness ◽  
Lipid Lowering ◽  
The Us

scholarly journals Efficacy and safety of Shen-Song-Yang-Xin capsule for treating arrhythmia in the elderly patients with coronary heart disease

Medicine ◽  
2018 ◽  
Vol 97 (51) ◽  
pp. e13599
Author(s):  
Zhicong Zeng ◽  
ZhenJie Zhuang ◽  
YingXian He ◽  
ZhaoJun Yang ◽  
Yinzhi Song
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Elderly Patients ◽  
The Elderly ◽  
Efficacy And Safety

scholarly journals Chronic obstructive pulmonary disease in patients with coronary heart disease of elderly age groups

2020 ◽  
pp. 19-19
Author(s):  
G.P. Voinarovska ◽  
E.O. Asanov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Elderly Patients ◽  
Old Age ◽  
Age Groups ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease

Background. Among the combinations of comorbid conditions, a special role belongs to the combination of coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD). Because COPD is often associated with CHD, most authors believe that there is a direct link between COPD, progression of bronchial obstruction, and pathological conditions of the cardiovascular system, including mortality from myocardial infarction. In elderly patients, according to some researchers, the link between COPD and CHD is most pronounced. Objective. To establish the frequency of COPD in patients with CHD in older age groups. Materials and methods. The studies are based on the results of a comprehensive survey of 635 patients with CHD aged 60-89 years, who were observed for a long time of the State Institution “Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine”. Results and discussion. The share of patients with CHD in whom COPD was detected in the group of elderly people is 19.4 %. This is much more than the average population. The frequency of COPD in patients with CHD decreases significantly with further aging. The prevalence of COPD among elderly patients is much lower than among elderly patients. This can most likely be explained by the fact that a significant proportion of patients with CHD with COPD do not live to old age. The analysis revealed that in elderly patients there is bronchial obstruction of more severe stages. This is due to the fact that CHD patients with COPD who live to old age have worsening bronchial patency due to the longer duration of the disease. It has been established that the majority of patients with CHD with COPD, both elderly and senile, are male. This can be explained by the negative effects of smoking. Conclusions. The incidence of COPD in patients with CHD in the elderly is much higher than in the population. At the same time, the incidence of COPD among patients with CHD in the elderly is much lower than among the elderly. In patients of advanced age bronchial obstruction is more expressed.

Treatment of haemophilia in the elderly

2009 ◽  
Vol 29 (S 01) ◽  
pp. S29-S31
Author(s):  
S. Krekeler ◽  
S. Alesci ◽  
W. Miesbach
Keyword(s):  
Coronary Heart Disease ◽  
Chronic Hepatitis ◽  
Heart Disease ◽  
Retrospective Study ◽  
Hepatitis C ◽  
Elderly Patients ◽  
Chronic Hepatitis C ◽  
The Elderly ◽  
Haemophilia A

SummaryTreatment of elderly patients with haemophilia is an upcoming challenge in haemophilia care. We included patients with haemophilia A older than 60 years of age, who visited our haemophilia centre between 2006 and 2008. We conducted a retrospective study focussing on the patients’ co-morbidities as well as changes in their bleeding patterns between 2003 and 2008. Results: There is a tendency of increasing bleeding symptoms with increasing age of the patients due to more frequent spontaneous joint bleedings, malignancies or treatment with phenprocoumon or ASS. In consequence, FVIII dosage had to be increased for 8 patients (28%). Chronic hepatitis C, coronary heart disease and malignancies are the most frequent co-morbidities

Sign in / Sign up

Export Citation Format

Share Document