Coronary heart disease (CHD) is the most common cause of mortality and morbidity in the elderly. In the Western countries, it accounts for 80 to 85% of the elderly heart death.
When a person ages his or her cardiovascular system will experience some normal and predictable change. These may be age-related changes in cardiac anatomy; age-related changes in cardiovascular physiology; age-related changes in pharmacokinetics and pharmacodynamics.
Presentation of CHD can be altered by these changes, along with other age-related changes in the kidney, brain, and musculoskeletal system. Ultimately, the diagnosis of elderly people, hence the treatment of cardiac diseases, can be more complicated.
For the elderly, various conventional risk factors of young people 's CHD such as smoking, hypertension, hyperlipidemia and diabetes are still important. Furthermore, age is a powerful and independent risk factor of CHD. Risk will increase when men are over 55 and females are over 65.
The females have a much lower risk of CHD than men, but as the age progresses the difference between these men and women becomes smaller. For example, the event rate is 1: 5 favorable for women aged 35, but almost 1: 1 up to age 70.
Symptoms such as shortness of breath, itching and palpitations are common in the elderly CHD. Sometimes the elderly musculoskeletal problem can prevent patients from suffering from angina associated with exercise. Instead of complaining of chest pain during a heart attack, elderly patients may suffer from symptoms of breathing or stroke. Quiet heart attacks are also common. About 40% of unrecognized heart attacks were seen in patients aged 75 to 84, as reported in cardiovascular health studies and framing heart heart studies.
In managing cardiac disease, some diagnostic procedures, such as treadmill movement, may not be appropriate due to concerned joint problems of the elderly. It is also more dangerous to perform coronary angiography and coronary angioplasty of the elderly with impaired renal function. After a heart attack, the hospital mortality rate and the resulting risk of reinfarction or its complications all increase in elderly patients. The use of thrombotic analgesics (thrombolytics) increases the risk of cerebral haemorrhaging of the elderly very. Among the age-related changes in kidney or gastrointestinal function, a reduction in normal drug dosage may be required if cardiac drugs are used in elderly patients.
