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Geriatrics
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Geriatric Cardiovascular Comorbidities
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Geriatric Cardiovascular Comorbidities

A special issue of Geriatrics (ISSN 2308-3417). This special issue belongs to the section "Cardiogeriatrics".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 14929

Special Issue Editors

Dr. Tanya Ruff Gure

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Guest Editor
The Ohio State University Wexner Medical Center, Columbus, OH, USA
Dr. Brent Lampert

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Guest Editor
Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA

Special Issue Information

Dear Colleagues,

We are living in especially important times in geriatric health services where the older adult population is increasing to much larger proportions than in previous decades. Older adults are surviving into advanced age due in part to advancements in medical and procedural technologies, but this means that many are aging with complex illness. In particular, the prevalence of cardiovascular disease increases with age as a result of aging structural, biological, and physiological processes; these same mechanisms are also associated with other comorbid conditions, such as dementia.  Accordingly, most older adults with cardiovascular disease are likely to have other significant comorbidities—cardiac or noncardiac—that affect cardiovascular health and outcomes. Despite the high prevalence of cardiovascular disease in the geriatric population, they have been either excluded or dramatically underrepresented in most randomized clinical trials that influence society guidelines. A multidimensional clinical and research approach is needed to better understand the epidemiology of older adults with cardiovascular conditions as well as noncardiac multimorbidity.  We must be more responsive to the needs of our patients by discarding disease-specific care models and accepting a new paradigm of integrating multimorbidity into our cardiovascular patients.

We seek submissions for this Special Issue of Geriatrics focused on multiple aspects of Geriatric Cardiology. Submissions may include original research articles or comprehensive reviews and will undergo formal peer review.

Dr. Tanya Ruff Gure
Dr. Brent Lampert
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Geriatric cardiology
  • Heart failure
  • Atrial fibrillation
  • Quality of Life
  • Cardiac Palliative Care
  • Polypharmacy
  • Frailty
  • Cardiac procedures in the elderly
  • Cardiac risk stratification in non-cardiac surgery

Published Papers (4 papers)

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Research

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11 pages, 535 KiB  
Article
Non-Vitamin K Oral Anticoagulants Assessment in High Risk of Bleeding Patients with Non-Valvular Atrial Fibrillation
by Pedro Silva Cunha, André Viveiros Monteiro, Madalena Coutinho Cruz, Paula Malveiro, João Pedro Reis, Guilherme Portugal, Ana Dias, Rui Cruz Ferreira and Mário Martins Oliveira
Geriatrics 2022, 7(1), 20; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics7010020 - 17 Feb 2022
Viewed by 2998
Abstract
Atrial fibrillation (AF) is commonly associated with advanced age and the presence of multiple, concomitant acute and chronic health conditions, placing this population at high risk for serious therapeutic side effects. Nonvitamin K antagonist oral anticoagulants (NOACs) are increasingly used for stroke prevention [...] Read more.
Atrial fibrillation (AF) is commonly associated with advanced age and the presence of multiple, concomitant acute and chronic health conditions, placing this population at high risk for serious therapeutic side effects. Nonvitamin K antagonist oral anticoagulants (NOACs) are increasingly used for stroke prevention in patients with atrial fibrillation. The purpose of this study was to investigate the effectiveness and safety of NOAC in a group at high risk of bleeding complications, in a real-world setting. We conducted a retrospective analysis of a high-risk cohort of 418 patients (pts) followed-up in our anticoagulation unit; data on patient characteristics, anticoagulation treatment, and bleeding and thrombotic complications were evaluated. The population had a median age of 77.8 ± 10.3 years and the mean CHA2DS2-VASc score was 3.85 (SD ± 1.4). Overall, 289 (69.1%) were ≥75 years old. During a mean follow-up time of 51.2 ± 35.7 months, we observed a rate of any bleeding of 7, a clinically relevant non-major bleeding rate of 4.8, a major bleeding rate of 2.2, a stroke rate of 1.6, and a rate of thrombotic events of 0.28 per 100 patient-years. There were 59 hospitalizations due to any cause (14.1%) and 36 (8.6%) deaths (one due to ischemic stroke). A structured follow-up, with judicious prescribing and drug compliance, may contribute to preventing potential complications. Full article
(This article belongs to the Special Issue Geriatric Cardiovascular Comorbidities)
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Review

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16 pages, 5534 KiB  
Review
Lipid-Targeted Atherosclerotic Risk Reduction in Older Adults: A Review
by Lauren J. Hassen, Steven R. Scarfone and Michael Wesley Milks
Geriatrics 2022, 7(2), 38; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics7020038 - 25 Mar 2022
Cited by 1 | Viewed by 4027
Abstract
Aggressive lipid-lowering lifestyle modifications and pharmacologic therapies are the cornerstones of the primary and secondary prevention of atherosclerotic cardiovascular disease events. While statins are highly effective, inexpensive, and generally well-tolerated medications, many clinicians and patients express uncertainty regarding the necessity of statin treatment [...] Read more.
Aggressive lipid-lowering lifestyle modifications and pharmacologic therapies are the cornerstones of the primary and secondary prevention of atherosclerotic cardiovascular disease events. While statins are highly effective, inexpensive, and generally well-tolerated medications, many clinicians and patients express uncertainty regarding the necessity of statin treatment in older adults. Citing concerns such as polypharmacy, muscle symptoms, and even potential cognitive changes with statins, many patients and health care providers elect to de-intensify or discontinue statin therapy during the process of aging. A lack of clear representation of older individuals in many clinical trials and practice guidelines may contribute to the ambiguity. However, the recently prevailing data and practice patterns supporting the benefits, safety, and tolerability of a variety of lipid-lowering therapeutics in older adults are discussed here, with particular mention of a potential protective effect from incident dementia among a statin-treated geriatric population and an admonishment of the historical concept of “too-low” low-density lipoprotein cholesterol (LDL-C) levels. Full article
(This article belongs to the Special Issue Geriatric Cardiovascular Comorbidities)
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Graphical abstract

11 pages, 981 KiB  
Review
Heart Failure in Older Adults: Medical Management and Advanced Therapies
by Ellen Liu and Brent C. Lampert
Geriatrics 2022, 7(2), 36; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics7020036 - 23 Mar 2022
Cited by 2 | Viewed by 4938
Abstract
As the population ages and the prevalence of heart failure increases, cardiologists and geriatricians can expect to see more elderly patients with heart failure in their everyday practice. With the advancement of medical care and technology, the options for heart failure management have [...] Read more.
As the population ages and the prevalence of heart failure increases, cardiologists and geriatricians can expect to see more elderly patients with heart failure in their everyday practice. With the advancement of medical care and technology, the options for heart failure management have expanded, though current guidelines are based on studies of younger populations, and the evidence in older populations is not as robust. Pharmacologic therapy remains the cornerstone of heart failure management and has improved long-term mortality. Prevention of sudden cardiac death with implantable devices is being more readily utilized in older patients. Advanced therapies have provided more options for end-stage heart failure, though its use is still limited in older patients. In this review, we discuss the current guidelines for medical management of heart failure in older adults, as well as the expanding literature on advanced therapies, such as heart transplantation in older patients with end-stage heart failure. We also discuss the importance of a multidisciplinary care approach including consideration of non-medical co-morbidities such as frailty and cognitive decline. Full article
(This article belongs to the Special Issue Geriatric Cardiovascular Comorbidities)
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Other

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8 pages, 237 KiB  
Brief Report
Hair Cortisol Concentration, Perceived Stress, Mental Well-Being, and Cardiovascular Health in African American Older Adults: A Pilot Study
by Ericka L. Richards, Kathy D. Wright, Ingrid K. Richards Adams, Maryanna D. Klatt, Todd B. Monroe, Christopher M. Nguyen and Karen M. Rose
Geriatrics 2022, 7(3), 53; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics7030053 - 29 Apr 2022
Cited by 2 | Viewed by 2084
Abstract
(1) Background: African Americans experience high rates of psychological stress and hypertension, which increases their risk of cardiovascular disease with age. Easy-to-collect psychological and biological stress data are valuable to investigations of this association. Hair cortisol concentration (HCC), as a proxy biomarker of [...] Read more.
(1) Background: African Americans experience high rates of psychological stress and hypertension, which increases their risk of cardiovascular disease with age. Easy-to-collect psychological and biological stress data are valuable to investigations of this association. Hair cortisol concentration (HCC), as a proxy biomarker of chronic stress exposure, provides such advantages in contrast to collection of multiple daily samples of saliva. Objective: To examine the relationships among HCC, perceived stress, mental well-being, and cardiovascular health (systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP)). (2) Methods: Cross-sectional secondary data (N = 25) were used from a mind–body intervention study in hypertensive African Americans ages 65 and older. Data included HCC, a four-item perceived stress scale, SF-36 mental components summary, and SBP/DBP. SBP + 2 (DBP)/3 was used to calculate MAP. (3) Results: The relationship between mental well-being and perceived stress (r = −0.497, p ≤ 0.01) and mental well-being and DBP (r = −0.458, p = 0.02) were significant. HCC change was not significant. In a regression model, every unit increase in well-being predicted a 0.42 decrease in DBP (β = −0.42, 95% CI (−0.69–0.15)) and a 1.10 unit decrease in MAP (β = −1.10, 95% CI (−1.99–0.20)). (4) Conclusions: This study contributes to the knowledge of physiologic data regarding the relationship between MAP and well-being. Findings from this study may aid in the development of interventions that address mental well-being and cardiovascular health in African American older adults with hypertension. Full article
(This article belongs to the Special Issue Geriatric Cardiovascular Comorbidities)
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