Prevention and treatment strategies are the identical as for younger people, with a couple of additional nuances and suggestions.
Older Americans are the fastest-growing segment of the population on this country — including the “elderly,” or people age 85 and older. The possibilities of health problems increase with age, including those affecting the guts. But is the prevention and treatment of heart disease within the elderly different from that really useful for the young?
Stay lively
Sticking to an everyday physical exertion program might be a very powerful of those habits since it improves a variety of risk aspects, says Dr. O'Gara. Physical activity can improve your mood and the standard and duration of your sleep, which advantages heart health.
Walking or other activity that gets your heart rate up may also help keep blood pressure under control. Exercises that strengthen your core (like wall push-ups) can improve your balance and stop falls. According to at least one study, the incidence of falls amongst people age 65 and older with coronary artery disease is 34 percent, in comparison with 12 percent amongst older adults without heart problems.
Like falls, frailty — a syndrome marked by weakness, fatigue and wasting — becomes more common with age. If you might be frail or have been inactive for a while, see “Gentle Exercises for Older, Frail People” in September 2021. Heart Letter.
Adjustment of medication
Another problem that’s common amongst older adults is polypharmacy, defined as taking five or more medications. Around age 70, it's a superb idea to review your whole medications together with your physician to see if any adjustments are mandatory, says Dr. O'Gara. For example, many healthy people start taking low-dose aspirin day by day to stop heart attacks in middle age. But when you reach age 70, the danger of bleeding may outweigh the protection against heart attack or stroke if there isn’t any evidence of atherosclerosis. Bleeding can range from minor (reminiscent of bleeding gums or bruising) to more serious complications, including bleeding within the stomach, small intestine and, in rare cases, within the brain.
The risk of bleeding can be a priority for individuals who take anticoagulants, that are prescribed to treat atrial fibrillation, a heart rhythm disorder that increases the prospect of stroke. Once you reach your 80s, it could make sense to scale back the dose of your anti-clotting medication to scale back the danger of bleeding. Weight loss and worsening kidney function, which sometimes occurs with age, affect the dosage of a few of these medications.
Although current guidelines recommend a goal of a blood pressure reading of 130/80 or less, this goal could also be too aggressive for some people age 80 and older. “The older you are, the less forgiving your body becomes. This can put you at greater risk of side effects from blood pressure medications, such as dizziness or lightheadedness,” says Dr. O'Gara. can.” If this starts to occur to you, work together with your doctor to dial back your dose.
Time to intervene
Another consideration for the elderly is to undergo invasive cardiac procedures, reminiscent of aortic valve substitute. In the past, the common practice was to attend until an individual's symptoms were so debilitating that quality of life was compromised. But sometimes, waiting longer implies that the person is simply too old and frail that valve substitute surgery is simply too dangerous. Now, a less invasive alternative—transcatheter aortic valve substitute, or TAVR—has turn into more widely available, expanding eligibility for older people. But there's also an increasing trend to do TAVR later, which Dr. O'Gara calls the “golden moment.” This is the age at which an individual will likely get well easily from the procedure and still have a superb decade to go.
Longevity Advice
Dr. O'Gara has had a couple of patients who’ve lived past 100, although one recently died on the age of 108. Besides good medical care, is there anything special about centenarians that contributes to their longevity? “They exercise, volunteer, and have access to other types of social activities and interactions that give them a sense of purpose and belonging in their community,” says Dr. O'Gara.
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