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September 2006

Renal dysfunction in older age groups and mortality after acute myocardial infarction

September 17, 2008

Lipids

Only one third of patients admitted to the hospital with acute myocardial infarction have normal renal function, and 17% have severe renal impairment. Decreased renal function is associated with the presence of comorbid conditions, underuse of effective treatments, and higher mortality. Renal function parameters should not only be included in scoring systems to assess risk levels, but patients with abnormal renal function should benefit from careful application of guidelines-recommended treatments for acute and long-term care.

Hypertension in the elderly

September 17, 2008

Lipids

More important than the choice of pharmaceutical agent in the treatment of elderly hypertensive patients is the achievement of goal blood pressure. Low-dose diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers are equally effective in reducing cardiovascular end points. Most patients will require 2 or more drugs to achieve target blood pressure, and physicians should feel comfortable prescribing 3 to 4 agents to a significant proportion of patients.

Congestive heart failure in the elderly

September 17, 2008

Lipids

Studies have shown that elderly patients with heart failure are undertreated with evidence-based therapy, such as angiotensin-converting enzyme inhibitors and beta-blockers, although these therapeutic options appear to be effective in this age group. The risk of some side effects may be increased in elderly patients, and physicians should be aware of those when prescribing therapy. Cardiac resynchronization therapy is predicted to play a major role in future heart failure treatment, including in the elderly population.