Cardiac Care for Older Adults Time fr a New Paradigm gnygcc心照顾老年人的时间为一个新的范式gnygcc.docxVIP

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Cardiac Care for Older Adults Time fr a New Paradigm gnygcc心照顾老年人的时间为一个新的范式gnygcc.docx

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Cardiac Care for Older Adults Time fr a New Paradigm gnygcc心照顾老年人的时间为一个新的范式gnygcc

Cardiac Care for Older Adults: Time for a New Paradigm Daniel E. Forman, MD1,2 Michael W. Rich, MD3 Karen P. Alexander, MD4 Susan Zieman, MD5 Mathew S. Maurer, MD6 Samer S. Najjar, MD7 Joseph C. Cleveland, Jr., M.D.8 Harlan M. Krumholz, MD9 Nanette K. Wenger, MD10 1. Brigham and Women’s Hospital, Boston, MA. 2. New England GRECC, Boston VA Healthcare Center, Boston, MA 3. Washington University School of Medicine, St. Louis, MO 4. Duke University Medical Center, Durham NC 5. National Institute on Aging/National Institutes of Health, Bethesda, MD 6. Columbia University Medical Center, New York Presbyterian Hospital 7. MedStar Health Research Institute, Washington Hospital Center, Washington, DC 8. University of Colorado at Denver, Division of Cardiothoracic Surgery, Denver, CO 9. Yale University School of Medicine, New Haven, CT 10. Emory University School of Medicine, Atlanta, GA Special thanks to William Hazzard, MD for his review, thoughtful comments, and strong endorsement Introduction Advanced age as a primary determinant of cardiovascular disease Recent decades have witnessed striking growth in the number of older adults both in the US and throughout much of the world largely due to improved public health, nutrition, and medical care. Between 2000 and 2030, the proportion of the worlds population age 65 and older is expected to increase from 6.9% to 12% (1). In the US, the ‘old age’ demographic is accelerating even more rapidly (from 12.9% to 20% between 2000 and 2030) as baby boomers enter their senior years (2). Furthermore, by 2050, the subgroup of US seniors aged 85 years and older is expected to triple. Ironically, aging also catalyzes fundamental changes that increase susceptibility to cardiovascular disease (CVD) such that CVD is endemic in the burgeoning senior population (3). Already, the prototypical US cardiology patient is an older adult and management of cardiac issues is fundamentally linked to the frailties and multi-morb