Gerstenblith (Johns Hopkins U. School of Medicine) notes that the high number of elderly patients with cardiovascular disease (CVD) is due not only to population trends but also to better identification, prevention, and management strategies in younger adults. Contributors to 15 chapters, some of whom have conducted prospective clinical trials informing current recommendations, stress newly recognized risk factors associated with aging, e.g., insulin resistance, and the value of lifestyle changes. They review "successful and unsuccessful cardiovascular aging," common CVD syndromes, complications, suitability for surgery, rehabilitation, and sensitive end-of-life issues including the high cost of dying in America, barriers to communication, and physician-assisted suicide. Annotation ©2005 Book News, Inc., Portland, OR (booknews.com)
A panel of clinicians, researchers, and leaders in the field review and discuss the latest findings on the pathophysiology, diagnosis, and management of cardiovascular disease in the older patient. The authors explain the physiological changes associated with the normal aging process that may lead to the development of disease, to adverse consequences once disease develops, and which alter the risk-benefit equation for medical and other interventions designed to diagnose, assess, and treat cardiovascular disease. The focus is on particularly common syndromes in the elderly, including cardiac failure with normal ejection fraction, isolated systolic hypertension, and atrial fibrillation. Wherever possible, the authors take an evidence-based approach to recommendations and rely heavily on prospective clinical trials.
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