Heart disease is a major concern for people over 65, but treatments have improved significantly. However, this progress can complicate decision-making for older heart patients.
Older hearts are physiologically different, with stiffer muscles, less blood filling capacity, and changes in blood vessels that can lead to hypertension. These changes affect the entire cardiovascular system, making treatment decisions more challenging.
Recent research suggests that certain medical approaches may not be effective for older patients, while others have shown promise. For example, implantable cardioverter defibrillators (I.C.D.s) have been used to prevent sudden cardiac death, but studies have shown mixed results in older adults.
A recent study found that I.C.D.s did not reduce mortality in patients over 70 with nonischemic heart failure. Instead, medications alone appeared to be at least as effective in treating these patients. However, this finding may not apply to all older adults, and more research is needed.
Cardiac rehabilitation programs have been shown to benefit patients with heart disease, reducing hospitalization and cardiovascular deaths. Despite their benefits, these programs remain underused, particularly among older adults.
Researchers are working to develop effective delivery systems for cardiac rehabilitation programs, including remote options. A recent trial showed that an at-home program was not as effective as in-person exercise sessions, but it highlighted the need for further research on technology and motivation factors.
Ultimately, patients and their families must carefully consider treatment options and ask important questions about the potential benefits and risks of each approach. With ongoing research and development, there is hope for improving care and outcomes for older heart patients.
Source: https://www.nytimes.com/2025/02/15/health/heart-disease-aging.html