More than 70% of older adults have cardiovascular disease (CVD), and the vast majority of these have multiple coexisting conditions; indeed, more than 50% of older adults have multimorbidity (MM), defined as three or more chronic conditions. Tremendous advances in the diagnosis and treatment of CVD over the past five decades have culminated in the publication of numerous evidence-based guidelines, which have contributed to improved cardiovascular care and clinical outcomes. However, positive results from the “guideline age” have been tempered by two factors that have been increasingly recognized by cardiologists and geriatricians: (1) most patients with CVD are elderly and also have MM, increasing the likelihood that treatment of their CVD will exacerbate other chronic conditions; and (2) most guideline recommendations, based on evidence from studies with restrictive inclusion criteria or nonrepresentative enrollment, do not account for complicating effects from coexisting conditions and treatments.
from Clinics in Geriatric Medicine http://ift.tt/1VOhQV2
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