ABSTRACT
The aging population presents a unique challenge for the US health care system, which has traditionally focused on disease-centric health care delivery. Cardiovascular diseases are highly prevalent in older adults and impose an enormous burden on the aging society in terms of mortality, morbidity, disability, and health care costs. Optimal management of cardiovascular disease in older adults warrants special consideration of age-associated changes in structure and function of multiple organ systems as well as prevalent geriatric syndromes, such as frailty, multimorbidity, and cognitive impairment. The likelihood of benefit from cardiovascular therapy can change considerably due to these coexisting problems. However, the current evidence from clinical trials and clinical practice guidelines that were generated under the cardiovascular disease-centric paradigm fail to adequately represent the complexity of aging. This chapter will provide an overview of aging physiology and geriatric syndromes, and outline principles of patient-centered goals-directed care to help older patients achieve their desired health status.
