Geriatric Cardiology and the Imminent Patient Shift
As more baby boomers age, the growing number of older adults has created a major demographic imperative. It is estimated that by 2030 the number of older adults – individuals age 65 and older – will have doubled. This huge population shift is of particular significance to cardiologists as aging is the most potent risk factor for cardiovascular diseases. Older patients already make up 60 percent of all cardiovascular patients and while the pool of older adults continues to grow, all members of the cardiovascular team must learn to treat this unique community.
“We have already begun to see the effects of this shift,” remarks Mathew Maurer, MD, FACC, chair of ACC’s Geriatric Cardiology Member Section. “General cardiology has become geriatric cardiology. Knowledge of how to treat this unique population is now relevant across the specialties, which includes understanding age-related changes in pharmacology, physiology, cardiovascular disease presentation, management of cardiovascular disease and prevention.”
As Maurer suggests, there are certain inherent physiological changes that occur once a patient reaches a certain age, that causes them to develop cardiovascular diseases more often. These changes must be studied in relation to each sub-specialty in order to better understand how to treat older adults.
“Take prevention for example,” comments Maurer. “Physicians tend to see prevention as an oxymoron for the geriatric population. They think, ‘we’ve already missed the boat, what can we really do at this point?’ But that’s not the case. People are living longer than ever and lifestyle and medication strategies can help reduce or prevent cardiovascular events and improve functional capacity and quality of life.”
Heart failure is another condition that can be better treated in older adults once the phenotype of this patient group is better understood. Individuals 75 and older are disproportionately affected by heart failure, resulting in significant morbidity, mortality and health care costs. Outcomes are greatly improved, however, once physicians embrace the individuality of each older patient and use treatment strategies tailored to their specific presentation or case.
The list goes on. Aging alters the presentation, treatment options and treatment response in almost any sub-specialty and knowing how to treat patients appropriately is crucial. So what’s being done to help address these knowledge gaps?
“The College’s Geriatric Cardiology Member Section has a robust portfolio of initiatives to help educate cardiologists on geriatric care,” explains Maurer. “To name a few, the Section was able to secure ACC’s first-ever National Institute on Aging U13 grant; led the charge on developing the Essentials of Cardiovascular Care in Older Adults (ECCOA) curriculum; and launched an ACC-wide palliative care survey.”
The U13 grant funds a series of three scientific conferences – the first of which took place this past year – aimed at identifying knowledge gaps and formulating a research agenda in the three pivotal areas in geriatric cardiology. ECCOA was developed by Section members to teach practitioners about the key features of aging that directly affect cardiovascular diseases in a free, digital format. Practitioners can use ECCOA to improve their understanding of age-related changes in pharmacology, physiology, cardiovascular disease presentation, management of cardiovascular disease and prevention strategies. Finally, the palliative care working group launched a survey in order to assess ACC member opinion on how palliative care is administered to ventricular assist device and transcatheter aortic valve replacement patients at their institutions and whether they were receiving the resources and education needed to continue to provide this care.
“The growth of the older adult population in conjunction with the effect that age-related changes have on cardiology is not something to be ignored,” Maurer shares. “I encourage all cardiologists and care team members to garner the skills and knowledge base necessary to provide the highest quality care to our most vulnerable older adult patients and take advantage of all the resources the Section and the College has to offer.”
To learn more about the geriatric population and take advantage of all the Geriatric Member Section’s offerings, visit ACC.org/Geriatric.
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