Download e-book for iPad: Cardiovascular Disease in the Elderly:Third Edition, Revised by Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich

By Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich

Absolute to turn into the main relied on resource in geriatric cardiology, this 3rd variation compiles the most recent reviews and services at the epidemiology, pathophysiology, and administration of heart problems within the aged patient-tracking the swift velocity of innovation within the box with in-depth explorations of the newest scientific trials and advances in vascular biology, cardiology, and cardiovascular surgical procedure for influential advancements in affliction prevention and administration.

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Associated increases in PWV have been demonstrated in populations with little or no atherosclerosis, again indicating that these vascular parameters are not necessarily indicative of atherosclerosis [29]. However, more recent data emerging from epidemiological studies indicate that increased large vessel stiffening also occurs in the context of atherosclerosis and diabetes [30–32]. The link may be that stiffness is governed not only by the structural changes within the matrix, as noted above, but also by endothelial regulation of vascular smooth muscle tone and of other aspects of vascular wall structure/ function.

The heart rate-corrected Q–T interval increases by about 10 ms from the third to the sixth decade [134]. Table 4 summarizes those changes in resting ECG measurements thought to be secondary to normative aging. ARRHYTHMIAS Atrial Arrhythmias An increase in the prevalence and complexity of both supraventricular and ventricular arrhythmias, whether detected by resting ECG, ambulatory monitoring, or exercise testing, is a hallmark of normal human aging. Isolated premature atrial ectopic beats (AEB) appear on the resting ECG in 5 to 10% of individuals older than 60 years and are not generally associated with heart disease.

Orthostatic hypotension (OH), defined by a decline of systolic blood pressure z20 mmHg or diastolic blood pressure z10 mmHg, occurred in 16% of volunteers aged 65 years and older from the Cardiovascular Health Study [82] and in 7% of men aged 71 to 93 years from the Honolulu Heart Program [83]; in both of these older cohorts the prevalence of OH increased with age. 64), and there was a linear relationship between the magnitude of orthostatic decline in systolic blood pressure and 4-year mortality rate [83].

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