In the current issue of Cardiovascular Innovations and Applications (Special Issue on Stable Ischemic Heart Disease, Volume 3, Number 3, 2019, pp. 291-296(6); DOI: https://doi.org/10.15212/CVIA.2017.0072 Juan R. Vilaro from the Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA considers stable ischemic heart disease in the older adult.
Demographic trends worldwide show a progressively aging population and an increase in the overall medical complexity of elderly patients with cardiovascular disease. Elderly patients, especially those aged 75 or older, are relatively under-represented in many of the clinical trials that helped create major society guidelines for evaluation and management of ischemic heart disease. Consequently, risk benefit ratios of a guideline-based approach in these patients are not well defined, especially with regards to pharmacotherapies and percutaneous coronary interventions. In this article we offer a practical approach to defining the elderly population, and provide an evidenced based review of the diagnostic and therapeutic implications of advanced age in the evaluation and management of ischemic heart disease.