Cardiovascular Disease in the Elderly PDF
Preview Cardiovascular Disease in the Elderly
CARDIOVASCULAR DISEASE IN THE ELDERLY DEVELOPMENTS IN CARDIOVASCULAR MEDICINE Reiber, j.H.C.. Sertuys, P.W .. Siagcr. C.J.: Quantitative coronary and left ventricular cineangiography. ISBN 0-89838-760-4. Fagard. RH., Bebert. I.E.. cds.: Sports cardiology. ISBN 0-89838-782-5. DieM 52. Reiber, ].H.C., SeCTUYS, P.W .. cds.: State ofthc art in quantitative coronary arteriography. ISBN 0-8983R-804-X. DIeM 53. Roelandt. j.. cd.: Color doppler flow imaging. ISBN 0-89838-806-6. DIeM 54. van de Wall. E.E., cd.: Nonlnvasivc imaging of cardlac metabolism. ISBN 0-89838-812-0. DIeM 55. Leibman. J.. Piomey. R.. Rudy, Y .• cds.: Pediatric and fundamental electrocardiography. ISBN 0-89838-815-5. DIeM 56. Higter. H .. Hombach, V., cds.: Invasive cardiovascular therapy. ISBN 0-89838-818-X. DIeM 57. Scrruys, P.W .. Meester. G.T.. cds.: Coronary angioplasty: a controlled model for ischemia. ISBN 0-89838-819-8. DIeM 58. Tooke. J.E .• Smaje. LH .. eds.: Clinical investigation of the microcirculation. ISBN 0-89838-833·3. DIeM 59. van Dam. Th .. van Oosternm. A .• cds.: Electrocardiographic body surface mapping. ISBN 0-89838-834-1. DICM 60. Spencer. M.P .. ed.: Ultrasonic diagnosis of cerebrovascular disease. ISBN 0-89838-836-8. DICM 61. Legato. M.J .• ed.: The Stressed heart. ISBN 0-8983R-<l49-X. DIeM 62. Safar. M.E. • ed.: Arterial and venous systems In essential hypertension. ISBN O-S983S-857-O. DICM 63. Roeland. J., ed.: Digital techniques in echo cardiography. ISBN 0-89838-861-9. DIeM 64. Dhalla. N.S .. Singal. P.K., Beamish, RE., cds.: Pathophysiology of heart disease. ISBN 0-89838-864-3. DIeM 65. Dhalla. N.S., Pierce, G.N., Beamish, R.E .. cds.: Heart function and metabolism. ISBN 0-89838-865-1. DICM 66. Dhalla. N.S .. Innes. LR., Beamish. R.E .. cds.: Myocardial ischemia. ISBN 0-89838-866-X. DICM 67. Beamish. R.E., Panagia. V., Dhalla. N.S .. cds.: Pharmacological aspects of heart disease. ISBN 0-89838-867-8. DICM 68. Ter Keuts. H.E.D.].. Tyberg.]. V .. cds.: Mechanics of the circulation. ISBN 0-89838-870-8. DIeM 69. Sideman. S., Beyar. R., cds.: ActivatIon metabolism and perfusion ofthc heart. ISBN 0-89838-871-6. DieM 70. Aliot, E., Lazzara. R., cds.: Ventricular tachycardias. ISBN 0-89838-881-3. DICM 71. Schnecweiss. A. . Schettler. G.: Cardiovascular drug therapy in the elderly. ISBN 0-89838-883-X. DICM 72. Chapman, J. V .. Sgalambro. A .• cds.: Basic concepts in doppler cchocardiogcaphy. ISBN 0-89838-888-0. DICM 73. Chien, S .• Dormandy. J.. Ernst. E.. Matrai. A .. ecis.: Clinical hemorheology. ISBN 0-89838-807-4. DICM 74. Morganroth,].. Moore. E. Neil, cds.: Congestive heart failure. ISBN 0-89838-955-0. DICM 75. Hcintzcn. P.R, Bursch, J.H .. eds.: Progress in digital angiocardiography. ISBN 0-89838-%5-8. Scheinman. M .. ed.: Catheter ablation of cardiac arrhythmias. ISBN 0-89R38-%7-4. DIeM 78. Spaan. ].A.E. . Bruschke. A.V.G., Gittcnberger. A.C.. cds.: Coronary circulation. ISBN 0-89838-978-X. DIeM 79. Bayes de Luna. A., cd.: Therapeutics in cardiology. ISBN 0-89838-981-X. DICM 81. Visser, c.. Kan. G .. Meltzer. R .. eds.: Echocardiography in coronary artery disease. ISBN 0-89838-979-8. DIeM 80. SingJ", P.K .. cd.: Oxygen radicals in the parhophysiology of heart disease. ISBN 0-89838-375-7. DICM 86. Iwata, H .. Lombardini, J-R. Scgawa. T., cds.: Taurine and the heart. ISBN 0-89838-396-X. DICM 93. Mirvis. D.M .. cd.: Body surface electrocardiographic mapping. ISBN ()....89838-983-6. DIeM 82. Morganroth. J.. Moore. E.N .. eds.: Silent myocardial ischemia. [SBN 0-89838-380-3. DIeM 88. R. Vos: Drugs Looking for Diseases. Innovative Drug Rc~earch and the Development of [he Beta Blockers and the Calcium Antagonists. 1991 ISBN 0-7923-0%8-5. S. Sideman. R. Bcyar and A.G. Kleber (cds.): Cardiac Electrophysiology. Circulation. and Transport. Proceedings of the 7th Henry Goldberg Workshop (Berne, Switzerland, 1990). 1991 ISBN 0-7923-1145-0. D.M. Ben;: Excitation-Contraction Coupbng and Cardiac Contractile Force. 1991 ISBN 0-7923-1186-8. A.·M. Salmasi and A.N. Nicolaides (eds.): Occuh Atherosclerotic Disease. Diagnosis. Assessment and Management. 1991 ISBN 0-7923-1 188-4. J.A.E. Spaan: Coronary Blood Flow. Mech.anics. Distribution. and Control, 1991 ISBN 0-7923-1210-4. R.W. Stout (cd.): Diabetes and Atherosclerosis. 1991 ISBN 0-7923-1310-0. A.G. Herman (cd.): Antithrombotics. Pathophysiological Rationale for Pharmacological Interventions. 1991 ISBN 0-7923-1413- I. N.H.J. Pijls: Maximal Myocardial Perfusion as a Measure of the Functional SignifiCance of Coronary Arteriogram. From a Pathoanatomic to a Pathophysiologic Interpretation of the Coronary Arteriognm. 1991 ISBN 0-7923-1430-1. J.H.C. Reiber and E.£. v.d. Wall ({'ds.): Cardiovascular Nuclear Medicine and MRI. Quantitation and Clinical Applications. 1992 ISBN 0-7n3-1467-tl E. Andries. P. Brugada and It StiOobrar:dt (cds.); How to Face 'the Faces' ofCardJl(;: Pacing. 1992 ISBN 0-7923-1528-6 M. Nagano. S. Mochizuki and N.S. Dhalla (cds.); Cardiovascular Disease in Diabetes. 1992 ISBN 0-7923-1554-5. P.W. Serruys, RH. Strauss and S.B. King III (cds.): Restenosis after Intervention with New Mechanical Devices. 1992 ISBN 0-7923-1555-3. P.]. Walter (cd.); Quality of Life after Open Heart Surgery. 1992 [SBN 0-7923-1580-4. E.E. van der Wall. H. Sochor, A. Righetti and M.G. Niemeyer (eds.): What is new in Cardiac Imaging? SPECT. PET and MRI. 1992 ISBN 0-7923-161S-~. P. Hanrath. R. Uebis and W. Kreb~ (cds.): Cardiovascular Imaging by Uitra:>,:mnd. 1992 ISBN 0-7923. .. 1755-6. F.H. Messerli (cd.): Cardiov,l.<;cula!" DIsease in t~e Elderly. 3rd ed. 19':12 ISBN u-7923-1859-5. J. Hess and G.R. Sutherland (eds.): Congenital Heart Disease in Adclescents and Adults. 1992 ISBN 0-7923-1862-5. J.H.C. Reiber and P.W. Scrruys (cds.): Advances in Quantitative Coronary Arteriography. 1992 ISBN 0-7923-1863-3. CARDIOVASCULAR DISEASE IN THE ELDERLY THIRD EDITION EDITED BY FRANZ H. MESSERLI Ochsner Clinic and Alton Ochsner Medical Foundation New Orleans, Louisiana ~. " SPRINGER SCIENCE+BUSINESS MEDIA, B.V. Library ofCongress Cataloging-in-Publication Data Cardiovaseular disease in the e1derly 1 Franz H. Messerli, editor.- 3rd ed. p. em.-(Developments in eardiovaseular medieine; 129) Includes bibliographieal referenees and index. ISBN 978-1-4613-6560-0 ISBN 978-1-4615-3516-4 (eBook) DOI 10.1007/978-1-4615-3516-4 l. Geriatrie eardiology. I. Messerli, Franz H. 11. Series: Developments in eardiovaseular medieine; v. 129. [DNLM: l. Cardiovaseular Diseases-in old age. W1 DE997VME v.129] RC669.C278 1993 618.9'7612-de20 DNLMIDLC for Library of Congress 92-23628 CIP Copyright 1993 by Springer Science+Business Media Dordrecht Originally published by Kluwer Academic Publishers in 1993 Softcover reprint ofthe hardcover 3rd edition 1993 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, meehanical, photocopying, recording, or otherwise, without the prior written permission of the publisher, Kluwer Aeademic Publishers, 101 Philip Drive, Assinippi Park, N orwel!, Massachusetts 02061. CONTENTS Contributing Authors Vll Foreword to the First Edition IRVIN H. PAGE (deceased) XVll Preface FRANZ H. MESSERLI xix 1. Introduction: Older People and Cardiovascular Illness MARK PECKER AND JOHN H. LARAGH 2. Epidemiology JOHN D. SWALES, ASTRID E. FLETCHER, AND CHRISTOPHER J. BULPITT 9 3. Pathophysiology of the Aging Heart and Circulation JEROME L. FLEG, GARY GERSTENBLITH, AND EDWARD G. LAKATTA 27 4. Clinical Findings in the Elderly Heart Patient JULES CONSTANT 59 5. Diagnostic Testing for Cardiovascular Diseases CARL J. LA VIE AND FRANZ H. MESSERLI 73 6. Heart Failure BARRY M. MASSIE AND CHRISTOPHER L. WOLFE 91 7. Hypertension FRANZ H. MESSERLI AND TOMASZ GRODZICKI 121 Hypertensive Emergencies DWIGHT DAVIS, K. DANNER CLOUSER, AND ROBERT ZELIS 145 v vi Contents 8. Disturbances of Cardiac Rhythm KELLY ANNE SPRATT, ERIC L. MICHELSON AND LEONARD S. DREIFUS 163 9. Heart Block/Cardiac Pacing SETH J. RIALS, ROGER A. MARINCHAK AND PETER R. KOWEY 195 10. Postural Hypotension and Syncope MICHAEL G. ZIEGLER AND RICHARD R. BARAGER 211 1I. Valvular Heart Disease in the Elderly DAVID C. BOOTH AND ANTHONY N. DEMARIA 231 12. Coronary Artery Disease ANDREW P. REES, CARL J. LA VIE, AND CARL J, PEPINE 253 13. Acute Myocardial Infarction NOBLE O. FOWLER 275 14. Diseases of the Myocardium, Pericardium, and Endocardium CELIA M. OAKLEY 293 15. Diseases of the Aorta and Arterial Tree DONALD J. BRESLIN AND NICHOLAS P. TSAPATSARIS 331 16. Cardiac Manifestations of Noncardiac Disease DAVID W. SNYDER 375 17. Psychological Adaptation to Cardiovascular Disease RICHARD V. MILANI, ANDREW B. LITTMAN, AND CARL J. LAVIE 401 18. Ethical Considerations K. DANNER CLOUSER AND DWIGHT DAVIS 413 19. Risk Modification JAMES A. SCHOENBERGER 423 20. Dietary Considerations in the Elderly: Nutrition and Cardiovascular Disease JOYCE P. BARNETT 435 2I. Exercise and Rehabilitation in Elderly Cardiac Patients NANETTE K. WENGER 453 22. Medical Treatment of Cardiovascular Disease LIONEL H. OPIE, T.A. MABIN, AND P. DE V. MEIRING 473 23. Interventional Cardiology STEPHEN R. RAMEE AND CHRISTOPHER J. WHITE 499 24. Surgery in the Aged JAMES R. DOUGLAS, JR. AND JOHN L. OCHSNER 531 25. Cardiac Transplantation in Older Patients: Changing Perspectives HECTOR O. VENTURA, HERMAN L. PRICE, FRANK W. SMART, DWIGHT D. STAPLETON, AND CLIFFORD H. VAN METER 555 Index 563 CONTRIBUTING AUTHORS Richard R. Barager, M.D. Tri-City Medical Center 3923 Waring Road Suite D Oceanside, CA 92056 Joyce P. Barnett, M.S., R.D.!L.D. Instructor Department of Clinical Nutrition Allied Health Sciences School The University of Texas Southwestern Medical Center 5323 Harry Hines Boulevard Dallas, TX 75235-8Sn David C. Booth, M.D. Associate Professor of Medicine University of Kentucky College of Medicine and Director, Cardiac Catheterization Laboratories A.B. Chandler Medical Center University of Kentucky and Chief, Cardiology Section Lexington Veterans Affairs Medical Center vii viii Contributing Authors Mailing Address: Division of Cardiology Rm MN670 University of Kentucky Medical Center 800 Rose Street Lexington, KY 40536-0084 Donald J. Breslin, M.D. Section of Vascular Medicine and Hypertension Lahey Clinic Medical Center Burlington, MA and Assistant Clinical Professor Harvard Medical School Boston, MA Mailing Address: Section of Vascular Medicine and Hypertension Lahey Clinic Medical Center 41 Mall Road Burlington, MA 01805 Christopher J. Bulpitt, M.D. Head Division of Geriatric Medicine Royal Postgraduate Medical School Du Cane Road London W12 ONN England K. Danner Clouser, Ph.D. University Professor of Humanities The Pennsylvania State University Hershey, P A 17033 Jules Constant, M.D. 57 Tillinghast Place Buffalo, NY 14216 Dwight Davis, M.D. The Milton S. Hershey Medical Center The Pennsylvania State University Division of Cardiology P.O. Box 850 Hershey, P A 17033 Anthony N. DeMaria, M.D. Professor of Medicine Chief, Cardiovascular Section A.B. Chandler Medical Center University of Kentucky Lexington, KY 40536-0084 ix James R. Douglas, Jr., M.D. Department of Anesthesiology Ochsner Clinic and Alton Ochsner Medical Foundation 1514 Jefferson Highway New Orleans, LA 70121 Leonard S. Dreifus, M.D. Professor of Medicine and Director, Heart Station Hahnemann University M.S. 470 Broad and Vine Philadelphia, P A 19102-1192 Jerome L. Fleg, M.D. Staff Cardiologist National Institutes of Health National Institute on Aging Gerontology Research Center 4940 Eastern A venue Baltimore, MD 21224 Astrid E. Fletcher, M.D. Epidemiology Research Unit Division of Geriatric Medicine Royal Postgraduate Medical School Du Cane Road London W12 ONN England Noble O. Fowler M.D. Department of Internal Medicine Division of Cardiology University of Cincinnati Medical Center Mail Location 542 231 Bethesda Avenue (Rm 3354) Cincinnati, OH 45267-0542 Gary Gerstenblith, M.D. Laboratory of Cardiovascular Science Gerontology Research Center National Institute on Aging National Institutes of Health and Assistant Professor of Medicine (Cardiology) Johns Hopkins Medical Institutions Baltimore, MD x Contributing Authors Mailing Address: Johns Hopkins Hospital 565 Carnegie Building 660 N. Wolfe Street Baltimore, MD 21205 Tomasz Grodzicki, M.D. Department of Internal Medicine Section on Hypertensive Diseases Ochsner Clinic and Alton Ochsner Medical Foundation 1514 Jefferson Highway New Orleans, LA 70121 Peter R. Kowey, M.D. Chief Division of Cardiovascular Diseases The Lankenau Hospital and Medical Research Center and Professor of Medicine Thomas Jefferson University School of Medicine Mailing Address: Lankenau Medical Office Building East Suite 556 100 Lancaster A venue west of City Line Wynnewood, P A 190% Edward G. Lakatta, M.D. Chief, Cardiovascular Section Gerontology Research Center National Institute on Aging National Institutes of Health and Associate Professor of Medicine (Cardiology) Johns Hopkins Medical Institutions and Adjunct Associate Professor of Physiology University of Maryland School of Medicine Baltimore, MD Mailing Address: Johns Hopkins Hospital 565 Carnegie Building 600 N. Wolfe Street Baltimore, MD 21205 John H. Laragh, M.D. Hilda Altschul Master Professor of Medicine and Director Cardiovascular Center and Hypertension Center and Chief Cardiology Division Department of Medicine The New York Hospital-Cornell Medical Center
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