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The epidemiology and management of elderly patients with myocardial infarction or heart failure.

https://arctichealth.org/en/permalink/ahliterature144992
Source
Heart Fail Rev. 2010 Sep;15(5):407-13
Publication Type
Article
Date
Sep-2010
Author
Justin A Ezekowitz
Padma Kaul
Author Affiliation
Division of Cardiology, University of Alberta, 2C2 WMC, 8440-112 Street, Edmonton, Alberta T6G 2B7, Canada. Justin.ezekowitz@ualberta.ca
Source
Heart Fail Rev. 2010 Sep;15(5):407-13
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Age Factors
Aged
Aged, 80 and over
Aging - physiology
Alberta - epidemiology
Angioplasty, Balloon, Coronary
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Female
Heart Failure - drug therapy - epidemiology - therapy
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Myocardial Infarction - drug therapy - epidemiology - therapy
Myocardial Reperfusion
Risk factors
Abstract
Heart disease is important in elderly patients. The treatment of myocardial infarction and heart failure are particularly important and will continue to play an important role across the globe. Advances in treatment of myocardial infarction have made tremendous inroads in the short and long term survival of patients, young and old, however, many currently employed strategies have not been tested in patients who are elderly, who paradoxically, form a growing subset of patients with heart disease. A similar paradigm exists in heart failure for both diagnosis and treatment. Attention to this issue is important when selecting treatment strategies and a focus on the goals of care is critical when decisions for care must be undertaken.
PubMed ID
20213185 View in PubMed
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Potential gaps in congestive heart failure management in a rural hospital.

https://arctichealth.org/en/permalink/ahliterature173480
Source
Can J Rural Med. 2005;10(3):155-61
Publication Type
Article
Date
2005
Author
Margaret D Sanborn
Douglas G Manuel
Ewa Ciechanska
Douglas S Lee
Author Affiliation
South Bruce Grey Health Care Centre, Chesley, Ont. msanborn@sbghc.on.ca
Source
Can J Rural Med. 2005;10(3):155-61
Date
2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Health Care Surveys
Health Services Accessibility - standards - statistics & numerical data
Heart Failure - drug therapy - epidemiology - therapy
Hospitals, Community - standards - statistics & numerical data
Hospitals, Rural - standards - statistics & numerical data
Humans
Middle Aged
Ontario - epidemiology
Patient Care Planning - standards - statistics & numerical data
Retrospective Studies
Rural Health
Rural Health Services - standards - statistics & numerical data
Rural Population - statistics & numerical data
Abstract
Congestive heart failure (CHF) is increasingly recognized as an important cause of morbidity and mortality. Previous studies in urban settings have shown that patients frequently are not receiving recommended therapy. There is a paucity of studies that have evaluated CHF management in a rural setting. We therefore reviewed hospital and outpatient care in this setting as an initial step toward improving CHF care.
A retrospective chart review was used to examine the care of all 34 patients hospitalized for CHF from 2000-2001 in a small rural hospital, to assess the need for improved CHF management.
The median age of the patients was 78 yr, and a number of them had many co-morbid cardiovascular risks. Similar to other studies, only 23% of patients were prescribed recommended doses of angiotensin-converting enzyme (ACE) inhibitors. Use of beta-blockers was far below expected rates. Although there was follow-up care for nearly all patients (97%), few patients had echocardiography performed (38%) or had their medications altered in the outpatient setting.
There is a need for improved management of CHF in the rural setting. Approaches to improving CHF care should use the continuity of care advantage provided by primary care physicians to optimize outpatient medical treatment regimens and improve access to diagnostic services such as echocardiography.
PubMed ID
16079031 View in PubMed
Less detail