One of the risk factors for coronary artery disease is age. It is one of the major causes of death in the elderly American population and its incidence has doubled over the past 30 years. The best approach to this problem is taking early steps to prevent atherosclerosis caused by high cholesterol levels and elevated blood pressure.
Heart changes and age: What you should know
It is very normal for people over the age of 65 to be more likely to develop a heart-related problem. Coronary artery disease is merely one of those examples, as age takes a toll on blood vessels as well as other organs in the body.
Age influences heart health in many ways. A common example reflects the difficulty in exercising for as long as one could in their youth, as the heart is less able to pump the oxygen needed to support the exercise.
Every heart has its own natural pacemaker, which determines the heartbeats. When fat deposits are found in the coronary arteries, a person can develop fibrous tissue, which makes this pacemaker lose some cells. When this occurs, the heart rate slows down.
Older people are also more likely to have an increased heart size, particularly in the left chamber. Despite this growth, the walls of the heart also grow thicker, which means that the heart hosts less and less blood.
As people grow older, the aorta (the heart’s main artery) becomes stiffer and thicker. As a consequence, blood pressure rises, which exerts more force on the walls of the arteries. This leads to inner lining artery damage, paving the way for fatty deposits to stick to the artery walls.
It’s important to mention that diagnosing and treating coronary artery disease in older people is more complicated, for several different reasons. Compared to young adults, the elderly might not be able to take different drugs that are normally prescribed for such a condition, nor will they respond to treatment as younger people do.
Diagnosing coronary artery disease in the elderly
Doctors will often choose to examine the presence of risk factors in a particular patient, and screen those who have at least two risk factors. The purpose of screening tests isn’t just to identify if a patient has coronary artery disease, but also to determine its severity. Doctors may ask their patients to do an electrocardiogram, both in a resting phase and during a stress test.
There are cases where older patients have signs of coronary artery disease, and this may push doctors to approach the diagnosis pattern differently. A thallium scan is very common in patients with angina.
Treatment for coronary artery disease in the elderly
Naturally, each patient should benefit from individual therapy paths that will take into account their overall health status. Generally speaking, drugs to manage angina in younger adults are also efficient in treating older patients. It’s important to start off with lower doses, and gradually increase them until symptoms improve. Doctors will prioritize medication that can be prescribed once or twice per day.
Older people with coronary artery disease may be prescribed beta blockers, but doctors have to be really careful with patients who have diabetes that requires insulin shots. Calcium channel blockers might also be a good treatment, but verapamil and diltiazem are to be avoided by patients with heart failure.
Coronary angiography is a more invasive form of treatment, which can be suggested by doctors if patients are willing to accept the risks of the procedure.
It’s also important to note that heart attacks in people above the age of 75 are more likely to be fatal. Older patients who are at risk of having a heart attack might benefit from nitroglycerin and beta blockers, administered the same as they would be in younger patients.
Vascular mortality for people over the age of 70 is reduced when taking aspirin, so doctors often prescribe it to their older patients.
As you can see, there is no “one-size-fits-all” treatment for coronary artery disease in the elderly. While there are general guidelines that doctors follow when looking to treat coronary artery disease in their patients, the health status of an older person introduces many variables, making individual diagnosis and treatment plans essential.
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