Cardiovascular care in the older adult: Introduction

There are many sources for cardiovascular guidelines – notably from the National Institute for Health and Care Excellence (NICE), the British Cardiovascular Society, European Society of Cardiology and American Heart Association. These organisations summarise the best available evidence from numerous high-quality trials of cardiovascular investigations, treatments and clinical care pathways.

 

However, many of these guidelines are based on evidence from trials that do not include older and frailer patients. In this group, there may be greater uncertainty of the potential benefits of invasive investigations and treatments. The effects of multimorbidity and frailty may increase the risks of treatment. Ongoing major cardiovascular trials are now actively addressing gaps in evidence, while observational studies and disease registries are providing useful data on the effects of our current treatments.

 

These concepts are central to the purpose of the BGS Cardiovascular SIG. If you would like a summary of the broad topic of cardiovascular care for frailer patients, this position statement from the Acute Cardiovascular Care Association provides an excellent overview: https://doi.org/10.1177/2048872618758931

 

In the sections that follow, we have summarised the latest research and relevant guidelines for the cardiovascular care of older adults in specific conditions. These summaries are intended to inform discussions around clinical decisions but should be used as a source of information and learning rather than formal guidance.

 

We hope you find these documents helpful. If you have any suggestions for improvements or updates of new research, please do let us know by emailing scientificofficer@bgs.org.uk.