ABSTRACTCerebrovascular disease remains an important cause of disability and death in the geriatric population. This paper reviews the current state of knowledge with respect to the pathogenesis and medical and surgical treatment of carotid atherosclerosis. The majority of strokes are probably due to embolization from an ulcerated atherosclerotic plaque at…
ABSTRACTManagement of ischemic heart disease in the elderly is complex. Invasive therapies such as percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) are associated with significant morbidity and mortality. The short-term advantage of PTCA is that its associated noncardiac morbidity and mortality are less than that of…
ABSTRACTReduction of hypertension, whether systolic and diastolic or isolated systolic, is associated with significant reductions in mortality and morbidity rates even in older asymptomatic patients, particularly those less than 80 years old. The increased availability of antihypertensive preparations makes it possible to individualize the choice of therapy to meet the…
ABSTRACTThe diagnosis of coronary artery disease in the elderly is problematic because older patients often present atypical symptoms or are asymptomatic. Once coronary disease is diagnosed, the proper course of treatment is not always clear, since few studies have focused on patients older than 65 years. Moreover, older patients often…
ABSTRACTThe National Cholesterol Education Program and physician/patient awareness of the risks of hypercholesterolemia have resulted in aggressive screening and treatment of elevated cholesterol levels. The “one size fits all” concept has been used as the criterion for intervention. However, this has been promulgated without convincing evidence that levels of cholesterol…
ABSTRACTThis article is directed primarily to primary care physicians. The challenge is to suspect, diagnose, and treat pulmonary arterial hypertension when treatment is most effective and before the effects of cor pulmonale become fully manifested. A good history and physical examination should be followed by electrocardiographic and roentgenographic evaluations. Of…
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