Story at a glance
- A person’s heart muscles and arteries may stiffen as they get older, increasing risk for blood clots.
- Older adults may also have multiple health conditions and take numerous medications, including anti-clotting medications.
- Heart disease diagnosis and treatment need to consider age, according to a scientific statement from the American Heart Association.
As bodies age, heart muscles and arteries may change in ways that could increase risk for heart disease. For that reason, age needs to be taken into consideration in the diagnosis and treatment of heart disease, the American Heart Association (AHA) said in a scientific statement published Monday in Circulation in which it updated its recommendations for age-appropriate heart disease care.
Acute coronary syndrome (ACS) is a group of conditions in which blood flow to the heart is reduced, including angina and heart attacks, or myocardial infarctions.
According to a press release from the AHA, “ACS is more likely to occur without chest pain in older adults, presenting with symptoms such as shortness of breath, fainting or sudden confusion.”
The statement, titled titled “Management of acute coronary syndrome (ACS) in the older adult population,” highlights normal aging and age-related changes in the heart and blood vessels, and also points out that older adults often have multiple medical conditions and medications.
With age, large arteries and the heart muscle become stiffer, and the heart may work harder but pump blood less efficiently. Many of the changes may increase risk for blood clots.
“Age-related changes in metabolism, weight and muscle mass may necessitate different choices in anti-clotting medications to lower bleeding risk,” the release said. Kidney function also declines with age.
One of the issues the authors highlight is that clinical practice guidelines are based on clinical trial research, but older adults are often not included in trials “because their health care needs are more complex when compared to younger patients,” said Abdulla A. Damluji, chair of the scientific statement writing committee and an associate professor of medicine at Johns Hopkins School of Medicine in Baltimore, in the press release.
“Older patients have more pronounced anatomical changes and more severe functional impairment, and they are more likely to have additional health conditions not related to heart disease,” said Damluji. “These include frailty, other chronic disorders (treated with multiple medications), physical dysfunction, cognitive decline and/or urinary incontinence – and these are not regularly studied in the context of ACS.”
The authors emphasize the need to look beyond the clinical outcomes for older adults, like bleeding, stroke and heart attack, and to also focus on quality of life and the ability to live independently and/or return to their previous lifestyle or living environment.
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