Cardiovascular Institute of San Antonio

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Heart Disease and the Elderly

This information has been provided by Dr William Wu, the President & CEO of Central Cardiovascular Institute of San Antonio (CCISA).

Americans are living longer, healthier, and happier lives then ever before. This can be attributed to a number of reasons such as improvements in environmental and social living conditions, control of infections diseases, revolutionary pharmaceuticals and technological advances in medicine. However, the most important factor in your health is YOU, because what YOU know and what YOU do can make a difference in not only how long you live, but the quality of life that you have, particularly as you age.

In the United States, cardiovascular (heart and blood vessels) diseases are the most common cause of death overall. According to the American Heart Association, 83% of cardiovascular deaths occur in persons over age 65. In fact, deaths from cardiovascular disease increase 79% in people aged 55 to 65 compared to people aged 45 to 54. Women generally develop coronary heart disease approximately 10 later than men (age > 55 men, while age >65 for women). Because of this age disparity, women who develop heart attacks at older ages are also more likely to die from them. Stroke is a leading cause of death and severe disability in the elderly, with 88% of all stroke deaths occurring in persons 65 years of age or older. The risk of other major cardiovascular diseases, such as hypertension (high blood pressure), peripheral arterial disease, arrhythmias (irregular heart beats), and heart failure (weakness of stiffness of the heart muscle) also increase as we age. Let's review some of the major modifiable risk factors for cardiovascular disease, as well as their complications, and treatments.

1. Diabetes Mellitus: Diabetes is the Number 1 risk for cardiovascular diseases. If diabetes is left untreated, it can result in serious complications affecting the eyes and kidneys, hypertension, cerebrovascular disease (leading to stroke), coronary artery disease (leading to heart attack), and peripheral arterial disease (leading to amputation). Treatment involves taking medications and checking the blood glucoses regularly, a strict diabetic diet, and exercise.

2. Tobacco Use: Use of tobacco can lead to cardiovascular diseases such as blood clots, hypertension, hypertension, cerebrovascular disease (leading to stroke), coronary artery disease (leading to heart attack), peripheral arterial disease (leading to amputation), and aneurysms. The only way to avoid the complication associated with nicotine is to quit.

3. Hypertension is defined as a blood pressure greater than 140/90. Pre-hypertension is a blood pressure of 120-139/80-89. If you have pre-hypertension, you are likely to develop high blood pressure at some point. Complications of hypertension include kidney failure, heart failure (cardiomyopathy), arrhythmias, cerebrovascular disease (leading to stroke), coronary artery disease (leading to heart attack), and sudden cardiac death. Treatment for hypertensdion includes medications, exercise, diet, and weight reduction.

4. Dyslipidemia is an abnormally amount of fatty substances in the blood. The accepted ranges the total cholesterol should be under 200 mg/dL. A value over 200 mg/dL may indicate a greater risk for heart disease. However, LDL levels are a better predictor of heart disease and determine how your high cholesterol should be treated. How you are treated also depends on whether you have any of these additional risk factors for heart disease. Treatment includes a diet high in whole grains, fruit and veggies, exercise, and medications. Even if your cholesterol is normal, you may have been prescribed a specific kind of medication for cholesterol (called a statin) because these medications reduce the risk of adverse events such as heart attack and stroke.

5. Sleep Apnea is an abnormal breathing pattern where the individual stops breathing at frequent intervals in the night. Symptoms include snoring at night, daytime sleepiness, fatigue, and decreased attention span. Sleep apnea leads to early heart disease. A sleep study can confirm the diagnosis, and treatment involves weight loss, cessation of tobacco use, avoiding alcohol or sedative medications, and either a mouthpiece to adjust the jaw at night, an assistive mechanical breathing device known as a CPAP, or surgery.

6. Sedentary Lifestyles & Obesity decrease overall heath and fitness. The benefits of exercise are enormous, contributing to health by reducing the heart rate, decreasing the risk for cardiovascular disease, and reducing the amount of bone loss that is associated with age and osteoporosis. Physical activity also helps the body use calories more efficiently, thereby helping in weight loss and maintenance. It can increase basal metabolic rate, reduces appetite, and helps in the reduction of body fat. Modest low-impact exercise is best for seniors. Exercise should be performed 30 minutes 3-5 times a week.

Even if you have no risk factors or your risk factors are managed well, you may still have a heart attack. Many people think that heart attacks only happen suddenly, but the truth is that most start slow and may occur over a period of days. Even if you have had a heart attack in the past you could experience an entirely different set of symptoms the second time. That is why it is important to recognize the warning signs, which include:

Some people experience the "classic" chest pain syndrome associated with a heart attack. However, women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, increasing fatigue, abdominal pain, nausea/vomiting, and/or back or jaw pain. Other people, particularly those with diabetes, may have no symptoms at all, or only a general feeling of malaise. It is important to listen to your body because you may experience only one or several of these symptoms or none at all. If you are experiencing any type of discomfort then you should follow-up with your physician immediately, or call 9-1-1 for severe symptoms. Acting in time can often prevent disability and death from a heart attack.

This information has been provided by Dr William Wu, the President & CEO of Central Cardiovascular Institute of San Antonio (CCISA). Dr. Wu is primarily located in the Heart Plaza One near Crossroads mall at the intersection of IH- 10 and Loop 410. If you are experiencing any symptoms and would like to consult with a board certified cardiovascular specialist, please call us to schedule an appointment at 210-271-3203. CCISA has 15 Cardiologists of various specialties, and seven locations strategically placed around San Antonio for your convenience. Our goal is to meet your needs and exceed your expectations.