CVD – a major health concern among elderly……….

Bhopal: Divisional Railway Hospital based at Bhopal held a day long Cardiac Awareness-cum Health Check-up camp on wednesday for the retired railway employees and aged patients in Bhopal to educate them about cardiac friendly lifestyle and provide them with necessary medications.
While interacting with the patients, Executive Member Academy of Cardiovascular Sciences – Dr. Naresh Purohit stated that cardiovascular disease (CVD) is a major health concern among elderly individuals, particularly those residing in nursing homes or assisted living facilities.
“The aging process, combined with the high prevalence of comorbidities in this population, significantly increases the risk of developing CVD. Managing these conditions in elderly home-aged patients requires a comprehensive, multidisciplinary approach tailored to their unique needs and vulnerabilities. The most common forms of cardiovascular disease in the elderly include coronary artery disease (CAD), heart failure, arrhythmias, hypertension, peripheral arterial disease (PAD) and valvular heart disease,” renowned physician Dr Purohit said.

“These conditions are often driven by a combination of non-modifiable risk factors, such as age and genetic predisposition and modifiable factors, including smoking, obesity, physical inactivity, hypertension, diabetes and high cholesterol levels.”
He elaborated that the aging process itself contributes to cardiovascular risk through structural and functional changes in the heart and blood vessels.
“For example, arterial stiffness and endothelial dysfunction increase with age, promoting atherosclerosis and hypertension. In addition, the presence of comorbid conditions such as chronic kidney disease or diabetes exacerbates the burden of cardiovascular disease in this population,” he said.                   “Caring for elderly home-aged patients with cardiovascular disease presents unique challenges. One significant issue is poly pharmacy, as these individuals often require multiple medications to manage not only CVD but also other chronic conditions. This increases the risk of drug interactions, side effects, and medication non-adherence. Furthermore, frailty, characterized by reduced physiological reserves and increased vulnerability to stressors, complicates disease management and heightens the risk of adverse outcomes”, he said.

“Elderly patients often present with atypical symptoms of CVD. “For instance, instead of experiencing classic chest pain during a myocardial infarction, they may report fatigue, confusion, or shortness of breath. Cognitive impairment, common in nursing home residents, further complicates diagnosis and treatment by limiting the patient’s ability to communicate symptoms or adhere to prescribed therapies,” he added.

He averred that effective management of cardiovascular disease in elderly home-aged patients requires a holistic and patient-centred approach. “Lifestyle modifications, such as a heart-healthy diet, moderate physical activity, and smoking cessation, should be encouraged within the patient’s physical and cognitive capabilities. Pharmacological treatment is often essential for controlling blood pressure, cholesterol, and blood glucose levels,” Dr Purohit said, adding that “Anti hypertensives, statins and anticoagulants are commonly prescribed, but their use must be carefully monitored to minimize side effects. For patients with heart failure, medications such as diuretics and beta-blockers can improve symptoms and quality of life. Regular monitoring is crucial for early detection of disease progression or complications. ”

He pointed that blood pressure, cholesterol levels, and symptoms such as edema or breathlessness should be routinely evaluated. Additionally, vaccinations against influenza and pneumococcal infections are recommended to prevent illnesses that can exacerbate CVD.

*Dr. Naresh Purohit-MD, DNB, DIH, MHA, MRCP(UK), is an Epidemiologist, Advisor-National Communicable Disease Control Program of Govt. of India, Madhya Pradesh and several state organizations.). He is  Chief Advisor  to Hospitals Association  of India.

Dr.  Purohit is also Principal Investigator for the Association of Studies For Kidney Care.