Clin-STAR corner: Practice changing advances in cardiology

J Am Geriatr Soc. 2023 Apr;71(4):1021-1027. doi: 10.1111/jgs.18201. Epub 2022 Dec 16.

Abstract

Although cardiovascular disease is the leading cause of death and major disability in older adults, older patients have been consistently under-represented in most cardiovascular clinical trials. This article summarizes the results of four trials published from 2020 to 2022 with practice-changing implications directly applicable to the care of older adults. The key findings from these trials were that: (1) an initial conservative approach to managing selected patients with stable ischemic heart disease is reasonable, even in the setting of moderate or severe ischemia; (2) empagliflozin is effective in reducing heart failure hospitalizations in patients with heart failure and preserved ejection fraction, with or without diabetes; (3) an individually tailored physical rehabilitation program reduces deconditioning and functional decline in older patients hospitalized with heart failure; and (4) restricting dietary sodium intake to less than 1500 mg/day is unlikely to improve outcomes in most patients with heart failure.

Keywords: cardiology; heart failure; ischemic heart disease; rehabilitation; sodium-glucose cotransporter-2 (SGLT2) inhibitors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Cardiology*
  • Cardiovascular Diseases* / drug therapy
  • Diabetes Mellitus, Type 2* / drug therapy
  • Heart Failure*
  • Humans
  • Sodium-Glucose Transporter 2 Inhibitors* / adverse effects

Substances

  • Sodium-Glucose Transporter 2 Inhibitors