title: [Recent aspects of cardiologic therapy in advanced age].
abstract: The aging heart differs in several aspects from the heart in younger people: Cardiac muscle mass, systolic and diastolic wall stress increase, the velocity of electrical conduction decreases in different anatomical structures. Supraventricular and ventricular arrhythmias appear more frequently than in younger people. Heart rate and cardiac index tend to diminish, especially under work load. Work capacity is reduced. In the treatment of coronary heart disease drugs are preferred which lead to a reduction of preload. Nitrates and molsidomine are followed by calcium channel blockers and--afterwards--by beta-blockers. Bypass surgery is performed in elderly patients more often for therapeutical than for prognostic reasons, similarly in the case of valvular surgery. Typical tachyarrhythmias are treated only in case of hemodynamic relevance, whereas pacemaker therapy is not limited by greater age. The choice of the most suitable pacemaker model, however, has to be based upon the overall circumstances in each individual case. For the treatment of congestive heart failure, vasodilators, especially angiotensin-converting enzyme inhibitors, seem to be superior, in elderly patients, to diuretics and digitalis glycosides.
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000188:drug therapy; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000188:drug therapy; D006331:Heart Diseases / Q000188:drug therapy*; D006333:Heart Failure / Q000188:drug therapy; D006349:Heart Valve Diseases / Q000188:drug therapy; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy; D011379:Prognosis
chemical_list: D000889:Anti-Arrhythmia Agents; D002316:Cardiotonic Agents
vernacular_title: Neuere Aspekte der kardiologischen Therapie im höheren Lebensalter.