title: Unanswered clinical questions in the management of cardiometabolic risk in the elderly: a statement of the Spanish Society of Internal Medicine.
abstract: BACKGROUND
  Despite the progressive increase in life expectancy and the relationship between aging with multi-morbidities and the increased use of healthcare resources, current clinical practice guidelines (CPG) on cardiometabolic risk cannot be adequately applied to elderly subjects with multiple chronic conditions. Its management frequently becomes complicated by both, an excessive use of medications that may lead to overtreatment, drug interactions and increased toxicity, and errors in dosage and non-compliance. Concerned by this gap, the Spanish Society of Internal Medicine created a group of independent experts on cardiometabolic risk who discussed what they considered to be unanswered questions in the management of elderly patients.
  
  
  CONCLUSIONS
  Current guidelines do not specifically address the problem of elderly with multiple chronic conditions. For this reason, the combined use of the limited available evidence, clinical experience and common sense, could all help us to address this unmet need. In very old people, life expectancy and functionality are the most important factors for guiding potential treatments. Their higher propensity to develop serious adverse events and their shorter lifespan could prevent them from obtaining the potential benefits of the interventions administered.
  
  
  CONCLUSIONS
  In this document, experts on cardiometabolic risk factors have established a number of consensual recommendations that have taken into account international guidelines and clinical experience, and have also considered the more effective use of healthcare resources. This document is intended to provide general recommendations for clinicians and to promote the effective use of procedures and medications.
authors.affiliation: Hospital Regional Universitario, IBIMA, Málaga, Spain. ricardogomezhuelgas@hotmail.com.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gómez-Huelgas
authors.forename: Vicente
authors.initials: V
authors.lastname: Giner-Galvañ
authors.forename: José M
authors.initials: JM
authors.lastname: Mostaza
authors.forename: José I
authors.initials: JI
authors.lastname: Cuende
authors.forename: Jose M
authors.initials: JM
authors.lastname: de Miguel-Yanes
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rovira
authors.forename: Demetrio
authors.initials: D
authors.lastname: Sánchez-Fuentes
authors.forename: Carmen
authors.initials: C
authors.lastname: Suárez Fernández
authors.forename: Pilar
authors.initials: P
authors.lastname: Román Sánchez
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D048909:Diabetes Complications / Q000628:therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy; D008659:Metabolic Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D015596:Nutrition Assessment; D009765:Obesity / Q000150:complications / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011322:Primary Prevention; D012307:Risk Factors; D055502:Secondary Prevention; D013030:Spain / Q000453:epidemiology
chemical_list: D000925:Anticoagulants; D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors