دانلود کتاب بیماریهای قلبی عروقی در سالمندان

In 2010, the first of the baby boomers turned 65 years old, and we are now in the midst of an explosive growth in the older adult population in the United States, from 49 million in 2016 to approximately 73 million by 2030, with a further increase to 86 million by 2050.1 Moreover, the most rapid growth will occur in the subgroup 85 years of age or older—from 6.4 million in 2016 to 9.0 million in 2030 and 18.6 million by 2050, an almost threefold rise. Similar demographic shifts are occurring in many countries around the world. Accompanying this graying of the population is a dramatic rise in the number of older persons with cardiovascular disorders, including hypertension, coronary artery disease, valvular heart disease, heart failure, and cardiac rhythm disturbances. Since persons over age 65 already account for more than 80% of all deaths attributable to cardiovascular disease, it is essential for all clinicians involved in the care of older adults—not just primary care physicians, geriatricians, and cardiologists, but also surgeons, anesthesiologists, other medical subspecialists, and nurse practitioners—to have a basic understanding of the effects of aging on cardiovascular structure and function, as well as the impact of aging and prevalent comorbid conditions on the clinical presentation, diagnosis, and response to therapy in older adults with cardiovascular disease. As with prior editions, the primary objective of the present volume is to provide an up-to-date and in-depth, yet clinically relevant and readable overview of the epidemiology, pathophysiology, evaluation, and treatment of cardiovascular disorders in older adults. To the extent possible, clinical recommendations are evidence based, but it is also acknowledged that existing data are often quite limited or nonexistent in the very elderly (persons 85 years of age or older), and especially in older adults with multiple coexisting conditions and/or frailty. Thus, careful consideration of each patient’s unique clinical and psychosocial circumstances, medical and nonmedical needs, and personal preferences is required in designing an individualized care plan. Indeed, it is perhaps in the compassionate management of these challenging patients where the “art” of medicine most clearly flourishes. This edition appears 4 years after the fifth edition, which was published in 2014. During the intervening period, an extensive body of new research relevant to the diagnosis and treatment of cardiovascular disorders in older adults has been reported. In addition to an expanding literature derived from population-based observational studies, an increasing number of clinical trials focusing on older adults have been undertaken, practice guidelines are increasingly providing explicit commentary on the diagnosis and management of older adults, and both the American College of Cardiology and the American Heart Association have established sections focusing on issues relevant to older adults with cardiovascular disease. With the sixth edition of this work, we have added a new chapter entitled “General Principles on Caring for Older Adults,” which subsumes and expands the chapter on disability and frailty from the fifth edition. We also expanded the chapter on heart failure to two chapters addressing “Heart Failure with Reduced Ejection Fraction in Older Adults” and “Heart Failure with Preserved Ejection Fraction in Older Adults” in recognition of the importance of the latter form of heart failure in older patients. In addition, all chapters have been thoroughly revised and updated by recognized experts to incorporate the most recent knowledge in the field. We would like to thank all of the contributors for their outstanding work. We also wish to express our gratitude to Ben O’Hara, Shivangi Pramanik, and Mouli Sharma at Taylor & Francis Group for their dedication and support in bringing this sixth edition to fruition. Finally, we want to thank you, the reader, for your commitment to providing the best possible care for your older patients with cardiovascular disease. We hope you will find this volume to be a valuable resource as you strive to help your older patients enjoy both longer and fuller lives. We welcome any comments you may have.