Use of invasive heart procedures decreases after the age of 75

ATLANTA Duke University Medical Center cardiologists have found that the use of invasive procedures used to clear clogged heart vessels declines as the age of patients increases, with the decrease especially noticeable after the age of 75.

Although the reasons for this decline are unclear, the researchers believe that -- based on their analysis of large clinical trials and their survey of patient preferences -- the key might lie in the complex interaction between patients and their physicians when treatment options are being discussed.

In two poster presentations at the 51st annual scientific sessions of the American College of Cardiology, Duke cardiologist Karen Alexander, M.D., sheds new light on this phenomenon affecting an ever-growing population.

"As the population ages, we are seeing more and more elderly people with symptoms of heart disease, and these patients are safely receiving such invasive procedures as bypass surgery and angioplasty," Alexander said. "Interestingly, the usage of these procedures declines markedly at the age of 75. We don't know why, or whether it is necessarily right or wrong, but the trend is there, clear and strong."

Alexander hopes that the decline is not due to ageism, in which physicians might not want to consider invasive procedures, basing their recommendations solely on a patient's age. One problem physicians face when explaining procedures or new therapies to the elderly is insufficient clinical data, since only 2 percent of all clinical trials enroll patients over the age of 75.

"There is very little data out there for physicians to use when discussing possible procedures with their elderly patients," Alexander said. "Ideally physicians should be able to discuss the potential risks and benefits of any procedure regardless of age, and the elderly patients should be able to fully understand their options."

Alexander first pooled and analy

Contact: Richard Merritt
Duke University Medical Center

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