Blood pressure, lipids, glucose and vascular ageing.
Heart & Metabolic
Guidelines have shifted twice in a decade, and the right number for an older adult depends on more than age. What matters is frailty, standing blood pressure and how many other drugs are in the box.
Heart & Metabolic
Cardiorespiratory fitness declines about 10 per cent a decade, and accelerates after 70. It is also among the strongest predictors of mortality ever measured — and one of the more responsive to training.
Heart & Metabolic
For secondary prevention the case remains good at any age. For primary prevention in the over-75s, the trials that would answer the question have mostly not been done.
Heart & Metabolic
Tight glucose control prevents complications that take fifteen years to develop, and causes hypoglycaemia this week. In an eighty-year-old, that trade runs the wrong way.
Heart & Metabolic
The commonest sustained arrhythmia becomes markedly more common with age, and the decision that follows it is one of the most consistently mishandled in medicine — usually in the direction of undertreatment.
Heart & Metabolic
Total cholesterol is close to useless on its own, HDL is not simply the good one, and there is a measurement that outperforms all of them which most laboratories still do not report by default.
Heart & Metabolic
Breathlessness on the stairs, swollen ankles and needing an extra pillow are the three commonest presentations, and all three are routinely attributed to age. Half of cases involve a heart that pumps normally.
Heart & Metabolic
Cramping calf pain that starts after a predictable distance and stops within minutes of resting is claudication, and it signals atherosclerosis affecting more than the legs.
Heart & Metabolic
Hypothyroidism presents as fatigue and slowing that is attributed to ageing. Hyperthyroidism in older adults can present with none of the classic features at all — just weight loss and atrial fibrillation.
Heart & Metabolic
Consumer devices measure some things well, some things badly, and several things they should not be reporting at all. Knowing which is which makes them genuinely useful.
Heart & Metabolic
A drop in blood pressure on standing affects a large minority of older adults, causes falls and fainting, and is missed because blood pressure is almost always measured sitting down.
Heart & Metabolic
A falling eGFR alarms a great many people who have nothing seriously wrong, while the test that better predicts trouble is frequently not done at all.
