Skip to main content
SpringerLink
Log in

Cardiovascular and Peripheral Arterial Diseases

  • Chapter
Fundamentals of Geriatric Medicine

  • 1997 Accesses

Abstract

Upon completion of the chapter, the student will be able to:

  1. 1.

    Describe the age-related physiologic changes in the cardiovascular system.

  2. 2.

    Explain and identify clinical features of cardiovascular and peripheral vascular diseases in the older adult.

  3. 3.

    Recognize and be familiar with a variety of testing modalities used in the workup of cardiovascular and peripheral vascular diseases.

  4. 4.

    Identify and describe the treatments for cardiovascular and peripheral arterial diseases.

Material in this chapter is based on the following chapters in Cassel CK, Leipzig RM, Cohen HJ, Larson EB, Meier DE, eds. Geriatric Medicine: An Evidence-Based Approach, 4th ed. New York: Springer, 2003: Wenger NK. Cardiovascular Disease, pp. 509–543. Hiatt WR, Nehler MR, Peripheral Arterial Disease, pp. 561–571. Selections edited by Anna U. Loengard.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Suggested Readings

  • Hiatt WR, Nehler MR. Peripheral arterial disease. In: Cassel CK, Leipzig RM, Cohen HJ, et al., eds. Geriatric Medicine, 4th ed. New York: Springer, 2003:561–571.

    Google Scholar 

  • Wenger NK. Cardiovascular disease. In: Cassel CK, Leipzig RM, Cohen HJ, et al., eds. Geriatric Medicine, 4th ed. New York: Springer, 2003:509–543.

    Google Scholar 

References

  1. National Center for Health Statistics. Advance report of final mortality statistics, 1988. Monthly Vital Statistics Report, vol 39, No. 7 suppl. Hyattsville, MD: Public Health Service, 1990:p 1–48.

    Google Scholar 

  2. Mittelmark MB, Psaty BM, Rautaharju PM, et al. Prevalence of cardiovascular diseases among older adults: the Cardiovascular Health Study. Am J Epidemiol 1993;137:311–317.

    PubMed  CAS  Google Scholar 

  3. Sollott SJ, Lakatta EG. Normal aging changes in the cardiovascular system. Cardiol Elderly 1993;1:349–358.

    Google Scholar 

  4. Lindroos M, Kupari M, Heikkilä J, et al. Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample. J Am Coll Cardiol 1993;21:1220–1225.

    PubMed  CAS  Google Scholar 

  5. Ooi WL, Barrett S, Hossain M, et al. Patterns of orthostatic blood pressure change an their clinical correlates in a frail, elderly population. JAMA 1997;277:1299–1304.

    Article  PubMed  CAS  Google Scholar 

  6. Newman AB, Siscovick DS, Manolio TA, et al., for the Cardiovascular Health Study (CHS) Collaborative Research Group. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Circulation 1993;88:837–845.

    PubMed  CAS  Google Scholar 

  7. Ingerslev J, Bjerregaard P. Prevalence and prognostic significance of cardiac arrhythmias detected by ambulatory electrocardiography in subjects 85 years of age. Eur Heart J 1986;7:570–575.

    PubMed  CAS  Google Scholar 

  8. Iskandrian AS, Heo J, Decoskey D, et al. Use of exercise thallium-201 imaging for risk stratification of elderly patients with coronary artery disease. Am J Cardiol 1988;61:269–272.

    Article  PubMed  CAS  Google Scholar 

  9. Hilton TC, Shaw LJ, Chaitman BR, et al. Prognostic significance of exercise thallium-201 testing in patients aged ≥70 years with known or suspected coronary artery disease. Am J Cardiol 1992;69:45–50.

    Article  PubMed  CAS  Google Scholar 

  10. Lam JYT, Chaitman BR, Glaenzer M. Safety and diagnostic accuracy in dipyridamole-thallium imaging in the elderly. J Am Coll Cardiol 1988;11:585–589.

    PubMed  CAS  Google Scholar 

  11. Smith WM. Epidemiology of congestive heart failure. Am J Cardiol 1985;55:3A–8A.

    Article  PubMed  CAS  Google Scholar 

  12. McKee PA, Castelli WP, McNamara PM, et al. The natural history of congestive heart failure: the Framingham Study. N Engl J Med 1971;285:1441–1446.

    PubMed  CAS  Google Scholar 

  13. Moser M, Hebert PR. Prevention of disease progression, left ventricular hypertrophy and congestive heart failure in hypertension treatment trials. J Am Coll Cardiol 1996;27:1214–1218.

    Article  PubMed  CAS  Google Scholar 

  14. Konstam MA, Dracup K, Baker D, et al. Heart failure: evaluation and care of patients with left-ventricular systolic dysfunction. Clinical Practice Guideline No. 11. AHCPR Publication No. 94-0612. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, June 1994.

    Google Scholar 

  15. Wong WF, Gold S, Fukuyama O, et al. Diastolic dysfunction in elderly patients with congestive heart failure. Am J Cardiol 1989;63:1526–1528.

    Article  PubMed  CAS  Google Scholar 

  16. The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987;316:1429–1435.

    Google Scholar 

  17. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991;325:293–302.

    Google Scholar 

  18. Cohn JN, Johnson G, Ziesche S, et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med 1991;325:303–310.

    PubMed  CAS  Google Scholar 

  19. Chapman D, Wang T, Gheorghiade M. Therapeutic approaches to heart failure in elderly patients. Cardiol Elderly 1994;2:89–97.

    Google Scholar 

  20. De Bock V, Mets T, Romagnoli M, et al. Captopril treatment of chronic heart failure in the very old. J Gerontol 1994;49:M148–152.

    PubMed  Google Scholar 

  21. Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 1996;334:1349–1355.

    Article  PubMed  CAS  Google Scholar 

  22. CIBIS-II Investigators and Committees. The Cardiac Insufficiency Bisoprolol Study II (CIBIS II): a randomized trial. Lancet 1999;353:9–13.

    Article  Google Scholar 

  23. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 1999;353:2001–2007.

    Article  Google Scholar 

  24. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999;341:709–717.

    Article  PubMed  CAS  Google Scholar 

  25. Packer M, Gheorghiade M, Young JB, et al. Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-convertingenzyme inhibitors. RADIANCE Study. N Engl J Med 1993;329:1–7.

    Article  PubMed  CAS  Google Scholar 

  26. The Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med 1997;336:525–533.

    Article  Google Scholar 

  27. Rich MW, Beckham V, Wittenberg C, et al. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med 1995;333:1190–1195.

    Article  PubMed  CAS  Google Scholar 

  28. Rich MW, Gray DB, Beckham V, et al. Effect of a multidisciplinary intervention on medication compliance in elderly patients with congestive heart failure. Am J Med 1996;101:270–276.

    Article  PubMed  CAS  Google Scholar 

  29. Kornowski R, Zeeli D, Averbuch M, et al. Intensive home-care surveillance prevents hospitalization and improves morbidity rates among elderly patients with severe congestive heart failure. Am Heart J 1995;129:762–766.

    Article  PubMed  CAS  Google Scholar 

  30. Lipsitz LA, Wei JY, Rowe JW. Syncope in an elderly, institutionalized population: prevalence, incidence, and associated risk. Q J Med 1985;55:45–54.

    PubMed  CAS  Google Scholar 

  31. Gordon M, Huang M, Gryfe CI. An evaluation of falls, syncope, and dizziness in prolonged ambulatory cardiographic monitoring in a geriatric institutional setting. J Am Geriatr Soc 1982;30:6–12.

    PubMed  CAS  Google Scholar 

  32. Ryder KM, Benjamin EJ. Epidemiology and significance of atrial fibrillation. Am J Cardiol 1999;84:131R–138R.

    Article  PubMed  CAS  Google Scholar 

  33. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation: a major contributor to stroke in the elderly. Arch Intern Med 1987;147:1561–1564.

    Article  PubMed  CAS  Google Scholar 

  34. Furberg CD, Psaty BM, Manolio TA, et al., for the Cardiovascular Health Study (CHS) Collaborative Research Group. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol 1994;74: 236–241.

    Article  PubMed  CAS  Google Scholar 

  35. Stroke Prevention in Atrial Fibrillation Investigators. Stroke prevention in atrial fibrillation study: final results. Circulation 1991;84:527–539.

    Google Scholar 

  36. Zado ES, Callans DJ, Gottlieb CD, et al. Efficacy and safety of catheter ablation in octogenarians. J Am Coll Cardiol 2000;35:458–462.

    Article  PubMed  CAS  Google Scholar 

  37. Shen W-K, Hayes DL, Hammill SC, et al. Survival and functional independence after implantation of a permanent pacemaker in octogenarians and nonagenarians. A population-based study. Ann Intern Med 1996;125: 476–480.

    PubMed  CAS  Google Scholar 

  38. Panotopoulos PT, Axtell K, Anderson AJ, et al. Efficacy of the implantable cardioverter-defibrillator in the elderly. J Am Coll Cardiol 1997;29: 556–560.

    Article  PubMed  CAS  Google Scholar 

  39. Wenger NK, Furberg CD, Pitt E. Coronary Heart Disease in the Elderly. Working Conference on the Recognition and Management of Coronary Heart Disease in the Elderly, National Institutes of Health, Bethesda 1985. New York: Elsevier Science, 1986.

    Google Scholar 

  40. Marcus FI, Friday K, McCans J, et al. Age-related prognosis after acute myocardial infarction (the Multicenter Diltiazem Postinfarction trial). Am J Cardiol 1990;65:559–566.

    Article  PubMed  CAS  Google Scholar 

  41. Vaccarino V, Parsons L, Every NR, et al., for the National Registry of Myocardial Infarction 2 Participants. Sex-based differences in early mortality after myocardial infarction. N Engl J Med 1999;341:217–225.

    Article  PubMed  CAS  Google Scholar 

  42. Nadelmann J, Frishman WH, Ooi WL, et al. Prevalence, incidence and prognosis of recognized and unrecognized myocardial infarction in persons aged 75 years or older: The Bronx Aging Study. Am J Cardiol 1990;66: 533–537.

    Article  PubMed  CAS  Google Scholar 

  43. Solomon CG, Lee TH, Cook EF, et al., for the Chest Pain Study Group. Comparison of clinical presentation of acute myocardial infarction in patients older than 65 years of age to younger patients: the Multicenter Chest Pain Study experience. Am J Cardiol 1989;63:772–776.

    Article  PubMed  CAS  Google Scholar 

  44. Forman DE, Bernal JLG, Wei JY. Management of acute myocardial infarction in the very elderly. Am J Med 1992;93:315–326.

    Article  PubMed  CAS  Google Scholar 

  45. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet 1988;2:349–360.

    Google Scholar 

  46. The First International Study of Infarct Survival (ISIS-I) Collaborative Group. Randomised trial of intravenous atenolol among 16,027 cases of suspected acute myocardial infarction. Lancet 1986;2:57–66.

    Google Scholar 

  47. Hjalmarson A, Elmfeldt D, Herlitz J, et al. Effect on mortality of metoprolol in acute myocardial infarction: A double-blind randomise trial. Lancet 1981; 2:823–827.

    Article  PubMed  CAS  Google Scholar 

  48. The MIAMI Trial Research Group. Metoprolol in acute myocardial infarction (MIAMI): a randomised placebo-controlled international trial. Eur Heart J 1985;6:199–226.

    Google Scholar 

  49. The International Collaborative Study Group. Reduction of infarct size with the early use of timolol in acute myocardial infarction. N Engl J Med 1984; 310:9–15.

    Google Scholar 

  50. The TIMI Study Group. Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction: results of the Thrombolysis in Myocardial Infarction (TIMI) phase II trial. N Engl J Med 1989;320:618–627.

    Google Scholar 

  51. Held PH, Yusuf S, Furberg CD. Calcium channel blockers in acute myocardial infarction and unstable angina: an overview. BMJ 1989;299:1187–1192.

    PubMed  CAS  Google Scholar 

  52. Majumdar SR, Gurwitz JH, Soumerai SB. Undertreatment of hyperlipidemia in the secondary prevention of coronary artery disease. J Gen Intern Med 1999;14:711–717.

    Article  PubMed  CAS  Google Scholar 

  53. Ryan TJ, Anderson JL, Antman EM, et al. ACC/AHA guidelines for the management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol 1996;28:1328–1428.

    Article  PubMed  CAS  Google Scholar 

  54. Chaitman BR, Thompson B, Wittry MD, et al. The use of tissue-type plasminogen activator for acute myocardial infarction in the elderly: Results from Thrombolysis in Myocardial Infarction Phase I, open label studies, and the Thrombolysis in Myocardial Infarction Phase II pilot study. J Am Coll Cardiol 1989;14:1159–1165.

    Article  PubMed  CAS  Google Scholar 

  55. The International Study Group. In-hospital mortality and clinical course of 20,891 patients with suspected acute myocardial infarction randomised between alteplase and streptokinase with or without heparin. Lancet 1990; 336:71–75.

    Article  Google Scholar 

  56. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico. GISSI-2: a factorial randomised trial of alteplase versus streptokinase and heparin versus no heparin among 12 490 patients with acute myocardial infarction. Lancet 1990;336:65–71.

    Google Scholar 

  57. Gore JM, Sloan M, Price TR, et al. Intracerebral hemorrhage, cerebral infarction, and subdural hematoma after acute myocardial infarction and thrombolytic therapy in the Thrombolysis in Myocardial Infarction Study: Thrombolysis in Myocardial Infarction, Phase II, pilot and clinical trial. Circulation 1991;83:448–459.

    PubMed  CAS  Google Scholar 

  58. Noyez L, van der Werf T, Remmen GHJ, et al. Importance of the internal mammary artery for coronary bypass grafting in patients aged ≥70 years. Am J Cardiol 1995;75:734–736.

    Article  PubMed  CAS  Google Scholar 

  59. Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery). J Am Coll Cardiol 1999;34:1262–1347.

    Article  PubMed  CAS  Google Scholar 

  60. World Health Organization Study Group. Epidemiology and prevention of cardiovascular diseases in elderly people. WHO Technical Report Series 853. Geneva: World Health Organization, 1995.

    Google Scholar 

  61. Tervahauta M, Pekkanen J, Nissinen A. Risk factors of coronary heart disease and total mortality among elderly men with and without preexisting coronary heart disease: The Finnish Cohorts of the Seven Countries Study. J Am Coll Cardiol 1995;26:1623–1629.

    Article  PubMed  CAS  Google Scholar 

  62. The Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Final Report of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation 2002;106(25):3143–3421.

    Google Scholar 

  63. Pacala JT, McBride PE, Grady SL, Management of older adults with hypercholesterolaemia. Drugs Aging 1994;4:366–378.

    PubMed  CAS  Google Scholar 

  64. Santinga JT, Rosman HS, Rubenfire M, et al. Efficacy and safety of pravastatin in the long-term treatment of elderly patients with hypercholesterolemia. Am J Med 1994;96:509–515.

    Article  PubMed  CAS  Google Scholar 

  65. Hulley SB, Newman TB. Cholesterol in the elderly: Is it important? JAMA 1994;272:1372–1374.

    Article  PubMed  CAS  Google Scholar 

  66. Scandinavian Simvastatin Survival Study group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994;344:1383–1389.

    Article  Google Scholar 

  67. LaCroix AZ, Lang J, Scherr P, et al. Smoking and mortality among older men and women in three communities. N Engl J Med 1991;324: 1619–1625.

    PubMed  CAS  Google Scholar 

  68. Hermanson B, Omenn GS, Kronmal RA, et al., and Participants in the Coronary Artery Surgery Study. Beneficial six-year outcome of smoking cessation in older men and women with coronary artery disease. Results from the CASS Registry. N Engl J Med 1988;319:1365–1369.

    PubMed  CAS  Google Scholar 

  69. Lavie CJ, Milani RV. Effects of cardiac rehabilitation programs on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in a large elderly cohort. Am J Cardiol 1995;76:177–179.

    Article  PubMed  CAS  Google Scholar 

  70. Hiatt WR, Hoag S, Hamman RF. Effect of diagnostic criteria on the prevalence of peripheral arterial disease. The San Luis Valley diabetes study. Circulation 1995;91:1472–1479.

    PubMed  CAS  Google Scholar 

  71. Criqui MH, Langer RD, Fronek A, et al. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med 1992;326: 381–386.

    PubMed  CAS  Google Scholar 

  72. Vogt MT, Cauley JA, Newman AB, Kuller LH, Hulley SB. Decreased ankle/arm blood pressure index and mortality in elderly women. JAMA 1993;270: 465–469.

    Article  PubMed  CAS  Google Scholar 

  73. Newman AB, Tyrrell KS, Kuller LH. Mortality over four years in SHEP participants with a low ankle-arm index. J Am Geriatr Soc 1997;45: 1472–1478.

    PubMed  CAS  Google Scholar 

  74. Leng GC, Fowkes FG, Lee AJ, et al. Use of ankle brachial pressure index to predict cardiovascular events and death: a cohort study. BMJ 1996;313: 1440–1444.

    PubMed  CAS  Google Scholar 

  75. Leng GC, Lee AJ, Fowkes FG, et al. Incidence, natural history and cardiovascular events in symptomatic and asymptomatic peripheral arterial disease in the general population. Int J Epidemiol 1996;25:1172–1181.

    Article  PubMed  CAS  Google Scholar 

  76. Murabito JM, D’Agostino RB, Silbershatz H, Wilson WF. Intermittent claudication. A risk profile from The Framingham Heart Study. Circulation 1997;96:44–49.

    PubMed  CAS  Google Scholar 

  77. Quick CRG, Cotton LT. The measured effect of stopping smoking on intermittent claudication. Br J Surg 1982;69(suppl):S24–S26.

    Article  PubMed  Google Scholar 

  78. Stewart CP. The influence of smoking on the level of lower limb amputation. Prosthet Orthot Int 1987;11:113–116.

    PubMed  CAS  Google Scholar 

  79. Malinow MR, Kang SS, Taylor LM, et al. Prevalence of hyperhomocyst(e)inemia in patients with peripheral arterial occlusive disease. Circulation 1989;79: 1180–1188.

    PubMed  CAS  Google Scholar 

  80. Carter SA. Clinical measurement of systolic pressures in limbs with arterial occlusive disease. JAMA 1969;207:1869–1874.

    Article  PubMed  CAS  Google Scholar 

  81. Hiatt WR, Hirsch AT, Regensteiner JG, Brass EP. Clinical trials for claudication. Assessment of exercise performance, functional status, and clinical end points. Vascular Clinical Trialists. Circulation 1995;92:614–621.

    PubMed  CAS  Google Scholar 

  82. Jonason T, Bergstrom R. Cessation of smoking in patients with intermittent claudication. Acta Med Scand 1987;221:253–260.

    PubMed  CAS  Google Scholar 

  83. Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustainedrelease bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 1999;340:685–691.

    Article  PubMed  CAS  Google Scholar 

  84. Joseph AM, Norman SM, Ferry LH, et al. The safety of transdermal nicotine as an aid to smoking cessation in patients with cardiac disease. N Engl J Med 1996;335:1792–1798.

    Article  PubMed  CAS  Google Scholar 

  85. Estacio RO, Jeffers BW, Hiatt WR, et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med 1998;338:645–652.

    Article  PubMed  CAS  Google Scholar 

  86. Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure; the JNC VII report. JAMA 2003:289(19):2560–2572.

    Article  PubMed  CAS  Google Scholar 

  87. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000;342:145–153.

    Article  Google Scholar 

  88. Antiplatelet Trialists’ Collaboration. Secondary prevention of vascular disease by prolonged antiplatelet treatment. Br Med J 1988;296:320–331.

    Article  Google Scholar 

  89. Collaborative overview of randomised trials of antiplatelet therapy-I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Antiplatelet Trialists’ Collaboration. BMJ 1994;308:81–106.

    Google Scholar 

  90. Collaborative overview of randomised trials of antiplatelet therapy-II: Maintenance of vascular graft or arterial patency by antiplatelet therapy. Antiplatelet Trialists’ Collaboration. BMJ 1994;308:159–168.

    Google Scholar 

  91. Kohda N, Tani T, Nakayama S, et al. Effect of cilostazol, a phosphodiesterase III inhibitor, on experimental thrombosis in the porcine carotid artery. Thromb Res 1999;96:261–268.

    Article  PubMed  CAS  Google Scholar 

  92. Igawa T, Tani T, Chijiwa T, et al. Potentiation of anti-platelet aggregating activity of cilostazol with vascular endothelial cells. Thromb Res 1990;57: 617–623.

    Article  PubMed  CAS  Google Scholar 

  93. Tsuchikane E, Fukuhara A, Kobayashi T, et al. Impact of cilostazol on restenosis after percutaneous coronary balloon angioplasty. Circulation 1999;100: 21–26.

    PubMed  CAS  Google Scholar 

  94. Beebe HG, Dawson DL, Cutler BS, et al. A new pharmacological treatment for intermittent claudication: results of a randomized, multicenter trial. Arch Intern Med 1999;159:2041–2050.

    Article  PubMed  CAS  Google Scholar 

  95. Money SR, Herd JA, Isaacsohn JL, et al. Effect of cilostazol on walking distances in patients with intermittent claudication caused by peripheral vascular disease. J Vasc Surg 1998;27:267–274.

    Article  PubMed  CAS  Google Scholar 

  96. Dawson DL, Cutler BS, Meissner MH, Strandness DEJ. Cilostazol has beneficial effects in treatment of intermittent claudication: results from a multicenter, randomized, prospective, double-blind trial. Circulation 1998;98: 678–686.

    PubMed  CAS  Google Scholar 

  97. Wilson SE, Wolf GL, Cross AP. Percutaneous transluminal angioplasty versus operation for peripheral arteriosclerosis. J Vasc Surg 1989;9:1–8.

    Article  PubMed  CAS  Google Scholar 

  98. Poulias GE, Doundoulakis N, Prombonas E, et al. Aorto-femoral bypass and determinants of early success and late favourable outcome. Experience with 1000 consecutive cases. J Cardiovasc Surg 1992;33:664–678.

    CAS  Google Scholar 

  99. Lorentzen JE, Nielsen OM, Arendrup H, et al. Vascular graft infection: an analysis of sixty-two graft infections in 2411 consecutively implanted synthetic vascular grafts. Surgery 1985;98:81–86.

    PubMed  CAS  Google Scholar 

  100. Veith FJ, Gupta SK, Ascer E, et al. Six-year prospective multicenter randomized comparison of autologous saphenous vein and expanded Polytetrafluorethylene grafts in infrainguinal arterial reconstructions. J Vasc Surg 1986;3: 104–114.

    Article  PubMed  CAS  Google Scholar 

  101. Dalman RL, Taylor LM. Basic data related to infrainguinal revascularization procedures. Ann Vasc Surg 1990;4:309–312.

    Article  PubMed  CAS  Google Scholar 

  102. Samson RH, Veith FJ, Janko GS, Gupta SK, Scher LA. A modified classification and approach to the management of infections involving peripheral arterial prosthetic grafts. J Vasc Surg 1988;8:147–153.

    Article  PubMed  CAS  Google Scholar 

  103. Nehler MR, Moneta GL, Edwards JM, et al. Surgery for chronic lower extremity ischemia in patients eighty or more years of age: Operative results and assessment of postoperative independence. J Vasc Surg 1993;18: 618–626.

    Article  PubMed  CAS  Google Scholar 

  104. Tripses D, Pollak EW. Risk factors in healing of below-knee amputation. Appraisal of 64 amputations in patients with vascular disease. Am J Surg 1981;141:718–720.

    Article  PubMed  CAS  Google Scholar 

  105. Rigdon EE, Monajjem N, Rhodes RS. Criteria for selective utilization of the intensive care unit following carotid endarterectomy. Ann Vasc Surg 1997;11:20–27.

    Article  PubMed  CAS  Google Scholar 

  106. Gregg RO. Bypass or amputation? Concomitant review of bypass arterial grafting and major amputations. Am J Surg 1985;149:397–402.

    Article  PubMed  CAS  Google Scholar 

  107. Rush DS, Huston CC, Bivins BA, Hyde GL. Operative and late mortality rates of above-knee and below-knee amputations. Am Surg 1981;47:36–39.

    PubMed  CAS  Google Scholar 

  108. Whitehouse FW, Jurgensen C, Block MA. The later life of the diabetic amputee: another look at the fate of the second leg. Diabetes 1968;17: 520–521.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY, 10029, USA

    Anna U. Loengard MD (Assistant Professor)

Authors
  1. Anna U. Loengard MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY, 10029, USA

    Rainier P. Soriano MD (Assistant Professor and Director of Medical Student Education), Helen M. Fernandez MD (Assistant Professor and Fellowship Director) & Rosanne M. Leipzig MD, PhD (Professor and Vice Chair of Education) (Assistant Professor and Director of Medical Student Education),  (Assistant Professor and Fellowship Director) &  (Professor and Vice Chair of Education)

  2. ABIM Foundation and American Board of Internal Medicine, Philadelphia, PA, 19106, USA

    Christine K. Cassel MD, MACP (President and CEO) (President and CEO)

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Loengard, A.U. (2007). Cardiovascular and Peripheral Arterial Diseases. In: Soriano, R.P., Fernandez, H.M., Cassel, C.K., Leipzig, R.M. (eds) Fundamentals of Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-32326-8_23

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-32326-8_23

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-32324-4

  • Online ISBN: 978-0-387-32326-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation