Cardiovascular Problems in the Elderly and Nursing Management

Öz

Cardiovascular diseases are the leading cause of premature death and morbidity in Turkey as well as in the world. Age is defined as the main risk factor for cardiovascular morbidity and mortality in developed countries. Many changes occur in both the cardiac and vascular systems with aging, and these changes pave the way for diseases. Therefore, cardiovascular diseases are increasing globally due to the aging of the population. Nurses constitute the largest healthcare discipline managing chronic diseases and risk factors globally. Nurses constitute the largest healthcare discipline managing chronic diseases and risk factors globally. Nurses, with their responsibilities, reduce the risk factors of cardiovascular system diseases, but also reduce hospitalizations, morbidity and mortality by complying with treatment guidelines and protocols. With the increasing number of elderly adults with cardiovascular system diseases and the positive effects of appropriate care on patient outcomes, the importance of nursing follow-up for these patients becomes evident. The aim of this review is to discuss nursing approaches to cardiovascular system diseases that are common in the elderly.

Anahtar Kelimeler

• Aged
• Cardiovascular Diseases
• Geriatric Nursing Care
• Nursing

Yaşlılarda Kardiyovasküler Sorunlar ve Hemşirelik Yönetimi

Öz

Kardiyovasküler hastalıklar dünyada olduğu gibi Türkiye’de de erken ölüm ve morbiditenin önde gelen nedenidir. Yaş ise gelişmiş ülkelerde kardiyovasküler morbidite ve mortalite için ana risk faktörü olarak tanımlanır. Yaşlanmayla birlikte hem kardiyak hem de vasküler sistemde birçok değişiklik olmakta ve bu değişiklikler hastalıklara zemin hazırlamaktadır. Dolayısıyla kardiyovasküler hastalıklar küresel olarak nüfusun yaşlanması nedeniyle artmaktadır. Hemşireler, küresel olarak kronik hastalıkları ve risk faktörlerini yöneten en büyük sağlık hizmeti disiplinini oluşturmaktadır. Hemşireler üstlendikleri sorumluluklarla kardiyovasküler sistem hastalıkları risk faktörlerini azaltmakla beraber, aynı zamanda tedavi kılavuzlarına ve protokollerine uyarak hastaneye yatışları, morbidite ve mortaliteyi azaltmaktadırlar. Kardiyovasküler sistem hastalığı olan yaşlı yetişkinlerin sayısının artması ve bu hastalarda uygun bakımın hasta sonuçlarına olumlu etkileri göz önüne alındığında bu hastaların hemşirelik takibinin önemi ortaya çıkmaktadır. Bu derlemenin amacı da yaşlılarda sık görülen kardiyovasküler sistem hastalıklarına yönelik hemşirelik yaklaşımlarını ele almaktır.

Anahtar Kelimeler

• Geriatri Hemşireliği
• Hemşirelik
• Kardiyovasküler Hastalıklar
• Yaşlı

Kaynakça

1. Abraham LN, Sibilitz KL, Berg SK, Tang LH, Risom SS, Lindschou J, et al. (2021). Exercise-based cardiac rehabilitation for adults after heart valve surgery. Cochrane Database Syst Rev, 5(5). doi: 10.1002/14651858.CD010876.pub3.
2. Ağar A. (2020). Yaşlılarda ortaya çıkan fizyolojik değişiklikler. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 3(3), 347-354. doi:10.38108/ouhcd.752133
3. Aluru JS, Barsouk A, Saginala K, Rawla P, Barsouk A. (2022). Valvular heart disease epidemiology. Medical Sciences, 10(2), 32. doi: 10.3390/medsci10020032.
4. An X, Zeng L, Shen L, Jiang Y. (2021). Influences of a hierarchical nursing model on rescue outcomes and nursing quality of patients with acute cerebral infarction. American Journal of Translational Research, 13(6), 6498-6506.
5. Avila FR, Torres-Guzman RA, Maita KC, Garcia JP, Haider CR, Ho OA et al. (2023). Perceived age as a mortality and comorbidity predictor: a systematic review. Aesthetic Plastic Surgery, 47(1),442-454. doi: 10.1007/s00266-022-02932-5
6. Benenson I, Waldron FA, Bradshaw MJ. (2020). Treating hypertension in older adults: Beyond the guidelines. Journal of the American Association of Nurse Practitioners, 32(3), 193-199. doi: 10.1097/JXX.0000000000000220
7. Chen MS, Lee RT, Garbern JC. (2022). Senescence mechanisms and targets in the heart. Cardiovascular Research, 118(5), 1173-1187. doi: 10.1093/cvr/cvab161
8. Cutugno CL. (2015). Atrial fibrillation: updated management guidelines and nursing implications. American Journal of Nursing, 115(5),26-38. doi: 10.1097/01.NAJ.0000465028.05223.39

9. Dai L. (2021). Effect of hierarchical nursing management in patients with hypertension complicated with cardiovascular and cerebrovascular risk factors. Computational and Mathematical Methods in Medicine, 2021, 1246566. doi: 10.1155/2021/1246566
10. Damluji AA, Forman DE, Wang TY, Chikwe J, Kunadian V, Rich MW, et al. (2023). Management of acute coronary syndrome in the older adult population: a scientific statement from the American Heart Association. Circulation, 147(3), e32-e62. doi: 10.1161/CIR.0000000000001112.
11. Gorodeski EZ, Goyal P, Hummel SL, Krishnaswami A, Goodlin SJ, Hart LL, et al. (2018). Domain management approach to heart failure in the geriatric patient: present and future. Journal of the American College of Cardiology, 71(17), 1921-1936. doi: 10.1016/j.jacc.2018.02.059
12. Hayman LL, Berra K, Fletcher BJ, Houston Miller N. (2015). The role of nurses in promoting cardiovascular health worldwide: the global cardiovascular nursing leadership forum. Journal of the American College of Cardiology, 66(7), 864-866. doi: 10.1016/j.jacc.2015.06.1319
13. Himmelfarb CRD, Commodore-Mensah Y, Hill MN. (2016). Expanding the role of nurses to improve hypertension care and control globally. Annals of Global Health, 82(2), 243-253. doi: 10.1016/j.aogh.2016.02.003
14. İltus F, Karadakovan A. (2017). Atriyal Fibrilasyon-İnme İlişkisi ve Hemşirelik Yaklaşımı. Journal of Cardiovascular Nursing, 8(17), 71-76. doi: 10.5543/khd.2017.02419
15. Jakovljevic DG. (2018). Physical activity and cardiovascular aging: Physiological and molecular insights. Experimental Gerontology, 109, 67-74. doi: 10.1016/j.exger.2017.05.016
16. Jepma P, Jorstad HT, Snaterse M, Ter Riet G, Kragten H, Lachman S, et al. (2020). Lifestyle modification in older versus younger patients with coronary artery disease. Heart, 106(14), 1066-1072. doi: 10.1136/heartjnl-2019-316056
17. Kalyoncu S, Kartın PT. (2021). Aktif yaşlanma ve hemşirelik bakımı. ERÜ Sağlık Bilimleri Fakültesi Dergisi, 8(1), 26-32.
18. Lee S. (2019). Comprehensive nursing management for valvular disease. Critical Care Nursing Clinics, 31(1), 31-38. doi:10.1016/j.cnc.2018.11.002
19. Madhavan MV, Gersh BJ, Alexander KP, Granger CB, Stone GW. (2018). Coronary artery disease in patients≥ 80 years of age. Journal of the American College of Cardiology, 71(18), 2015-2040. doi: 10.1016/j.jacc.2017.12.068
20. Meiner SE, Yeager, JJ. (2018). Gerontologic Nursing (6th ed.). [Adobe Acrobat Reader sürümü]. Erişim adresi: https://books.google.com.tr/books?hl=tr&lr=&id=uUxPAQAAQBAJ&oi=fnd&pg=PP1&dq=28.%09Meiner+SE,+Yeager,+JJ.+Gerontologic+Nursing:+E-Book.+6th+ed.+Maryland+Heights:+Elsevier+Health+Sciences%3BMosby%3B2018.&ots=uhksZuVgR1&sig=g-82Y2mYy6zuFKOpAL4qu1fsMYA&redir_esc=y#v=onepage&q&f=false
21. Ministrini S, Wenzl FA, Lüscher TF, Camici GG. (2024). Trajectories of cardiovascular ageing–from molecular mechanisms to clinical implementation. Cardiovascular Research, cvae178. doi: 10.1093/cvr/cvae178
22. Mujović N, Marinković M, Mihajlović M, Mujović N, Potpara TS. (2020). Risk factor modification for the primary and secondary prevention of atrial fibrillation. Part 2. Kardiologia Polska, 78(3), 192-202. doi: 10.33963/KP.15221
23. Oertel LB, Fogerty AE. (2017). Use of direct oral anticoagulants for stroke prevention in elderly patients with nonvalvular atrial fibrillation. J Am Assoc Nurse Pract, 29(9), 551-561. doi: 10.1002/2327-6924.12494
24. Oliver-McNeil S. (2019). Management of valvular heart disease in adults: implications for nurse practitioner practice. The Journal for Nurse Practitioners, 15(1), 65-72. doi:10.1016/j.nurpra.2018.08.029
25. Organisation for Economic Co-operation and Development (OECD). (2021). Main causes of mortality across OECD countries, 2019 (or latest year), in Health at a Glance 2021: OECD Indicators. https://www.oecd-ilibrary.org/social-issues-migration-health/main-causes-of-mortality-across-oecd-countries-2019-or-latest-year_55294860-en.
26. Orkaby AR, Onuma O, Qazi S, Gaziano JM, Driver JA. (2018). Preventing cardiovascular disease in older adults: One size does not fit all. Cleveland Clinic Journal of Medicine, 85, 55–64. doi: 10.3949/ccjm.85a.16119
27. Öztop KE, Aykaç V, Varım P. (2018). Yaşlılarda Kullanılması Uygun Olmayan İlaçlar: Priscus Listesi. Journal of Human Rhythm, 4(2), 104-110.
28. Ponikowski P, Anker SD, AlHabib KF, Cowie MR, Force TL, Hu S, et al. (2014). Heart failure: preventing disease and death worldwide. ESC heart failure, 1(1), 4-25. Doi:10.1002/ehf2.12005
29. Posadas-Collado G, Membrive-Jiménez MJ, Romero-Béjar JL, Gómez-Urquiza JL, Albendín-García L, Suleiman-Martos N, et al. (2022). Continuity of nursing care in patients with coronary artery disease: a systematic review. International Journal of Environmental Research and Public Health, 19(5), 3000. doi: 10.3390/ijerph19053000 Ramadhani FB, Liu Y, Jing X, Qing Y, Xiong H, Zhang F, et al. (2020). Comparing the association of cardiovascular nursing care with blood pressure and length of stay of in-patients with coronary artery disease in Wuhan, China. African Health Sciences, 20(4), 1716-24. doi: 10.4314/ahs.v20i4.23
30. Rich MW, Chyun DA, Skolnick AH, Alexander, KP, Forman, DE, Kitzman, DW, et al. (2016). Knowledge gaps in cardiovascular care of older adults: a scientific statement from the American Heart Association, American College of Cardiology, and American Geriatrics Society: executive summary. Journal of the American Geriatrics Society, 64(11), 2185-2192. doi: 10.1016/j.jacc.2016.03.004
31. Riley JP, Astin F, Crespo‐Leiro MG, Deaton CM, Kienhorst J, Lambrinou E, et al. (2016). Heart Failure Association of the European Society of Cardiology heart failure nurse curriculum. European Journal of Heart Failure, 18(7), 736-743. doi:10.1002/ejhf.568
32. Rogers C, Bush N. (2015). Heart failure: pathophysiology, diagnosis, medical treatment guidelines, and nursing management. Nursing Clinics, 50(4), 787-799. doi: 10.1016/j.cnur.2015.07.012
33. Rudnicka E, Napierała P, Podfigurna A, Męczekalski B, Smolarczyk R, Grymowicz M. (2020). The World Health Organization (WHO) approach to healthy ageing. Maturitas, 139, 6-11. doi:10.1016/j.maturitas.2020.05.018
34. Saheera S, Krishnamurthy P. (2020). Cardiovascular changes associated with hypertensive heart disease and aging. Cell Transplantation, 29. doi: 10.1177/0963689720920830
35. Schippinger W. (2022) Comprehensive geriatric assessment. Wiener Medizinische Wochenschrift, 172(5-6), 122-125. doi: 10.1007/s10354-021-00905-y
36. Sieber, C. C. (2017). Patient-oriented medicine in the elderly. Der Internist, 58, 354-358. doi: 10.1007/s00108-017-0202-7
37. Skou ST, Mair FS, Fortin M, Guthrie B, Nunes BP, Miranda JJ et al. (2022). Multimorbidity. Nature Reviews Disease Primers, 8(1),48. doi: 10.1038/s41572-022-00376-4
38. Sterne PP, Grossman S, Migliardi JS, Swallow AD. (2014). Nurses' knowledge of heart failure: implications for decreasing 30-day re-admission rates. Medsurg Nursing, 23(5), 321.
39. Teo KK, Rafiq T. (2021). Cardiovascular risk factors and prevention: a perspective from developing countries. Canadian Journal of Cardiology. 37(5),733-743. doi: 10.1016/j.cjca.2021.02.009
40. Türkiye İstatistik Kurumu (TÜİK). (2022). İstatistiklerle Yaşlılar. https://data.tuik.gov.tr/Bulten/Index?p=%C4%B0statistiklerle-Ya%C5%9Fl%C4%B1lar202249667&dil=1#:~:text=Birle%C5%9Fmi%C5%9F%20Milletler%20d%C3%BCnya%20n%C3%BCfus%20tahminlerine,8'ini%20ya%C5%9Fl%C4%B1%20n%C3%BCfus%20olu%C5%9Fturdu.
41. Türkiye İstatistik Kurumu (TÜİK). (2022). Ölüm ve Ölüm Nedeni İstatistikleri, 2022. https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2022-49679.
42. Türkiye Kardiyoloji Derneği (TKD). (2020). Yeni Nesil Pıhtı önler İlaç Kullanan Hastalar İçin Kılavuz. https://file.tkd.org.tr/kilavuzlar/Kilavuz-202002171723028.pdf?
43. United Nations. (2022). World Population Prospects 2022. New York.
44. Uysal İİ, Durmaz K, Ali FM, Erbaş F, Zeki Ş, Başpınar T vd. (2016). Farklı gözlerden yaşlıya ve yaşlanmaya bakış. Genel Tıp Dergisi, 26(Ek1), 20-23.
45. World Health Organisation (WHO). (2002). The World Health Report 2002 – Reducing Risks, Promoting Healthy Life. http://www.who.int/whr/ 2002/en/.
46. Yan H, Du YX, Wu FQ, Lu XY, Chen RM, Zhang Y. (2022). Effects of nurse-led multidisciplinary team management on cardiovascular hospitalization and quality of life in patients with atrial fibrillation: Randomized controlled trial. International Journal of Nursing Studies, 127,104159. doi: 10.1016/j.ijnurstu.2021.104159
47. Yıldırım N. (2021). Hipertansiyon yönetiminde hemşirenin rolü. Ebelik ve Sağlık Bilimleri Dergisi. 4(3), 305-315.
48. Young M. (2019) Atrial Fibrillation. Critical Care Nursing Clinics of North America, 31(1), 77–90. doi: 10.1016/j.cnc.2018.11.005.
49. Zhou X, Yuan Y, Wang Z, Zhang K, Fan W, Zhang Y, et al. (2021). Effect of continuous nursing on angina attack and quality of life in patients with coronary artery disease: A protocol for systematic review and meta-analysis. Medicine, 100(5). doi: 10.1097/MD.0000000000024536