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Diagnosis and Treatment of Cardiovascular Diseases in the Elderly

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Geriatric Medicine".

Deadline for manuscript submissions: 20 August 2026 | Viewed by 4285

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Dr. Carmelo Massimiliano Rao

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Guest Editor

Cardiology Department, Mauriziano Umberto I Hospital, 10128 Torino, Italy
Interests: atrial fibrillation; heart failure; cardiac resynchronization therapy; catheter ablationmitral valve; aortic valve; coronary artery bypass; echocardiography; doppler echocardiography; defibrillators
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Special Issue Information

Dear Colleagues,

Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality in the elderly population worldwide. Ageing is associated with progressive structural and functional changes in the cardiovascular system, as well as with the accumulation of comorbidities and polypharmacy, which complicate both diagnosis and treatment. This Special Issue aims to provide a comprehensive overview of the latest advances, challenges, and strategies in the diagnosis, management, and prevention of CVDs in older adults.

Key topics will include age-related cardiovascular pathophysiology, the role of frailty and cognitive impairment in clinical decision-making, non-invasive and invasive diagnostic tools adapted for elderly patients, and tailored therapeutic approaches including pharmacological, interventional, and lifestyle interventions. Special attention will be paid to conditions such as heart failure with preserved ejection fraction (HFpEF), atrial fibrillation, coronary artery disease, valvular heart disease, and hypertension in the elderly.

We welcome original research articles, reviews, and clinical perspectives that highlight innovative models of care, multidisciplinary approaches, and real-world data addressing the unique needs of the ageing population. By fostering knowledge exchange among geriatrics, cardiology, and internal medicine, this Special Issue aims to advance precision medicine and enhance cardiovascular outcomes for older patients.

Dr. Carmelo Massimiliano Rao
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

cardiovascular diseases
elderly population
diagnosis and management
age-related pathophysiology
frailty and cognitive impairment

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Published Papers (5 papers)

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Research

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24 pages, 964 KB

Open AccessArticle

Age-Dependent Lipid–Cardiovascular Interplay in Patients at High and Very High Cardiovascular Risk

by Mirela Baba, Mihaela Ioana Maris, Simina Mariana Moroz, Cristina Gug, Adina Bucur, Constantin Tudor Luca and Ioana Mozos

J. Clin. Med. 2026, 15(6), 2192; https://doi.org/10.3390/jcm15062192 - 13 Mar 2026

Viewed by 425

Abstract

Objectives: This study aimed to investigate the associations between serum lipid biomarkers and pulse wave analysis (PWA) variables in patients at high and very high cardiovascular risk, with particular emphasis on age-related differences. Methods: Seventy-six patients at high or very high cardiovascular risk were enrolled and stratified into middle-aged (Group 1) and elderly (Group 2). All participants underwent PWA, and multiple serum lipid biomarkers were measured, including composite lipid indices. Results: In both age groups, PWA parameters showed significant correlations with serum lipid biomarkers. Systolic blood pressure (SBP) was an independent determinant of the lipid balance index (LBI), while pulse wave velocity (PWV) and SBP were independent determinants of the triglyceride–glucose (TyG) index. PWV correlated with age in both groups and was higher in Group 2 for comparable blood pressure values. In middle-aged patients, diastolic blood pressure (DBP) showed significant, independent associations with triglycerides and TyG, indicating a close link between peripheral vascular resistance and metabolic dysfunction in earlier stages of cardiovascular risk. In elderly patients, SBP and pulse pressure were predominantly associated with lipid-derived indices, reflecting the increasing contribution of large-artery stiffness and lipid-driven vascular remodeling with advancing age. Systematic Coronary Risk Estimation 2 (SCORE2) correlated significantly with PWV, the lipid index (LI), and the LBI. Conclusions: Serum lipid biomarkers and PWA-derived hemodynamic variables exhibit a significant, age-dependent interplay in patients with high and very high cardiovascular risk. These findings underscore the importance of age-specific evaluation of lipid–hemodynamic interactions to improve early identification and targeted management of high-risk individuals. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Cardiovascular Diseases in the Elderly)

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13 pages, 932 KB

Open AccessArticle

Tooth Loss as a Predictor of Coronary Artery Disease Severity in Patients with Acute Myocardial Infarction: A Prospective Cross-Sectional Study

by Corina Cinezan, Camelia Bianca Rus, Alexandra Cinezan and Gabriela Ciavoi

J. Clin. Med. 2026, 15(2), 610; https://doi.org/10.3390/jcm15020610 - 12 Jan 2026

Viewed by 470

Abstract

Background: Tooth loss reflects cumulative oral inflammation and has been associated with adverse cardiovascular outcomes. This study evaluated the relationship between the number of missing permanent teeth and the angiographic severity of coronary artery disease (CAD) in patients with acute myocardial infarction (AMI). Methods: In this prospective cross-sectional study, 200 consecutive AMI patients underwent coronary angiography and standardized dental assessment during hospitalization. Tooth loss was categorized as 1–10, 11–20, or 21–32 missing teeth. CAD severity was defined by the number of major epicardial arteries with significant stenosis. Multivariate logistic regression adjusted for age, sex, smoking status, diabetes, obesity, dyslipidemia, and hypertension. Results: Increasing tooth loss was associated with more extensive CAD. The mean number of affected vessels rose from 1.58 ± 0.79 in the 1–10 tooth-loss group to 2.06 ± 0.99 in the 21–32 group (p = 0.014). Tooth loss correlated with CAD severity (r = 0.19, p = 0.007). After adjustment, >20 missing teeth remained an independent predictor of multivessel disease (OR = 1.84; 95% CI: 1.01–3.34; p = 0.047). ROC analysis showed modest discrimination (AUC = 0.61). Conclusions: Extensive tooth loss independently correlates with greater angiographic CAD severity in AMI patients. Dental status may serve as a simple, non-invasive clinical marker of cardiovascular disease burden. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Cardiovascular Diseases in the Elderly)

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14 pages, 884 KB

Open AccessArticle

Tooth Loss and Cardiovascular Risk Burden in Myocardial Infarction Patients

by Corina Cinezan, Camelia Bianca Rus, Alexandra Cinezan and Luminita Ligia Vaida

J. Clin. Med. 2025, 14(22), 8227; https://doi.org/10.3390/jcm14228227 - 20 Nov 2025

Cited by 1 | Viewed by 1019

Abstract

Background: Oral and cardiovascular health share inflammatory and behavioral pathways. Chronic oral inflammation leading to tooth loss may reflect systemic vascular injury. The relationship between tooth loss and cardiovascular risk among patients with myocardial infarction (MI) remains underexplored. Objective: We hypothesized that in post-MI patients, the extent of tooth loss reflects cumulative systemic inflammatory exposure and correlates with major cardiovascular risk factors and coronary artery disease severity. Methods: In this cross-sectional study, 200 consecutive MI patients (mean age 64 years, 65% male) underwent oral examination and cardiovascular risk assessment. Logistic and robust linear regression models were applied to identify independent predictors of tooth loss. Results: The median number of missing teeth was 20 (IQR 12–28). Age (OR 1.13/year, p < 0.001; β = 0.53, p < 0.001) and smoking (OR 3.28, p = 0.007; β = 3.13, p = 0.027) were significant independent predictors. Diabetes showed a borderline association (OR 2.20, p = 0.054), and a trend was observed with the number of affected coronary arteries (β = 1.05, p = 0.063). Conclusions: Tooth loss in MI patients is closely associated with age and smoking and may indicate cumulative inflammatory burden. As a simple, non-invasive marker, tooth loss could aid cardiovascular risk stratification and encourage interdisciplinary prevention integrating cardiology and dental care. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Cardiovascular Diseases in the Elderly)

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Review

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15 pages, 913 KB

Open AccessReview

Evidence on SGLT2 Inhibitors’ Efficacy in Older and Frail Patients

by Anna Kochanowska, Artur Mamcarz and Marcin Wełnicki

J. Clin. Med. 2026, 15(6), 2219; https://doi.org/10.3390/jcm15062219 - 14 Mar 2026

Viewed by 1403

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have proven their favorable cardiovascular and nephroprotective benefits in large randomized-controlled trials (RCTs). Given that older adults constitute a substantial part of patients with type 2 diabetes mellitus (T2DM), heart failure (HF), and chronic kidney disease (CKD), they are the primary target population for SGLT2 inhibitor therapy. However, their representation in clinical trials remains low and it does not reflect the real-life heterogeneity of this group of patients. As chronological age alone does not adequately reflect the biological age, it is important to evaluate older adults using a multidimensional approach, particularly with regard to frailty. This review aims to summarize and critically appraise the available evidence regarding the efficacy of SGLT2 inhibitors in older and frail adults, with a focus on age-specific outcomes, such as cognitive outcomes, risk of sarcopenia, functional activity and current gaps in evidence related to frailty. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Cardiovascular Diseases in the Elderly)

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14 pages, 1034 KB

Open AccessReview

Accelerated Vascular Aging in Women with Prior Preeclampsia: A Review of Epidemiology, Pathophysiological Mechanisms, and Geroprotective Strategies

by M. Yeo, D. W. Kwak, S. Y. Kim, A. Y. Choi, M. Kwak and J. I. Yang

J. Clin. Med. 2026, 15(5), 1880; https://doi.org/10.3390/jcm15051880 - 1 Mar 2026

Viewed by 581

Abstract

Preeclampsia (PE) has traditionally been regarded as a pregnancy-limited hypertensive disorder; however, accumulating evidence increasingly positions it as a pivotal early-life vascular stress test that manifests underlying vulnerabilities and accelerates biological aging. Women with a history of PE exhibit a heightened susceptibility to premature-onset multi-systemic diseases, specifically cardiovascular, ovarian, renal, and metabolic decline. This suggests that PE acts as a catalyst for accelerated aging, driven by shared pathophysiological pathways that represent common mechanisms of systemic senescence. This review provides a comprehensive analysis of the epidemiological links and pathogenic drivers underpinning accelerated systemic aging following PE, with a specific focus on the cardiovascular-ovarian axis. Epidemiological data consistently demonstrate that women with prior PE exhibit significantly reduced anti-Müllerian hormone (AMH) levels, translating to an estimated 1.5-year acceleration in reproductive aging. In parallel, PE is associated with a twofold increase in lifetime cardiovascular disease (CVD) risk and the onset of chronic hypertension occurring an average of 7.7 years earlier. However, reconciling the phenotypic heterogeneity of PE and transcending the constraints of non-experimental designs are essential for firmly establishing this accelerated aging paradigm. At the molecular level, PE and ovarian aging converge on shared pathways—including mitochondrial dysfunction, oxidative stress, inflammation, and epigenetic dysregulation—collectively defining a distinct pathogenic ovarian–vascular aging axis. Proposed geroscience-based strategies advocate for refined risk stratification by incorporating molecular aging biomarkers—such as epigenetic clocks and inflammatory profiles—alongside conventional clinical indicators. This integrative framework facilitates the early identification of high-risk aging phenotypes, enabling targeted monitoring and timely interventions to preemptively modulate accelerated aging pathways. Pharmacological approaches within this framework emphasize the judicious repurposing of established agents, such as metformin, statins, and SGLT2 inhibitors, while emerging gerotherapeutics, including senolytics and senomorphics, provide a conceptual foundation for targeting the fundamental biological drivers of senescence. Although these geroprotective strategies, including the repurposing of established agents and the use of senolytics, offer innovative conceptual frameworks for targeting the fundamental drivers of senescence, they remain largely exploratory and require further clinical validation. Such strategies offer novel opportunities to shift the clinical focus from treating isolated comorbidities to modulating the shared molecular substrates of aging, ultimately promoting healthy aging and functional longevity in the elderly female population. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Cardiovascular Diseases in the Elderly)

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