Beta-blockers are also given to reduce the workload of the heart, and thus reduce the demand for oxygen. In addition, ace-inhibitors are prescribed to help reduce the workload of the heart by lowering blood pressure Statins are prescribed to help process and break down cholesterol in the arteries (American Heart Association 2006). Finally, there have been significant advances in acute care and invasive surgical procedures for treating coronary blockage. Thrombolytics are a class of drugs that may be used to help dissolve the clot. Percutaneous coronary intervention (PCI) is used to clear out blockages of the coronary arteries. These procedures are now frequently accompanied by use of a stent to keep the occluded artery open. A more invasive option is coronary artery bypass grafting (abbreviated CABG, and pronounced like the vegetable).

Each of these technologies has been shown to increase survival after a heart attack among patients without contraindications for treatment (Krumholz, Radford et al. 1995; Hennekens, Albert et al. 1996; Krumholz, Radford et al. 1996; Soumerai, McLaughlin et al. 1997; Gottlieb, McCarter et al. 1998; Krumholz, Radford et al. 1998; Freemantle, Cleland et al. 1999; Shlipak, Browner et al. 2001; Braunwald, Antman et al. 2002; Antman, Anbe et al. 2004; Vitagliano, Curtis et al. 2004; Stukel, Lucas et al. 2005).

They have an ambiguous effect on disability, however, with the increase in survival among those with serious heart damage possibly offsetting the improved health among traditional survivors (Crimmins, Saito et al. 1989; Crimmins, Hayward et al. 1994; Waidmann, Bound et al. 1995). Cerebrovascular disease, or stroke, is the second major form of cardiovascular disease. Ischemic strokes are the most common type of stroke, and are similar to heart disease: an artery in the brain becomes blocked, and a part of the brain is denied oxygen. Disability is quite common after a stroke, particularly among the elderly (Pohjasvaara, Erkinjuntti et al. 1997; Prencipe, Ferretti et al. 1997; Zhu, Fratiglioni et al. 1998).

Recent studies report that 39% to 54% of stroke survivors are disabled 3-months after the stroke (Henon, Godefroy et al. 1995; Zhu, Fratiglioni et al. 1998; Glader, Stegmayr et al. 2003). The high level of disability can persist among survivors. One study found 37% of stroke survivors were disabled one year after the event (Appelros, Nydevik et al. 2003). In addition, stroke is associated with increased odds of cognitive impairment, both with and without dementia (Pohjasvaara, Erkinjuntti et al. 1997; Prencipe, Ferretti et al. 1997; Zhu, Fratiglioni et al. 1998).

Category: CARDIOVASCULAR DISEASE / Tags: Disability, elderly, medical care