From the Guidelines
Hypertension, coronary artery disease, heart failure, and atrial fibrillation are the most common cardiovascular conditions in nursing homes, with hypertension being the most prevalent. These conditions are prevalent in nursing homes due to the advanced age of residents, cumulative effects of risk factors over time, and the natural aging process of the cardiovascular system 1. The management of these conditions typically involves a combination of lifestyle modifications and medications, with a focus on minimizing polypharmacy and its associated risks 1.
Some key considerations in managing cardiovascular conditions in nursing homes include:
- Monitoring for potential drug interactions and side effects, particularly in patients with multiple comorbidities and polypharmacy 1
- Adjusting medical therapy to prioritize symptom improvement and minimize harm or burden 1
- Providing palliative care and support for patients with advanced heart failure, including advance care planning, spiritual care, and care for the dying 1
- Regular monitoring of blood pressure, kidney function, and electrolytes to guide treatment decisions and minimize the risk of complications 1
Proper management of cardiovascular conditions in nursing homes can significantly improve quality of life and reduce the risk of complications such as stroke or heart attack in this vulnerable population. This requires a comprehensive and multidisciplinary approach, taking into account the unique needs and challenges of nursing home residents 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Common Cardiovascular Conditions in Nursing Homes
- Heart failure (HF) is a prevalent condition in nursing homes, affecting approximately 20% of residents 2
- Hypertension is another common cardiovascular condition in nursing homes, with recent trials demonstrating cardiovascular benefits from more intensive blood pressure targets among ambulatory, less complex older adults, but generalizability to nursing home residents is questionable 3
- Congestive heart failure (CHF) is also a common clinical problem in nursing homes, often caused by coronary artery disease, such as myocardial infarction, ischemia, and hypertension 4
- Other cardiovascular conditions, such as coronary artery disease and acute myocardial infarction, can also lead to heart failure in nursing home residents 5, 4
Prevalence and Management of Cardiovascular Conditions
- The optimal approach to managing heart failure in nursing homes remains elusive, with guidelines endorsing the applicability of general heart failure guidelines to nursing home residents, tailored to comorbidities, frailty, and advance care preferences 2
- Nursing staff knowledge and job satisfaction, prescribing, and acute care utilization can be improved with guideline-based heart failure management in nursing homes 2
- Clinically-based education for staff and access to specialist mentorship are important for effective management of cardiovascular conditions in nursing homes 2
- Resident and family education, as well as advance care planning, are also crucial aspects of managing cardiovascular conditions in nursing homes, but are often neglected 2, 6