End-of-life issues in cardiology are becoming increasingly important in the management of patients in the cardiac unit, but there is frequently a lack of understanding regarding their impact on cardiology practice. The cardiac unit is increasingly becoming the location whereby a number of key clinical decisions relating to end-of-life care are being made, such as the decision to remove medications, the appropriate removal of cardiac devices, the management of do not resuscitate orders and the requirement for other cardiac procedures in light of the management of the terminally ill cardiac patients. Those working in palliative care need input from the cardiovascular team as the cardiologist is frequently still managing these patients until they are moved to the hospice. That this move into a hospice is often delayed until the very last moment, there is considerable onus on the cardiovascular management of these patients to be much broader in scope and take account of some of the more palliative medical decisions needed in this group of patients. This concise reference will detail the practical issues open to cardiovascular physicians and those medical professionals who manage patients reaching the end of their life from a cardiology perspective. It will detail the full management options open to them to ensure that their practice is in line with the requirements of the patient nearing the end of their life whether the cause be cardiovascular in origin or who need appropriate management of secondary cardiovascular symptoms. It will also include the various ethical, cultural and geographical issues that need to be considered when managing these patients.

With an exponential growth in the number of older adults, understanding the common disorders of the elderly patient requiring cardiac care is becoming increasingly important. Incorporating recent advances in the field, Tresch and Aronow's Cardiovascular Disease in the Elderly 6th Edition has been completely revised and updated to provide cardiologists, primary care physicians, geriatricians and other clinicians caring for the elderly a comprehensive and accessible overview of the epidemiology, pathophysiology and treatment of cardiovascular disorders in older patients.

End-of-life issues in cardiology are becoming increasingly important in the management of patients in the cardiac unit, but there is frequently a lack of understanding regarding their impact on cardiology practice. The cardiac unit is increasingly becoming the location whereby a number of key clinical decisions relating to end-of-life care are being made, such as the decision to remove medications, the appropriate removal of cardiac devices, the management of do not resuscitate orders and the requirement for other cardiac procedures in light of the management of the terminally ill cardiac patients. Those working in palliative care need input from the cardiovascular team as the cardiologist is frequently still managing these patients until they are moved to the hospice. That this move into a hospice is often delayed until the very last moment, there is considerable onus on the cardiovascular management of these patients to be much broader in scope and take account of some of the more palliative medical decisions needed in this group of patients. This concise reference will detail the practical issues open to cardiovascular physicians and those medical professionals who manage patients reaching the end of their life from a cardiology perspective. It will detail the full management options open to them to ensure that their practice is in line with the requirements of the patient nearing the end of their life whether the cause be cardiovascular in origin or who need appropriate management of secondary cardiovascular symptoms. It will also include the various ethical, cultural and geographical issues that need to be considered when managing these patients.

With an exponential growth in the number of older adults, understanding the common disorders of the elderly patient requiring cardiac care is becoming increasingly important. Incorporating recent advances in the field, Tresch and Aronow's Cardiovascular Disease in the Elderly 6th Edition has been completely revised and updated to provide cardiologists, primary care physicians, geriatricians and other clinicians caring for the elderly a comprehensive and accessible overview of the epidemiology, pathophysiology and treatment of cardiovascular disorders in older patients.

This issue of Clinics in Geriatric Medicine, guest edited by Drs. Cynthia Boyd, James T. Pacala, and Michael W. Rich, is devoted to Chronic Conditions in Older Adults with Cardiovascular Disease. Articles in this issue include: Epidemiology of multimorbidity in older adults with cardiovascular disease; Impact of multimorbidity on clinical outcomes in older adults with cardiovascular disease; Assessment of goals of care in patients with multiple chronic conditions; Challenges in decision-making: balancing trade-offs; Multimorbidity in older adults with heart failure; Multimorbidity in older adults with acute coronary syndromes; Multimorbidity in older adults with aortic stenosis; Multimorbidity in older adults with atrial fibrillation;Anticoagulation in older adults with multimorbidity; Approach to evaluating the multimorbid patient with cardiovascular disease undergoing non-cardiac surgery; Integrating care across disciplines; Assessing risks and benefits of invasive cardiac procedures in patients with advanced multimorbidity; Multimorbidity and end of life care in patients with cardiovascular disease; and Future research directions for cardiovascular disease.

This issue of Clinics in Geriatric Medicine focuses on the pharmacological, non-pharmacological, and device therapies in the medical management of cardiac rhythm disorders in the elderly population. It also reviews the epidemiology of arrhythmias and conduction disorders in older adults, atrial fibrillation and atrial flutter: stroke prevention, bradyarrhythmias and conduction disorders, and comorbidities, quality of life, and end-of-life issues in older patients with heart rhythm disorders.

With cardiovascular disease as the leading cause of death in the United States, the topic of preventive cardiology deserves intense examination. Michael Rich and George Mensah guest edit this issue, which explores important topics, such as the burden of cardiovascular disease, updates on hypertension, hyperlipidemia, and diabetes, all geared towards the elderly patient. This issue of Clinics in Geriatric Medicine also covers the effects of physical activity on cardiovascular and non-cardiovascular outcomes, impact of strength and resistance training on cardiovascular risk factors and outcomes, cellular mechanisms and the effects of caloric restriction, obesity and the obesity paradox, and the primary and secondary prevention of cardiovascular diseases in older adults.