This chapter addresses the major cardiovascular conditions faced by clinicians caring for older adults: ischemic heart disease, heart failure, valvular disease, arrhythmias and conduction system disorders, and pericardial diseases. After a brief review of the global burden of heart disease and the effects of aging on the cardiovascular system, each subsequent section of the chapter provides a consistent approach to the description of these disease processes. Beginning with a summary of the epidemiology and clinical presentations relevant to older adults, pharmacologic and procedural recommendations are then presented based on clinical trial data and practice guidelines specific to this patient population. Each section also highlights the importance of individualized care for patients with advanced age or substantial medical comorbidities, including commentary about prognosis and palliative care, when appropriate. With clinically relevant treatment recommendations, comprehensive trial review and data tables, and several illustrative figures, this chapter provides evidence-based guidance to assist with the daily clinical care of our aging population with cardiovascular diseases.