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Management of heart failure in elderly people

M Imazio1, A Cotroneo, G Gaschino

  • 1Cardiology Department, Maria Vittoria Hospital, Torino, Italy. massimo_imazio@yahoo.it

International Journal of Clinical Practice
|December 12, 2007
PubMed

Insights

Heart failure (HF) in elderly individuals presents unique challenges due to aging and comorbidities. Management often relies on empiric evidence from younger populations as older adults are typically excluded from clinical trials.

Area of Science:

  • Gerontology
  • Cardiology
  • Internal Medicine

Background:

  • Heart failure (HF) is a significant health concern in the elderly population.
  • Aging-related physiological changes can predispose individuals to HF and affect their response to illness.
  • Elderly patients often present with multiple chronic conditions and geriatric syndromes, complicating HF management.

Purpose of the Study:

  • To synthesize current knowledge on the presentation, clinical features, and management of heart failure in older adults.
  • To highlight the unique aspects of HF in the elderly and the challenges in its treatment.
  • To review the evidence base for HF management in elderly populations.

Main Methods:

  • A comprehensive literature search was conducted using multiple evidence-based databases.
  • Key databases included Cochrane Database of Systematic Reviews, Clinical Evidence, and MEDLINE.
  • Search terms focused on heart failure, elderly populations, and management strategies.

Main Results:

  • Aging features and comorbidities significantly impact HF presentation and progression in the elderly.
  • Diagnosis can be challenging due to atypical symptoms and overlapping conditions, though diagnostic criteria remain consistent.
  • Current drug treatments are largely empirical, mirroring recommendations for younger patients due to trial exclusions.
  • Disease management programs show promise in reducing HF morbidity and mortality in older adults.

Conclusions:

  • Heart failure is a leading cause of hospitalization and readmission among older adults.
  • HF in the elderly is characterized by specific features and frequent comorbidities, imposing a substantial global financial burden.
  • The exclusion of elderly individuals from clinical trials necessitates empirical management approaches based on data from younger cohorts.
Abstract

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