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Treatment of systolic heart failure in the elderly: an evidence-based review

Sally A Arif1, Kari A Mergenhagen, Roberto O Diaz Del Carpio

  • 1Midwestern University, Downers Grove, IL, USA. sarif@midwestern.edu

The Annals of Pharmacotherapy
|September 16, 2010
PubMed

Insights

Elderly patients aged 65 and older with heart failure benefit from medications like beta-blockers and ACE inhibitors. These treatments offer similar mortality benefits to younger patients, requiring careful monitoring.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Heart failure prevalence is increasing in the elderly due to population aging.
  • Clinical trials often underrepresent older adults, leading to unclear guideline recommendations for this demographic.

Purpose of the Study:

  • To review literature supporting pharmacotherapy for heart failure in patients aged 65 and older.
  • To evaluate the efficacy of beta-blockers, ACE inhibitors, ARBs, diuretics, digoxin, aldosterone antagonists, and vasodilators in elderly heart failure management.

Main Methods:

  • Searched PubMed, EMBASE, and MEDLINE (1960-2010) using keywords: heart failure, treatment, elderly.
  • Reviewed primary and tertiary literature, including subgroup analyses and ACC/AHA guidelines.
  • Focused on pharmacotherapy for systolic heart failure in elderly patients.

Main Results:

  • Limited clinical trial data exist for patients ≥65 years.
  • Pharmacotherapy, including beta-blockers, ACE inhibitors, ARBs, aldosterone antagonists, and vasodilators, shows similar mortality benefits in the elderly as in younger populations.
  • Current guidelines lack clear delineation of benefits for this age group.

Conclusions:

  • Pharmacotherapy for heart failure in the elderly, including beta-blockers, ACE inhibitors, ARBs, aldosterone antagonists, and vasodilators, demonstrates comparable mortality benefits to younger patients.
  • These agents should be used judiciously in elderly patients with close adverse event monitoring.
  • Further trials with greater elderly inclusion are needed to fully elucidate optimal pharmacotherapy benefits.
Abstract

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