CHF: reflections on current management of the older patient

The deleterious effects of prolonged bedrest on aerobic capacity, mineral balance, and various metabolic processes have been amply demonstrated. Since these functions are already compromised by aging per se, complete or prolonged bedrest should be avoided in geriatric cardiac patients if at all possible, regardless of their specific diagnosis. Diuretics are still the mainstay therapy for CHF. For elderly patients with mild CHF and preserved renal function, a thiazide rather than a loop diuretic appears preferable, due to more gentle diuresis and lower frequency of side effects.