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[Cardiac insufficiency in the elderly with particular reference to kidney function]

J Rieger, F Scheler

    Zeitschrift Fur Gerontologie
    |September 1, 1981
    PubMed
    Summary

    Cardiac insufficiency in the elderly stems from heart pathology, not aging. Treatment strategies vary based on heart rhythm and cause, with careful drug selection crucial for older patients.

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    Area of Science:

    • Gerontology
    • Cardiology
    • Nephrology

    Context:

    • Cardiac insufficiency in the elderly is often pathological, distinct from age-related renal function decline.
    • Standard treatments include diuretics, cardiac glycosides, and vasodilators.

    Purpose:

    • To outline treatment strategies for cardiac insufficiency in the elderly based on specific clinical presentations.
    • To highlight drug-specific considerations and potential adverse effects in geriatric patients.

    Summary:

    • Treatment prioritizes diuretics for sinus rhythm, followed by glycosides and vasodilators.
    • Hypertension-induced heart failure favors diuretics and vasodilators; glycosides are a last resort.
    • Tachyarrhythmia complicates heart failure, necessitating glycosides first, then diuretics and vasodilators.
    • Diuretics can cause electrolyte imbalances (hypokalemia) and volume depletion in the elderly.
    • Digoxin accumulation occurs with renal impairment; digitoxin has a long half-life.
    • Vasodilators require caution in atherosclerosis to prevent hypotension.

    Impact:

    • Provides a clinical guideline for managing cardiac insufficiency in elderly patients.
    • Emphasizes individualized pharmacotherapy to optimize outcomes and minimize risks in geriatric cardiology.

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