Heart failure in the community

Heart failure is a common and increasing problem, particularly in the elderly. Although a number of clinical trials have studied the disease, the data cannot readily be translated into practice guidelines for the benefit of all patients. This is partly because patients in clinical trials are highly selected and differ from those in the community, who are generally older and have a greater rate of comorbidity. In addition, heart failure in the elderly may differ in various respects from that in younger patients. Effective implementation of best practice guidelines will require an integrated approach between primary- and secondary-care physicians, with greater patient participation to optimize long-term outcomes.