Drugs & Aging

, Volume 24, Issue 12, pp 991–1006 | Cite as

Drug Treatment of Chronic Heart Failure in the Elderly

  • Gregor Leibundgut
  • Matthias Pfisterer
  • Hans-Peter Brunner-La Rocca
Therapy In Practice


Congestive heart failure is a growing public health problem worldwide, particularly in the elderly population, in whom it has a substantial impact on quality of life and survival. Despite the fact that heart failure is the most common reason for hospitalisation over the age of 65 years, most clinical trials have excluded the elderly population. This is unfortunate because it may not be generally assumed that elderly patients are similar to younger ones. Nonspecific symptoms and co-morbidities in the elderly may make diagnosis of heart failure difficult. In addition, physiology changes with age, polypharmacy complicates therapy and the aim of therapy may change in the presence of co-morbidities such as cancer or dementia. Furthermore, drug interactions and adverse effects are frequent in heart failure in general, but increase significantly with age. Nevertheless, there is little evidence that treatment of heart failure should be fundamentally different in elderly patients compared with younger patients, although careful monitoring of medical therapy is of particular importance in elderly heart failure patients. Therefore, general guidelines on diagnosis and therapy of heart failure also apply to elderly patients, but therapy may need to be adjusted to cater for individual needs, potential interactions and altered elimination of drugs.

This article summarises the evidence available for treatment in elderly patients with heart failure, discusses potential differences in elderly subjects compared with their younger counterparts and provides recommendations for clinical practice.


Heart Failure Elderly Patient Cardiac Resynchronisation Therapy Carvedilol Calcium Channel Antagonist 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this article. Dr Brunner-La Rocca has acted as a consultant for and/or received lecture fees from Menarini, Novartis, Servier, AstraZeneca and Pfizer. The other authors have no conflicts of interest that are directly relevant to the content of this article.


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Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  • Gregor Leibundgut
    • 1
  • Matthias Pfisterer
    • 1
  • Hans-Peter Brunner-La Rocca
    • 1
  1. 1.CardiologyUniversity Hospital BaselBaselSwitzerland

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