Abstract
Heart failure is a frequent disease in the elderly cohort. In most cases, coronary artery disease and myocardial infarction or arterial hypertension that had remained uncontrolled for years, resulting in diffuse myocardial damage (fibrosis, hypertrophy) and systolic failure, are the culprits. Heart failure can be considered as a progressive disorder that is superimposed on the aging process in a disease continuum (Fig. 1; Jugdutt 2010). The high prevalence of both conditions in elderly patients frequently results in mixed etiologies. While hospitalization and 1-year mortality rates for heart failure appear to be decreasing, the incidence of this syndrome continues to increase due to the aging of the population (Chen et al. 2011). The incidence of heart failure increases from 0.02/1,000 inhabitants at age 24–39 years to 11.6/1,000 inhabitants aged 85+, with a clear dominance of men (Fig. 2; Cowie et al. 1999). In the general population, about 1% of all people suffer from heart failure; in persons aged 85+, this figure rises to greater than 30% (Roger et al. 2011; data from Framingham, Fig. 3).
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References
Ahmed A, Husain A, Love TE et al (2006) Heart failure, chronic diuretic use, and increase in mortality and hospitalization: an observational study using propensity score methods. Eur Heart J 27:1431–1439
Brunner-La Rocca HP, Buser PT, Schindler R, Bernheim A, Rickenbacher P, Pfisterer M, TIME-CHF investigators (2006) Management of elderly patients with congestive heart failure—design of the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF). Am Heart J 151:949–955
Bulpitt CJ (2005) Secondary prevention of coronary heart disease in the elderly. Heart 91:396–400
Chen J, Mormand SL, Wang Y et al (2011) National and regional trends in heart failure hospitalization and mortality rates for Medicare beneficiaries, 1998–2008. JAMA 306:1669–1678
Cowie MR, Wood DA, Coats AJ, Thompson SG, Poole-Wilson PA, Suresh V, Sutton GC (1999) Incidence and aetiology of heart failure; a population-based study. Eur Heart J 20:421–428
Deedwania PC, Gottlieb S, Ghali JK et al (2004) Efficacy, safety and tolerability of beta-adrenergic blockade with metoprolol XL in elderly patients with heart failure. Eur Heart J 25:1300–1309
Flather MD, Yusuf S, Kober L et al (2000) Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients. ACE-Inhibitor Myocardial Infarction Collaborative Group. Lancet 355:1575–1581
Flather MD, Shibata MC, Coats AJ et al (2005) Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 26:215–225
Ho KKL, Pinsky JL, Kannel WB, Levy D (1993) The epidemiology of heart failure—the Framingham study. J Am Coll Cardiol 22:A6–A13
Hunt SA, Abraham WT, Chin MH et al (2005) ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Writing Committee to update the 2001 guidelines for the evaluation and management of heart failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112:e154–e235
Hunt SA, Abraham WT, Chin MH et al (2009) 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119:e391–e479
Jugdutt BI (2010) Aging and heart failure: changing demographics and implications for therapy in the elderly. Heart Fail Rev 15:401–405
Lindenfeld J, Albert NM, Boehmer JP et al (2010) Executive summary: HFSA 2010 comprehensive heart failure practice guideline. J Card Fail 16:475–539
Rathore SS, Curtis JP, Wang Y et al (2003) Association of serum digoxin concentration and outcomes in patients with heart failure. JAMA 289:871–878
Roger VL, Go AS, Lloyd-Jones DM et al (2011) Heart disease and stroke statistics—2011 update. A report from the American Heart Association. Circulation 123:e18–e209
von Leibundgut G, Pfisterer M, Brunner-La Rocca HP (2007) Drug treatment of chronic heart failure in the elderly. Drugs Aging 24:991–1006
Wong CY, Chaudhry SI, Desai MM et al (2011) Trends in comorbidity, disability, and polypharmacy in heart failure. Am J Med 124:136–143
Zuccala G, Onder G, Marzetti E et al (2005) Use of angiotensin converting enzyme inhibitors and variations in cognitive performance among patients with heart failure. Eur Heart J 26:226–233
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Study Acronyms
- A-HeFT
-
African American Heart Failure Trial
- CHARM
-
Study of Candesartan in Heart Failure—Assessment of Reduction in Mortality and Morbidity
- CIBIS
-
Cardiac Insufficiency Bisoprolol Study
- COMET
-
Carvedilol or Metoprolol European Trial
- DIG
-
Study of the Digitalis Investigation Group
- ELITE
-
Evaluation of Losartan in the Elderly Study
- EMPHASIS-HF
-
Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms
- EPHESUS
-
Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study
- I-PRESERVE
-
Irbesartan for Heart Failure with Preserved Ejection Fraction
- MERIT
-
Metoprolol Controlled Release/Extended Release (CR/XL) Randomized Intervention Trial
- PPP
-
Pravastatin Pooling Project
- RALES
-
Randomized Aldactone Evaluation Study
- SAVE
-
Survival and Ventricular Enlargement Study
- SENIORS
-
Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalisation in Seniors with Heart Failure
- SOLVD
-
Study of Left Ventricular Dysfunction
- TOPCAT
-
Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist
- Val-HeFT
-
Valsartan Heart Failure Trial
- V-HeFT II
-
Vasodilator in Heart Failure Trail II
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Wehling, M., Robert Lee Page 2nd. (2013). Heart Failure. In: Wehling, M. (eds) Drug Therapy for the Elderly. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0912-0_7
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DOI: https://doi.org/10.1007/978-3-7091-0912-0_7
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