[Features of the treatment of heart failure in the elderly].
PHARMACOLOGICAL MODIFICATIONS TO BE TAKEN INTO ACCOUNT: In elderly patients, there is a modification in the distribution columns of drugs, an alteration in glomerular filtration (doses require adaptation) and tubular function (greater sensitivity to low salt diet and diuretics), and a reduction in the hepatic elimination capacity. FOR SYSTOLIC HEART FAILURE: The choice of drugs is in practice the same as that for younger patients: diuretics, antialdosterone agents, converting enzyme inhibitors, angiotensin II receptor antagonists, beta-blockers and digitalics. FOR DIASTOLIC HEART FAILURE: The therapeutic approach combines an etiologic treatment (blood pressure, myocardial ischaemia), prevention and the rapid treatment of the decompensation factors (atrial arrhythmia), a pharmacological treatment (converting enzyme inhibitors, angiotensin II receptor antagonists, and bradycardia lowering agents). Non-pharmacological measures include dietary restrictions, regular physical exercise, and education for the patient and the family.
Aupetit
Jean-François
JF
Département de pathologie cardiovasculaire, Centre hospitalier Saint-Joseph et Saint Luc, Lyon.
Bourdariat
Katayoun
K
Lestaevel
Michel
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000375:Aging; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D004032:Diet; D004232:Diuretics / Q000627:therapeutic use; D005081:Exercise Therapy; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications; D008099:Liver / Q000502:physiology; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D017202:Myocardial Ischemia / Q000150:complications; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists