title: Management of heart failure in elderly people.
abstract: OBJECTIVE
  To review currently available knowledge on presentation, clinical features and management of heart failure (HF) in elderly people.
  
  
  METHODS
  To review currently available evidence, we performed a thorough search of several evidence-based sources of information, including Cochrane Database of Systematic Reviews, Clinical Evidence, Evidence-based guidelines from National Guidelines Clearinghouse and a comprehensive MEDLINE search with the MeSH terms: 'heart failure', 'elderly' and 'management'.
  
  
  RESULTS
  A number of features of ageing may predispose elderly people to HF, and may impair the ability to respond to injuries. Another hallmark of elderly patients is the increasing prevalence of multiple coexisting chronic conditions and geriatric syndromes that may complicate the clinical presentation and evolution of HF. Although diagnosis may be challenging, because atypical symptoms and presentations are common, and comorbid conditions may mimic or complicate the clinical picture, diagnostic criteria do not change in elderly people. Drug treatment is not significantly different from that recommended in younger patients, and largely remains empiric, because clinical trials have generally excluded elderly people and patients with comorbid conditions. Disease management programmes may have the potential to reduce morbidity and mortality for patients with HF.
  
  
  CONCLUSIONS
  Heart failure is the commonest reason for hospitalisation and readmission among older adults. HF shows peculiar features in elderly people, and is usually complicated by comorbidities, presenting a significant financial burden worldwide, nevertheless elderly people have been generally excluded from clinical trials, and thus management largely remains empiric and based on evidence from younger age groups.
authors: Cardiology Department, Maria Vittoria Hospital, Torino, Italy. massimo_imazio@yahoo.it
authors: M
authors: M
authors: Imazio
authors: A
authors: A
authors: Cotroneo
authors: G
authors: G
authors: Gaschino
authors: A
authors: A
authors: Chinaglia
authors: P
authors: P
authors: Gareri
authors: R
authors: R
authors: Lacava
authors: T D
authors: TD
authors: Voci
authors: R
authors: R
authors: Trinchero
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology; D001281:Atrial Fibrillation / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D015897:Comorbidity; D019317:Evidence-Based Medicine; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team
chemical_list: D000319:Adrenergic beta-Antagonists