Aging and heart failure: changing demographics and implications for therapy in the elderly.
The elderly population (age > or =65) is increasing and with it morbidity, hospitalizations, costs and mortality due to heart failure (HF). HF is a progressive disorder that is superimposed on an on-going aging process. The two broad categories of HF, HF with left ventricular (LV) systolic dysfunction or low ejection fraction (HF/low-EF) and HF with preserved ejection fraction (HF/PEF) are equally prevalent in the elderly. Trials of therapy for HF/low-EF in primarily non-elderly patients showed mortality benefit in elderly patients. In contrast, trials for HF/PEF have not shown mortality benefit in elderly or non-elderly patients. HF pharmacotherapy in the elderly is challenging and needs to be individualized and consider several aging-related changes. More research into the biology of aging and more clinical trials in elderly patients are needed to improve morbidity and mortality in elderly HF patients.
Jugdutt
Bodh I
BI
Division of Cardiology, Department of Medicine and Cardiovascular Research Group, Faculty of Medicine, 2C2 Walter MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB T6G 2R7, Canada. bjugdutt@ualberta.ca
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000416:Alberta / Q000453:epidemiology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial; D017147:Defibrillators, Implantable; D003710:Demography; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology* / Q000401:mortality; D016277:Ventricular Function, Left
D000959:Antihypertensive Agents