title: The diversity of heart failure in a hospitalized population: the role of age.
abstract: BACKGROUND
  The prevalence of heart failure (HF) among hospitalized elderly patients is high and steadily growing. However, because most studies have focused mostly on young patients, little is known about the clinical characteristics, echocardiographic measures, prognostic factors, and outcome of hospitalized elderly HF patients.
  
  
  RESULTS
  We identified all HF patients aged ≥50 years who had undergone ≥1 echocardiography study and had been hospitalized during January 2000 to December 2009. A comparative analysis was performed between 3,897 "young" patients (aged 50-75 years) and 5,438 "elderly" patients (aged >75 years), followed for a mean 2.8 ± 2.6 years. Elderly HF patients were more often female (50% vs 35%; P < .0001) and had a higher prevalence of HF with preserved ejection fraction (64.8% vs 53%; P < .0001), more significant valvular disease (35.7% vs 32.5%; P < .0001), and lower rates of ischemic heart disease (65.5% vs 70.9%; P < .0001) and diabetes (34.4% vs 53.9%; P < .0001). Thirty-day and 1-year mortality rates were significantly higher among the elderly population (12.2% vs 6.9% [P < .0001] and 34.3% vs 21.2% [P < .0001], respectively). Prognostic markers differed significantly between age groups. Young-specific predictors were chronic renal failure, diastolic dysfunction, malignancy, and tricuspid regurgitation, whereas elderly-specific predictors were HF with reduced ejection fraction, chronic obstructive pulmonary disease, pulmonary hypertension, and mitral regurgitation.
  
  
  CONCLUSIONS
  Hospitalized elderly, compared with young, HF patients differed in prevalence of cardiac and noncardiac comorbid conditions, echocardiographic parameters, and predictors of short- and intermediate-term mortality. Identifying unique features in the elderly population may render age-tailored therapeutics.
authors.affiliation: Department of Internal Medicine B, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Gideon Y
authors.initials: GY
authors.lastname: Stein
authors.forename: Angelika
authors.initials: A
authors.lastname: Kremer
authors.forename: Tzipi
authors.initials: T
authors.lastname: Shochat
authors.forename: Tamir
authors.initials: T
authors.lastname: Bental
authors.forename: Roman
authors.initials: R
authors.lastname: Korenfeld
authors.forename: Evgeny
authors.initials: E
authors.lastname: Abramson
authors.forename: Tuvia
authors.initials: T
authors.lastname: Ben-Gal
authors.forename: Alexander
authors.initials: A
authors.lastname: Sagie
authors.forename: Shmuel
authors.initials: S
authors.lastname: Fuchs
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D006760:Hospitalization; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000959:Antihypertensive Agents