Aging and heart failure: changing demographics and implications for therapy in the elderly

• Published in: Heart failure reviews 2010-09, Vol.15 (5), p.401-405
• Main Author: Jugdutt, Bodh I.
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Aging - physiology; Alberta - epidemiology; Antihypertensive Agents - therapeutic use; Cardiac Pacing, Artificial; Cardiology; Defibrillators, Implantable; Demography; Disease Progression; Female; Heart Failure - drug therapy; Heart Failure - epidemiology; Heart Failure - mortality; Heart Failure - therapy; Humans; Male; Medicine; Medicine & Public Health; Stroke Volume; Ventricular Dysfunction, Left - epidemiology; Ventricular Dysfunction, Left - mortality; Ventricular Function, Left
• ISSN: 1382-4147; 1573-7322
• DOI: 10.1007/s10741-010-9164-8

The elderly population (age ≥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.