Heart failure in the elderly

作     者：Pablo Diez-Villanueva Femando Alfonso 

作者机构：Department of Cardiology Hospital Universitario de la Princesa Madrid Spain 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2016年第13卷第2期

页      面：115-117页

核心收录：

学科分类：090603[农学-临床兽医学] 02[经济学] 0201[经济学-理论经济学] 1002[医学-临床医学] 09[农学] 0906[农学-兽医学] 

主　　题：心力衰竭 老年人 世界范围 健康问题 生活质量 心肌梗死 患病率 死亡率 

摘      要：Heart failure (HF) is a major public health problem worldwide entailing high morbidity and mortality as well as high costs. This chronic syndrome associates with a low functional status and quality of life. Most patients with HF are elderly, constituting up to 80% of patients suffering from this disease with both incidence and prevalence of the condition increasing with age. This is due to the progressive aging of the population as well as improved and better survival after cardiac insults, such as myocardial infarction, especially in developed countries. Notably, acute HF is the leading cause of hospitalization in patients over 65 years. Accordingly, early diagnosis and proper treatment are critical as they both influence prognosis in these patients.[3] Major therapeutic advancements, including drug development and some technological improvements related to HF therapies, have occurred in the last decade.[4] However, there is concern about whether patients treated every day in our clinical practice are similar to those included in clinical trials where these therapeutic strategies clearly demonstrated clinical efficacy. This is especially so for elderly patients, often under-represented or excluded in such large clinical trials. Of note, the term “elder has been applied until recently to patients with more than 65 years of age. Nevertheless, given the aging population, the age group that includes “elderly patients has shifted to over 70–80 years, with all the implications that this change implies. These patients are even more underrepresented in large controlled clinical trials. Therefore most experts consider further evidence is required, especially regarding issues related to specific characteristics of the elderly population. In addition, the importance of proper diagnosis and adequate and optimized therapy, which also refers to treatment of comorbidities, should be highlighted. Likewise, issues regarding the end-of-life care ought to be addressed with major attention in the subset of very old patients with HF.