Prevalence of Heart Failure in the Elderly

The prevalence of heart failure (HF) increases with age. While clinical trials suggest that contemporary evidence-based HF therapies have reduced morbidity and mortality, these trials largely excluded the elderly. Questions remain regarding the clinical characteristics of elderly HF patients and the impact of contemporary therapies on their outcomes.

In heart failure, the heart cannot pump enough blood through the body. The heart cannot fill with enough blood or pump with enough force, or both. Heart failure develops over time as the pumping action of the heart gets weaker. It can affect either the right, the left, or both sides of the heart. Heart failure does not mean that the heart has stopped working or is about to stop working.

Heart failure can also be called congestive heart failure, systolic heart failure, diastolic heart failure, left-sided heart failure, or right-sided heart failure. In most cases, heart failure affects the left side of the heart when it cannot pump enough oxygen-rich blood to the rest of the body. When heart failure affects the right side, the heart cannot pump enough blood to the lungs, where it picks up oxygen.

Regardless of the specific definition for elderly, it is clear that HF is primarily a condition of the older population in developed countries. Elderly HF patients demonstrate distinctive pathophysiological features, complex co-morbidity profiles, and unique issues of medication tolerance.