Acute heart failure syndrome in the elderly

Abstract

Acute heart failure (AHF) in the elderly is becoming an increasingly common clinical problem, associated with very high in-hospital and long-term mortality rates. Elderly AHF patients, as opposed to younger ones, may have a different demographic, pathophysiological, clinical, and prognostic profile, and therefore, some carefully considered therapeutic adjustments may be warranted for their treatment. Patients with older age, shock, diabetes, renal failure, infection, confusion, and severe non-cardiac comorbidities may be at the highest mortality risk.Answer questions and earn CME: https://wileyhealthlearning.com/Activity2/ 5608945/Activity.aspx

Treatment and management of advanced heart failure in elderly

“…Although it is a fact that mortality rates of end-stage HF patients are similar to those suffering from aggressive cancer, HF patients tend to overestimate their life expectancy [1]. For those, the trajectory is often stable for a period of time, and as their disease progresses, they experience repeated decompensations with return to near baseline function and health [8,21].…”

“…In high-income countries, the mean age of patients referring to medical wards with symptoms of acute heart failure is almost 75 years, while octogenarians (≥80 years) among them range between 21% and 38% [1][2][3]. Heart failure (HF) is currently the most common cause for hospitalization in the elderly and by 2030 it is expected that almost half of the medical resources for HF will be spent for the treatment of HF patients >80 years old age [1] and it stands to reason that the most terminal stage, known as advanced heart failure, is more common among the elderly [4].…”

“…In high-income countries, the mean age of patients referring to medical wards with symptoms of acute heart failure is almost 75 years, while octogenarians (≥80 years) among them range between 21% and 38% [1][2][3]. Heart failure (HF) is currently the most common cause for hospitalization in the elderly and by 2030 it is expected that almost half of the medical resources for HF will be spent for the treatment of HF patients >80 years old age [1] and it stands to reason that the most terminal stage, known as advanced heart failure, is more common among the elderly [4]. Patients with AHF comprise an estimated 1% to 10% of the overall heart failure population [5,6], and the increasing prevalence of HF in the elderly may be attributed to the outstanding improvements in the treatment of cardiovascular disease and the development of life-prolonging HF medication and device therapy.…”

“…Patients with AHF comprise an estimated 1% to 10% of the overall heart failure population [5,6], and the increasing prevalence of HF in the elderly may be attributed to the outstanding improvements in the treatment of cardiovascular disease and the development of life-prolonging HF medication and device therapy. Moreover, HF with preserved ejection fraction (HFpEF) syndrome is being increasingly acknowledged as a different entity, affecting primarily the elderly population [1][2][3][4][5][6][7].…”

Novel Markers and Therapies for Patients with Acute Heart Failure and Renal Dysfunction

“…La población anciana está creciendo rápidamente a nivel mundial, de 461 millones de personas mayores de 65 años en 2004, se estima un aumento hasta 2000 millones para el año 2050 (7). Para el 2030 se estima que casi la mitad de los recursos médicos destinados para falla cardiaca se empleen en el tratamiento de pacientes mayores de 80 años, población que además recibe un tratamiento médico subóptimo para esta condición (8).…”