Congestive Heart Failure in the Elderly
Over the past 30 years, the prevalence and incidence of heart failure (HF) have increased markedly with age, with increases of approximately fivefold from the age of 40 to 70 years. HF is predominantly a disorder of the elderly, and over 70% of HF patients are over 65 years old. The most important f...
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| Format: | Article |
| Language: | English |
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Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)
2007-12-01
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| Series: | International Journal of Gerontology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1873959808700383 |
| _version_ | 1819104906495131648 |
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| author | Chiung-Zuan Chiu Jun-Jack Cheng |
| author_facet | Chiung-Zuan Chiu Jun-Jack Cheng |
| author_sort | Chiung-Zuan Chiu |
| collection | DOAJ |
| description | Over the past 30 years, the prevalence and incidence of heart failure (HF) have increased markedly with age, with increases of approximately fivefold from the age of 40 to 70 years. HF is predominantly a disorder of the elderly, and over 70% of HF patients are over 65 years old. The most important factor in the increasing prevalence and incidence of HF is the growing proportion of elderly with new-onset diastolic HF resulting from chronic hypertension and coronary heart disease. Other predictors of HF include diabetes, prior stroke, atrial fibrillation, renal dysfunction, reduced ankle-brachial index, increased C-reactive protein, left ventricular hypertrophy, reduced forced expiratory volume, and obesity. At least half of all elderly HF patients have preserved left ventricular systolic function, and they are classified as diastolic HF. There was a strong female predominance (67%) in diastolic HF when compared with male HF patients. The morbidity and mortality of older HF patients are the highest of any chronic cardiovascular disorder. Mortality increases markedly with age. Mortality from diastolic HF is about half of that reported for systolic HF. There are some comorbidities in older HF patients, including renal dysfunction, chronic lung disease, cognitive dysfunction, depression, postural hypotension, urine incontinence, sensory deprivation, nutritional disorders, polypharmacy and frailty, which may precipitate and exacerbate the underlying HF symptoms. Clinical diagnosis of HF may be more difficult in the elderly because of frequently inadequate history taking, less evident HF symptoms for reduced daily activity, and similar symptoms to other frequent disorders. The treatment goals in older HF patients resemble those for any chronic disorder and include relief of symptoms, improvement in functional status, exercise tolerance, quality of life, prevention of acute exacerbation, and finally, prolongation of long-term survival. |
| first_indexed | 2024-12-22T02:13:48Z |
| format | Article |
| id | doaj.art-a8e1a4a4b9cd4f6fac4b0a254457eb1d |
| institution | Directory Open Access Journal |
| issn | 1873-9598 |
| language | English |
| last_indexed | 2024-12-22T02:13:48Z |
| publishDate | 2007-12-01 |
| publisher | Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM) |
| record_format | Article |
| series | International Journal of Gerontology |
| spelling | doaj.art-a8e1a4a4b9cd4f6fac4b0a254457eb1d2022-12-21T18:42:20ZengTaiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)International Journal of Gerontology1873-95982007-12-011414315210.1016/S1873-9598(08)70038-3Congestive Heart Failure in the ElderlyChiung-Zuan Chiu0Jun-Jack Cheng1School of Medicine, Fu Jen Catholic University, Taipei, TaiwanSchool of Medicine, Fu Jen Catholic University, Taipei, TaiwanOver the past 30 years, the prevalence and incidence of heart failure (HF) have increased markedly with age, with increases of approximately fivefold from the age of 40 to 70 years. HF is predominantly a disorder of the elderly, and over 70% of HF patients are over 65 years old. The most important factor in the increasing prevalence and incidence of HF is the growing proportion of elderly with new-onset diastolic HF resulting from chronic hypertension and coronary heart disease. Other predictors of HF include diabetes, prior stroke, atrial fibrillation, renal dysfunction, reduced ankle-brachial index, increased C-reactive protein, left ventricular hypertrophy, reduced forced expiratory volume, and obesity. At least half of all elderly HF patients have preserved left ventricular systolic function, and they are classified as diastolic HF. There was a strong female predominance (67%) in diastolic HF when compared with male HF patients. The morbidity and mortality of older HF patients are the highest of any chronic cardiovascular disorder. Mortality increases markedly with age. Mortality from diastolic HF is about half of that reported for systolic HF. There are some comorbidities in older HF patients, including renal dysfunction, chronic lung disease, cognitive dysfunction, depression, postural hypotension, urine incontinence, sensory deprivation, nutritional disorders, polypharmacy and frailty, which may precipitate and exacerbate the underlying HF symptoms. Clinical diagnosis of HF may be more difficult in the elderly because of frequently inadequate history taking, less evident HF symptoms for reduced daily activity, and similar symptoms to other frequent disorders. The treatment goals in older HF patients resemble those for any chronic disorder and include relief of symptoms, improvement in functional status, exercise tolerance, quality of life, prevention of acute exacerbation, and finally, prolongation of long-term survival.http://www.sciencedirect.com/science/article/pii/S1873959808700383chronic hypertensioncoronary artery diseasediastolic heart failureelderlyheart failure |
| spellingShingle | Chiung-Zuan Chiu Jun-Jack Cheng Congestive Heart Failure in the Elderly International Journal of Gerontology chronic hypertension coronary artery disease diastolic heart failure elderly heart failure |
| title | Congestive Heart Failure in the Elderly |
| title_full | Congestive Heart Failure in the Elderly |
| title_fullStr | Congestive Heart Failure in the Elderly |
| title_full_unstemmed | Congestive Heart Failure in the Elderly |
| title_short | Congestive Heart Failure in the Elderly |
| title_sort | congestive heart failure in the elderly |
| topic | chronic hypertension coronary artery disease diastolic heart failure elderly heart failure |
| url | http://www.sciencedirect.com/science/article/pii/S1873959808700383 |
| work_keys_str_mv | AT chiungzuanchiu congestiveheartfailureintheelderly AT junjackcheng congestiveheartfailureintheelderly |