The prevalence of heart failure rises with increasing age. Although patients
with heart failure are mainly elderly (age ≥65 years), evidence for efficacious
diagnostic and therapeutic approaches are limited in this population. Diagnosis of heart
failure in older people is challenging because of comorbidities masking symptoms and
signs; different diagnostic cut-offs of natriuretic peptides; and the high prevalence of
heart failure with preserved ejection fraction (HFPEF). Geriatric syndromes (such as
cognitive impairment, frailty, falls and incontinence) are common in heart failure and
can affect patients’ prognosis. In older patients with reduced ejection fraction,
angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and betablockers
have improved clinical outcomes. However no therapeutic strategy has yet
been found to improve prognosis of HFPEF which affect many older people.
Keywords: Ageing, Cardiac devices, Diagnosis, Ejection fraction, Elderly,
Geriatric syndromes, Heart failure, Left ventricular function, Systolic dysfunction,
Therapy.
