- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Chapter 95 Cardiac and vascular ageing
- Chapter 96 Dyslipidemias and other cardiometabolic risk factors in older adults
- Chapter 97 Physical factors in arterial ageing
- Chapter 98 Peripheral vascular disease in older adults: diagnostic and treatment considerations
- Chapter 99 Aneurysmal diseases
- Chapter 100 Pulmonary thromboembolism
- Chapter 101 Hypertension in older adults
- Chapter 102 Syncope and neurocardiovascular instability
- Chapter 103 Management of atrial fibrillation and anticoagulant therapies
- Chapter 104 Management of bradyarrhythmias
- Chapter 105 Management of tachyarrhythmias
- Chapter 106 Ischaemic heart disease
- Chapter 107 Valvular heart disease: state of the art and treatment perspectives
- Chapter 108 Heart failure: definitions, investigation, and management
- Chapter 109 Cardiac rehabilitation
- Chapter 110 Cardiopulmonary resuscitation: outcomes and decision-making processes for older adults
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing
(p. 837) Heart failure: definitions, investigation, and management
- Chapter:
- (p. 837) Heart failure: definitions, investigation, and management
- Author(s):
John G. F. Cleland
and John Baxter
- DOI:
- 10.1093/med/9780198701590.003.0108
Heart failure is among the most common chronic debilitating conditions among older adults. The diagnosis is complex and usually made late, only after severe symptoms develop. Natriuretic peptides (BNP or NT-proBNP) are the key to early diagnosis of heart failure and echocardiography to its cause; most commonly ventricular dysfunction [either with a reduced (HFrEF) or preserved (HFpEF) left ventricular ejection fraction] or valve disease. For patients with HFrEF, pharmacological treatment with angiotensin converting-enzyme (ACE) inhibitors and mineralo-corticoid receptor antagonists and for those in sinus rhythm beta-blockers and ivabradine have transformed prognosis. For patients with a QRS duration >140 msec, cardiac resynchronization with atrio-biventricular pacing should be considered. Iron deficiency should be sought for and treated. For patients with HFpEF, robust evidence that treatments improve outcome is lacking but for symptoms, the pharmacological treatment of HFpEF and HFrEF may be rather similar.
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- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Chapter 95 Cardiac and vascular ageing
- Chapter 96 Dyslipidemias and other cardiometabolic risk factors in older adults
- Chapter 97 Physical factors in arterial ageing
- Chapter 98 Peripheral vascular disease in older adults: diagnostic and treatment considerations
- Chapter 99 Aneurysmal diseases
- Chapter 100 Pulmonary thromboembolism
- Chapter 101 Hypertension in older adults
- Chapter 102 Syncope and neurocardiovascular instability
- Chapter 103 Management of atrial fibrillation and anticoagulant therapies
- Chapter 104 Management of bradyarrhythmias
- Chapter 105 Management of tachyarrhythmias
- Chapter 106 Ischaemic heart disease
- Chapter 107 Valvular heart disease: state of the art and treatment perspectives
- Chapter 108 Heart failure: definitions, investigation, and management
- Chapter 109 Cardiac rehabilitation
- Chapter 110 Cardiopulmonary resuscitation: outcomes and decision-making processes for older adults
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing