Clinical and therapeutical particularities of heart failure in elderly

Introduction: There is an increase in the percentage of elderly population, and also of cardiovascular disease prevalence and mortality in this patient category in our country. Aim: We proposed to assess and identify potential clinical and therapeutic particularities in elderly with heart failure, which may allow possible interventions to improve prognosis. Methods: We selected 420 patients (p) aged > 65 years admitted in hospital, 220 men (52.4%) and 200 women (47.6 %) with heart failure NYHA class II -147 (35%), III -162 (38%), IV -53 (12%) and 58p (13.8%) with HFpEF; a total of 63 p (13.8%) had LVEF < 30%. There were registered demographic data, etiology, further investigations, associated pathology, as well as the administered drug therapy. Etiology of heart failure was: coronary heart disease – 278 (66.2%), hypertension – 294 (70%), cardiomyopathies – 12 (2.9%), diabetes -115 (27.4 %), primary valvular lesions – 12 (12.4%), thyroid disorders 4 (1%). Results: Associated were documented: renal failure – 96 (22.9%), peripheral vascular pathology – 22 (5.2%), history of stroke – 56 (13.3%), dyslipidemia – 130 (31%), anemia – 66 (15.5%), anxious – depressive psychiatric pathology – 46 (11%). 239 (56.9 %) patients had permanent atrial fibrillation, 122 (29%) paroxysmal and persistent atrial fibrillation, right bundle branch – 34 (8.1%), left bundle branch – (6.2%), left ventricle hypertrophy – 118 (28.1%). As medication we noted: converting enzyme inhibitors/ARB – 275 (65.5%), betablockers – 301 (71.7%), spironolactone – 146 (34.8%), calcium channel blockers -78 (18.6%), loop diuretics/ thiazide – 280 (66.7%), nitrates – 85 (20.2%), statins – 95 (22.6%), antiplatelets – 183 (43.6%), oral anticoagulants – 159 (37.9%). Conclusions: 1. Hypertension and coronary heart disease are major causes of heart failure in our elderly; 2.In terms of therapeutic intervention it is imperative to use a more sustained treatment with spironolactone, statins, a more adherence to guidelines for oral anticoagulation, correction of anemia and also of associated psychosocial factors; 3. A more extensive application of interventional and devices procedures would also be useful in this subset of patients.

ISSN
ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
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CNCSIS B+
CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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