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Wiener klinische Wochenschrift
Erschienen in:

01.12.2016 | geriatrics: at crossroads of medicine

Heart failure management in the elderly – a public health challenge

verfasst von: Natasa Cvetinovic, Goran Loncar, Jerneja Farkas, MD, PhD

Erschienen in: Wiener klinische Wochenschrift | Sonderheft 7/2016

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Summary

Heart failure (HF) is a rapidly growing public health problem and the leading cause of morbidity, mortality, and hospitalization in populations > 65 years. The elderly HF patients have an increased prevalence of HF with preserved ejection fraction and comorbidities, may present with atypical symptoms and signs, have a higher risk for adverse drug reactions, and worse prognosis as compared with younger patients. Moreover, there is a lack of evidence-based therapies for this population because they are underrepresented in the clinical trials. The elderly are less likely to be evaluated by a cardiologist and to be treated in accordance with recommendations of the current HF guidelines. Although the treatment is improving, it is still suboptimal; therefore, HF in elderly patients requires mobilization of public health services and improvement of treatment strategies.
Vorheriger Artikel Muscle wasting in heart failure
Nächster Artikel Psychocardiology in the elderly
Literatur
1.
Ziaeian B, Fonarow GC. Epidemiology and aetiology of heart failure. Nat Rev Cardiol. 2016;13(6):368–78.CrossRefPubMed
2.
Ponikowski P, Voors AA, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891–975.CrossRefPubMed
3.
Shimokawa H, Miura M, Nochioka K, Sakata Y. Heart failure as a general pandemic in Asia. Eur J Heart Fail. 2015;17(9):884–92.CrossRefPubMed
4.
Sulaiman K, Panduranga P, Al-Zakwani I, et al. Clinical characteristics, management, and outcomes of acute heart failure patients: observations from the Gulf acute heart failure registry (Gulf CARE). Eur J Heart Fail. 2015;17(4):374–84.CrossRefPubMed
5.
Konishi M, Ishida J, Springer J, et al. Heart failure epidemiology and novel treatments in Japan: facts and numbers. Heart Fail. 2016;3:145–51.
6.
Christ M, Störk S, Dörr M, et al. Heart failure epidemiology 2000–2013: insights from the German Federal Health Monitoring System. Eur J Hear Fail. 2016;18(8):1009–18.CrossRef
7.
Bui AL, Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure. Nat Rev Cardiol. 2011;8(3):30–41.CrossRefPubMed
8.
Gabet A, Juillière Y, Lamarche-Vadel A, Vernay M, Olié V. National trends in rate of patients hospitalized for heart failure and heart failure mortality in France, 2000–2012. Eur J Heart Fail. 2015;17(6):583–90.CrossRefPubMed
9.
Von der Heidt A, Ammenwerth E, Bauer K, et al. Herz Mobil Tirol network: rationale for and design of a collaborative heart failure disease management program in Austria. Wien Klin Wochenschr. 2014;126(21–22):734–41.CrossRefPubMed
10.
Corrao G, Ghirardi A, Ibrahim B, Merlino L, Maggioni AP. Burden of new hospitalization for heart failure: a population-based investigation from Italy. Eur J Heart Fail. 2014;16(7):729–36.CrossRefPubMed
11.
Ponikowski P, Anker SD, AlHabib KF, et al. Heart failure: Preventing disease and death worldwide. Esc Heart Fail. 2014;1(1):4–25.CrossRef
12.
Omersa D, Farkas J, Erzen I, Lainscak M. National trends in heart failure hospitalization rates in Slovenia 2004–2012. Eur J Heart Fail. 2016; . doi:10.​1002/​ejhf.​617.PubMed
13.
Cowie MR, Anker SD, Cleland JG, et al. Improving care for patients with acute heart failure: before, during and after hospitalization. Esc Hear Fail. 2014;1(2):110–45.CrossRef
14.
Van Riet EES, Hoes AW, Wagenaar KP, Limburg A, Landman MAJ, Rutten FH. Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur J Heart Fail. 2016;18(3):242–52.CrossRefPubMed
15.
Lloyd-Jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. 2002;106(24):3068–72.CrossRefPubMed
16.
Lazzarini V, Mentz RJ, Fiuzat M, Metra M, O’Connor CM. Heart failure in elderly patients: distinctive features and unresolved issues. Eur J Heart Fail. 2013;15(7):717–23.CrossRefPubMedPubMedCentral
17.
Lainscak M, Letonja M, Kovacic D, et al. General public awareness of heart failure: results of questionnaire survey during Heart Failure Awareness Day 2011. Arch Med Sci. 2014;10(2):355–60.CrossRefPubMedPubMedCentral
18.
Störk S, Kavoliuniene A, Vinereanu D, et al. What does the lay public know about heart failure? Findings from the Heart Failure Awareness Day Initiative. Eur J Heart Fail. 2016;18(1):66–70.CrossRefPubMed
19.
SHAPE Study Group, Remme WJ, McMurray JJ, Hobbs FD, et al. Awareness and perception of heart failure among European cardiologists, internists, geriatricians, and primary care physicians. Eur Heart J. 2008;29(14):1739–52.CrossRef
20.
Remme WJ, McMurray JJ, Rauch B, et al. Public awareness of heart failure in Europe: first results from SHAPE. Eur Heart J. 2005;26(22):2413–21.CrossRefPubMed
21.
Vitale C, Rosano G, Fini M. Are elderly and women under-represented in cardiovascular clinical trials? Implication for treatment. Wien Klin Wochenschr. 2016; doi:10.​1007/​s00508-016-1082-x.
22.
Montero-Perez-Barquero M, Flather M, Roughton M, et al. Influence of systolic blood pressure on clinical outcomes in elderly heart failure patients treated with nebivolol: data from the SENIORS trial. Eur J Heart Fail. 2014;16(9):1009–15.CrossRefPubMed
23.
Metra M, Mentz RJ, Chiswell K, et al. Acute heart failure in elderly patients: worse outcomes and differential utility of standard prognostic variables. Insights from the PROTECT trial. Eur J Heart Fail. 2015;17(1):109–18.CrossRefPubMed
24.
Teixeira A, Parenica J, Park JJ, et al. Clinical presentation and outcome by age categories in acute heart failure: results from an international observational cohort. Eur J Heart Fail. 2015;17(11):1114–23.CrossRefPubMed
25.
Lund LH, Benson L, Ståhlberg M, et al. Age, prognostic impact of QRS prolongation and left bundle branch block, and utilization of cardiac resynchronization therapy: findings from 14713 patients in the Swedish Heart Failure Registry. Eur J Heart Fail. 2014;16(10):1073–81.CrossRefPubMed
26.
Vidán MT, Blaya-Novakova V, Sánchez E, Ortiz J, Serra-Rexach JA, Bueno H. Prevalence and prognostic impact of frailty and its components in non-dependent elderly patients with heart failure. Eur J Heart Fail. 2016;18(7):869–75.CrossRefPubMed
27.
Jugdutt BI. Aging and heart failure: changing demographics and implications for therapy in the elderly. Heart Fail Rev. 2010;15(5):401–5.CrossRefPubMed
28.
Abete P, Testa G, Della-Morte D, et al. Treatment for chronic heart failure in the elderly: current practice and problems. Heart Fail Rev. 2013;18(4):529–51.CrossRefPubMed
29.
Sahle BW, Owen AJ, Krum H, Reid CM. Incidence of heart failure in 6083 elderly hypertensive patients: the second Australian National Blood Pressure Study (ANBP2). Eur J Heart Fail. 2016;18(1):38–45.CrossRefPubMed
30.
Salam AM, AlBinali HA, Al-Mulla AW, et al. Women hospitalized with atrial fibrillation: gender differences, trends and outcome from a 20-year registry in a Middle Eastern country (1991–2010). Int J Cardiol. 2013;168(2):975–80.CrossRefPubMed
31.
Mogensen UM, Ersboll M, Andersen M, et al. Clinical characteristics and major comorbidities in heart failure patients more than 85 years of age compared with younger age groups. Eur J Hear Fail. 2011;13:1216–23.CrossRef
32.
Jones SA. Ageing to arrhythmias: conundrums of connections in the ageing heart. J Pharm Pharmacol. 2006;58(12):1571–6.CrossRefPubMed
33.
Musso CG, Oreopoulos DG. Aging and physiological changes of the kidneys including changes in glomerular filtration rate. Nephron Physiol. 2011;119:1–5.CrossRef
34.
Mangoni AA, Jackson SHD. Age-related changes in pharmacokinetics and pharmacodynamics: Basic principles and practical applications. Br J Clin Pharmacol. 2004;57(1):6–14.CrossRefPubMedPubMedCentral
35.
Barsheshet A, Shotan A, Cohen E, et al. Predictors of long-term (4-year) mortality in elderly and young patients with acute heart failure. Eur J Heart Fail. 2010;12(8):833–40.CrossRefPubMed
36.
Nieminen MS, Brutsaert D, Dickstein K, et al. Euro Heart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population. Eur Heart J. 2006;27(22):2725–36.CrossRefPubMed
37.
Cermakova P, Lund LH, Fereshtehnejad SM, et al. Heart failure and dementia: survival in relation to types of heart failure and different dementia disorders. Eur J Heart Fail. 2015;17(6):612–9.CrossRefPubMedPubMedCentral
38.
Ather S, Chan W, Bozkurt B, et al. Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved versus reduced ejection fraction. J Am Coll Cardiol. 2012;59(11):998–1005.CrossRefPubMedPubMedCentral
39.
Lainscak M, Hodoscek LM, Düngen HD, et al. The burden of chronic obstructive pulmonary disease in patients hospitalized with heart failure. Wien Klin Wochenschr. 2009;121(9–10):309–13.CrossRefPubMed
40.
Braunstein JB, Anderson GF, Gerstenblith G, et al. Noncardiac comorbidity increases preventable hospitalizations and mortality among medicare beneficiaries with chronic heart failure. J Am Coll Cardiol. 2003;42(7):1226–33.CrossRefPubMed
41.
Lainscak M, Cleland JG, Lenzen MJ, Follath F, Komajda M, Swedberg K. International variations in the treatment and co-morbidity of left ventricular systolic dysfunction: data from the EuroHeart Failure Survey. Eur J Heart Fail. 2007;9(3):292–9.CrossRefPubMed
42.
Loncar G, Springer J, Anker M, Doehner W, Lainscak M. Cardiac cachexia: hic et nunc. “hic et nunc” – here and now. Int J Cardiol. 2015;201:e1–e12.CrossRefPubMed
43.
Manzano L, Escobar C, Cleland JG, Flather M. Diagnosis of elderly patients with heart failure. Eur J Heart Fail. 2012;14(10):1097–103.CrossRefPubMed
44.
Olofsson M, Edebro D, Boman K. Are elderly patients with suspected HF misdiagnosed? A primary health care center study. Cardiology. 2007;107(4):226–32.CrossRefPubMed
45.
Wang CS, FitzGerald JM, Schulzer M, Mak E, Ayas NT. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA. 2005;294(15):1944–56.CrossRefPubMed
46.
Loncar G, Omersa D, Cvetinovic N, Arandjelovic A, Lainscak M. Emerging biomarkers in heart failure and cardiac cachexia. Int J Mol Sci. 2014;15(12):23878–96.CrossRefPubMedPubMedCentral
47.
Loncar G, Bozic B, Cvorovic V, et al. Relationship between RANKL and neuroendocrine activation in elderly males with heart failure. Endocrine. 2010;37(1):148–56.CrossRefPubMed
48.
McMurray JJ, Adamopoulos S, Anker SD, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012;14(8):803–69.CrossRefPubMed
49.
Bahrmann P, Bahrmann A, Hofner B, et al. Multiple biomarker strategy for improved diagnosis of acute heart failure in older patients presenting to the emergency department. Eur Heart J Acute Cardiovasc Care. 2015;4(2):137–47.CrossRefPubMed
50.
Rutten FH, Grobbee DE, Hoes AW. Differences between general practitioners and cardiologists in diagnosis and management of heart failure: a survey in every-day practice. Eur J Heart Fail. 2003;5(3):337–44.CrossRefPubMed
51.
Heiat A, Gross CP, Krumholz HM. Representation of the elderly, women, and minorities in heart failure clinical trials. Arch Intern Med. 2002;162(15):1682–8.CrossRefPubMed
52.
Flather MD, Shibata MC, Coats AJS, et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J. 2005;26(3):215–25.CrossRefPubMed
53.
Düngen HD, Apostolović S, Inkrot S, et al. Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS-ELD trial. Eur J Heart Fail. 2011;13(6):670–80.CrossRefPubMedPubMedCentral
54.
Pitt B, Segal R, Martinez FA, et al. Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE). Lancet. 1997;349(9054):747–52.CrossRefPubMed
55.
Cleland JG, Tendera M, Adamus J, et al. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J. 2006;27(19):2338–45.CrossRefPubMed
56.
Komajda M, Hanon O, Hochadel M, et al. Contemporary management of octogenarians hospitalized for heart failure in Europe: Euro Heart Failure Survey II. Eur Heart J. 2009;30(4):478–86.CrossRefPubMed
57.
Crespo-Leiro MG, Anker SD, Maggioni AP, et al. European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1‑year follow-up outcomes and differences across regions. Eur J Heart Fail. 2016;18(6):613–25.CrossRefPubMed
58.
Maggioni AP, Anker SD, Dahlström U, et al. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2013;15(10):1173–84.CrossRefPubMed
59.
Stock S, Redaelli M, Simic D, Siegel M, Henschel F. Risk factors for the prescription of potentially inappropriate medication (PIM) in the elderly : an analysis of sickness fund routine claims data from Germany. Wien Klin Wochenschr. 2014;126(19–20):604–12.CrossRefPubMed
60.
Lainscak M, Vitale C, Seferovic P, et al. Pharmacokinetics and pharmacodynamics of cardiovascular drugs in chronic heart failure. Int J Cardiol. 2016;224:191–8.CrossRefPubMed
61.
Roblek T, Trobec K, Mrhar A, Lainscak M. Potential drug-drug interactions in hospitalized patients with chronic heart failure and chronic obstructive pulmonary disease. Arch Med Sci. 2014;10(5):920–32.CrossRefPubMedPubMedCentral
62.
Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA. 2005;294(6):716–24.CrossRefPubMed
63.
Strehblow C, Smeikal M, Fasching P. Polypharmacy and excessive polypharmacy in octogenarians and older acutely hospitalized patients. Wien Klin Wochenschr. 2014;126(7–8):195–200.CrossRefPubMed
64.
Van Der Wal MHL, Jaarsma T, Van Veldhuisen DJ. Non-compliance in patients with heart failure; How can we manage it? Eur J Heart Fail. 2005;7(1):5–17.CrossRef
65.
Mazzella F, Cacciatore F, Galizia G, et al. Social support and long-term mortality in the elderly: role of comorbidity. Arch Gerontol Geriatr. 2010;51(3):323–8.CrossRefPubMed
66.
Tehrani F, Phan A, Chien CV, Morrissey RP, Rafique AM, Schwarz ER. Value of medical therapy in patients 〉80 years of age with heart failure and preserved ejection fraction. Am J Cardiol. 2009;103(6):829–33.CrossRefPubMed
67.
Massie BM, Carson PE, McMurray JJ, et al. Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med. 2008;359(23):2456–67.CrossRefPubMed
68.
Lainscak M, Pelliccia F, Rosano G, et al. Safety profile of mineralocorticoid receptor antagonists: spironolactone and eplerenone. Int J Cardiol. 2015;200:25–9.CrossRefPubMed
69.
Ferrara N, Davia K, Abete P, Rengo F, Harding SE. Alterations in beta-adrenoceptor mechanisms in the aging heart. Relationship with heart failure. Aging (Milano). 1997;9(6):391–403.
70.
Dungen HD, Musial-Bright L, Inkrot S, et al. Heart rate following short-term beta-blocker titration predicts all-cause mortality in elderly chronic heart failure patients: Insights from the CIBIS-ELD trial. Eur J Heart Fail. 2014;16(8):907–14.CrossRefPubMed
71.
Loncar G, von Haehling S, Tahirovic E, et al. Effect of beta blockade on natriuretic peptides and copeptin in elderly patients with heart failure and preserved or reduced ejection fraction: Results from the CIBIS-ELD trial. Clin Biochem. 2012;45(1–2):117–22.CrossRefPubMed
72.
Lainscak M, Podbregar M, Kovacic D, Rozman J, Von Haehling S. Differences between bisoprolol and carvedilol in patients with chronic heart failure and chronic obstructive pulmonary disease: A randomized trial. Respir Med. 2011;105(Suppl 1):S44–S49.CrossRefPubMed
73.
Kotecha D, Manzano L, Krum H, et al. Effect of age and sex on efficacy and tolerability of β blockers in patients with heart failure with reduced ejection fraction: individual patient data meta-analysis. BMJ. 2016;353:i1855.CrossRefPubMedPubMedCentral
74.
Tavazzi L, Swedberg K, Komajda M, et al. Efficacy and safety of ivabradine in chronic heart failure across the age spectrum: Insights from the SHIFT study. Eur J Heart Fail. 2013;15(11):1296–303.CrossRefPubMed
75.
Swindle JP, Rich MW, McCann P, Burroughs TE, Hauptman PJ. Implantable cardiac device procedures in older patients: use and in-hospital outcomes. Arch Intern Med. 2010;170(7):631–7.CrossRefPubMed
76.
Ghanbari H, Dalloul G, Hasan R, et al. Effectiveness of implantable cardioverter-defibrillators for the primary prevention of sudden cardiac death in women with advanced heart failure: a meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169(16):1500–6.CrossRefPubMed
77.
Butler CR, Jugdutt BI. Mechanical circulatory support for elderly heart failure patients. Heart Fail Rev. 2012;17(4–5):663–9.CrossRefPubMed
78.
McDonagh TA, Blue L, Clark AL, et al. European society of cardiology heart failure association standards for delivering heart failure care. Eur J Heart Fail. 2011;13(3):235–41.CrossRefPubMed
79.
Maggioni AP, Orso F, Calabria S, et al. The real-world evidence of heart failure: findings from 41 413 patients of the ARNO database. Eur J Heart Fail. 2016;18(4):402–10.CrossRefPubMed
80.
81.
Sciarretta S, Palano F, Tocci G, Baldini R, Volpe M. Antihypertensive treatment and development of heart failure in hypertension: a Bayesian network meta-analysis of studies in patients with hypertension and high cardiovascular risk. Arch Intern Med. 2011;171(5):384–94.PubMed
82.
SPRINT Research Group, Wright JT Jr, Williamson JD, Whelton PK, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103–16.CrossRef
83.
Dunbar SB, Clark PC, Quinn C, Gary RA, Kaslow NJ. Family influences on heart failure self-care and outcomes. J Cardiovasc Nurs. 2009;23(3):258–65.CrossRef
84.
Cleland JG, Ekman I. Enlisting the help of the largest health care workforce-patients. JAMA. 2010;304(12):1383–4.CrossRefPubMed
Metadaten
Titel
Heart failure management in the elderly – a public health challenge
verfasst von
Natasa Cvetinovic
Goran Loncar
Jerneja Farkas, MD, PhD
Publikationsdatum
01.12.2016
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe Sonderheft 7/2016
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-016-1138-y

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