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Congestive heart failure in the elderly: the Cardiovascular Health Study.

TitleCongestive heart failure in the elderly: the Cardiovascular Health Study.
Publication TypeJournal Article
Year of Publication2004
AuthorsMathew, ST, Gottdiener, JS, Kitzman, D, Aurigemma, G
JournalAm J Geriatr Cardiol
Volume13
Issue2
Pagination61-8
Date Published2004 Mar-Apr
ISSN1076-7460
KeywordsAged, Aged, 80 and over, Atrial Natriuretic Factor, Blood Pressure, Diagnosis, Differential, Female, Geriatric Assessment, Heart Atria, Heart Failure, Heart Rate, Humans, Incidence, Male, Prevalence, Risk Factors, Stroke Volume, United States, Ventricular Dysfunction, Left
Abstract<p>Congestive heart failure in the elderly is recognized as a national public health priority; however, clinical diagnosis can be problematic in elderly persons, many of whom have a history of heart failure in the presence of normal or only minimally decreased ejection fraction. Findings of the Cardiovascular Health Study have underscored the common substrate and predictors underlying heart failure both with decreased ejection fraction and with normal ejection fraction (i.e., diastolic heart failure). Coronary heart disease, systolic blood pressure, and C-reactive protein (a measure of inflammation) are predictive of heart failure independent of ejection fraction. Left atrial size, arguably a marker of the effects of impaired diastolic filling over time, is increased in both systolic and diastolic heart failure of the elderly, as is atrial natriuretic peptide. The outcome of heart failure in elderly persons is poor both for systolic and diastolic heart failure. Moreover, many community-dwelling elderly persons have decreased ejection fraction without heart failure. In these persons the chance of death is similar to that of participants with diastolic heart failure. Since most clinical trials have studied younger patients with predominantly systolic heart failure, the appropriate therapy for heart failure in elderly persons remains to be determined.</p>
DOI10.1111/j.1076-7460.2004.02121.x
Alternate JournalAm J Geriatr Cardiol
PubMed ID15010652
Grant ListR01 AG018915 / AG / NIA NIH HHS / United States