Current Heart Failure Reports

, Volume 10, Issue 4, pp 387–400

Heart Failure in Very Old Adults

Epidemiology of Heart Failure (J Butler, Section Editor)

DOI: 10.1007/s11897-013-0163-7

Cite this article as:
Forman, D.E., Ahmed, A. & Fleg, J.L. Curr Heart Fail Rep (2013) 10: 387. doi:10.1007/s11897-013-0163-7


Heart failure (HF) increases significantly in relation to advancing age, yet management for HF in very old adults remains ambiguous. With aging, not only do age-related, morphological and physiological cardiovascular changes predispose to HF, there is also increased prevalence of comorbid conditions that compound cardiac limitations (e.g., renal insufficiency and chronic obstructive lung disease) and others that tend to overwhelm limited cardiovascular reserves (e.g., infections and ischemia). Standard HF pharmacological and device therapies do little to moderate the wide spectrum of insidious age-related processes that are elemental to HF pathophysiology among older patients. Moreover, the utility of standard HF therapy is usually premised on its efficacy for life prolongation, whereas quality of life, increased physical and cognitive function, and preserved independence may be regarded as higher (or even highest) priority. In this review we study age-related susceptibility to HF, as well as the utility and limitations of standard HF strategies. Both HF with reduced ejection fraction and HF with preserved ejection fraction are considered.


Heart failureVery oldAdvanced ageAging physiologyGeriatricsHeart failure prevalenceComorbidityMultimorbidity

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Daniel E. Forman
    • 1
    • 2
  • Ali Ahmed
    • 3
  • Jerome L. Fleg
    • 4
  1. 1.Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonUSA
  2. 2.New England Geriatric Research, Education, and Clinical CenterVA Boston Healthcare SystemBostonUSA
  3. 3.University of Alabama at Birmingham and VA Medical CenterBirminghamUSA
  4. 4.National Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaUSA