Drugs & Aging

, Volume 30, Issue 10, pp 765–782

Medication Management of Chronic Heart Failure in Older Adults

  • Kannayiram Alagiakrishnan
  • Maciej Banach
  • Linda G. Jones
  • Ali Ahmed
  • Wilbert S. Aronow
Therapy in Practice

Abstract

Heart failure (HF) is a common problem in older adults. Individuals aged 65 years or older are at a higher risk for developing HF, especially diastolic HF or HF with preserved ejection fraction (HFpEF). HF can be seen in up to 20 % of adults aged 85 years or older. In contrast to middle-aged (40–64 years) HF patients, multiple cardiac, non-cardiac and geriatric syndrome co-morbidities are seen in elderly HF patients. Additionally, age-related changes in pharmacokinetics and pharmacodynamics influence medication therapy. Hence, the management of older patients with HF is challenging and treatment should be modified in the light of the above-mentioned conditions. This article discusses the current evidence for medication management in both systolic HF or HF with reduced ejection fraction (HFrEF) and HFpEF, noting, however, the limited data for HFpEF and HFrEF in those 80 years of age or older. The objective of this article is to discuss evidence-based and outcomes-driven pharmacologic management strategies for chronic HF in the older adults for whom functional and other patient-centered outcomes might be more than or as important as clinical outcomes. Optimal management would be expected to help to reduce illness burden, reduce mortality and hospitalizations, and improve function and quality of life.

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Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Kannayiram Alagiakrishnan
    • 1
  • Maciej Banach
    • 2
  • Linda G. Jones
    • 3
    • 4
  • Ali Ahmed
    • 3
    • 4
  • Wilbert S. Aronow
    • 5
  1. 1.Division of Geriatric Medicine, Department of MedicineUniversity of AlbertaEdmontonCanada
  2. 2.Department of HypertensionMedical University of LodzLodzPoland
  3. 3.Section of GeriatricsVeterans Affairs Medical CenterBirminghamUSA
  4. 4.Division of Gerontology, Geriatrics, and Palliative Care, Department of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  5. 5.Division of Cardiology, Geriatrics and Pulmonary/Critical Care, Department of MedicineNew York Medical CollegeValhallaUSA

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