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Heart failure management in the elderly – a public health challenge

  • geriatrics: at crossroads of medicine
  • Published:
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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.

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Abbreviations

ACEI:

Angiotensin-converting enzyme inhibitor

ARB:

Angiotensin receptor blocker

AF:

Atrial fibrillation

CRT:

Cardiac resynchronization therapy

GP:

General practitioner

HF:

Heart failure

HFmrEF:

Heart failure with mid-range ejection fraction

HFpEF:

Heart failure with preserved ejection fraction

HFrEF:

Heart failure with reduced ejection fraction

LVEF:

Left ventricular ejection fraction

ICD:

Implantable cardioverter defibrillator

RCT:

Randomized clinical trial

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Funding

The authors acknowledge the project (Epidemiology of heart failure in Slovenia: prevalence, hospitalizations, and mortality, J3-7405) was financially supported by the Slovenian Research Agency.

Conflict of interest

N. Cvetinovic, G. Loncar and J. Farkas declare that they have no competing interests.

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Authors and Affiliations

  1. Cardiology Department, Clinical Hospital Center Zvezdara, Belgrade, Serbia

    Natasa Cvetinovic & Goran Loncar

  2. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Goran Loncar

  3. National Institute of Public Health, Ljubljana, Slovenia

    Jerneja Farkas MD, PhD

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  1. Natasa Cvetinovic
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  2. Goran Loncar
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  3. Jerneja Farkas MD, PhD
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Correspondence to Jerneja Farkas MD, PhD.

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Cvetinovic, N., Loncar, G. & Farkas, J. Heart failure management in the elderly – a public health challenge. Wien Klin Wochenschr 128 (Suppl 7), 466–473 (2016). https://doi.org/10.1007/s00508-016-1138-y

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