The prevalence of chronic heart failure (CHF) is reaching epidemic proportions affecting as many as 10% of individuals by 80 years of age. The last decade has seen major advances in understanding the pathophysiology of CHF with coronary artery disease now being the leading cause. Also, the role of various neurohormones is being better defined. Several large trials have firmly established the survival benefit afforded by ACE inhibitors and beta- blockers. CHF in elderly patients is characterized by subtle clinical signs and a higher prevalence of patients with preserved systolic function. Also, changes in physiology result in altered pharmacokinetics and pharmacodynamic responses to various drugs, especially those excreted renally. Hence drug therapies should be tailored accordingly, keeping in mind the changes in the internal milieu. Studies from post-myocardial infarct survivors have demoonstrated trends in underutilization of beta-blockers in elderly patients, but have also shown that these very same patients derived a greater absolute benefit. Clearly there is a need for large, multicenter, randomized trials to better address this issue in elderly CHF patients.
|Translated title of the contribution||Beta-adrenergic blockade in elderly patients with chronic heart failure|
|Number of pages||10|
|Journal||Giornale di Gerontologia|
|State||Published - Jan 1 2000|
- Heart failure
ASJC Scopus subject areas
- Geriatrics and Gerontology