CONGESTIVE HEART FAILURE IN OLDER ADULTS*: Epidemiology, Pathophysiology, and Etiology of Congestive Heart Failure in Older Adults
- 1 August 1997
- journal article
- review article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 45 (8), 968-974
- https://doi.org/10.1111/j.1532-5415.1997.tb02968.x
Abstract
To review the epidemiology, pathophysiology, and etiology of congestive heart failure (CHF) in older adults. Published reports relevant to the epidemiology, pathophysiology, and etiology of CHF were systematically reviewed. Studies involving older adults and more recent studies were emphasized. More than 75% of patients with CHF in the United States are older than 65 years of age, and CHF is the leading cause of hospitalization in older adults. CHF is also a major cause of chronic disability, and annual expenditures for CHF currently exceed $10 billion. In addition, both the incidence and prevalence of CHF are increasing, largely as a result of the aging of the population. Older adults are predisposed to developing CHF as a result of age-related changes in the cardiovascular system and the high prevalence of hypertension, coronary artery disease, and valvular heart disease in this age group. Although the fundamental pathophysiology of CHF is similar in younger and older patients, older individuals are more prone to develop CHF in the setting of preserved left ventricular systolic function. This syndrome, referred to as diastolic heart failure, accounts for up to 50% of all cases of CHF in adults more than 65 years of age. Coronary heart disease and hypertension are the most common etiologies of CHF in older adults, and they often coexist. Valvular heart disease, especially aortic stenosis and mitral regurgitation, are also common in older adults, whereas nonischemic dilated cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathy occur less frequently. Congestive heart failure is a major public health problem in the United States today as a result of its high and increasing prevalence in the older population as well as its substantial impact on healthcare costs and quality of life. There is an urgent need to develop more effective strategies for the prevention and treatment of CHF in older individuals.Keywords
This publication has 42 references indexed in Scilit:
- Epidemiology of heart failure in the United StatesAmerican Heart Journal, 1993
- Ventilatory mechanisms of exercise intolerance in chronic heart failureAmerican Heart Journal, 1992
- Diastolic dysfunction in elderly patients with congestive heart failureThe American Journal of Cardiology, 1989
- Hypertensive Hypertrophic Cardiomyopathy of the ElderlyNew England Journal of Medicine, 1985
- Reduced Thirst after Water Deprivation in Healthy Elderly MenNew England Journal of Medicine, 1984
- Exercise cardiac output is maintained with advancing age in healthy human subjects: cardiac dilatation and increased stroke volume compensate for a diminished heart rate.Circulation, 1984
- Functional mitral stenosis in patients with massive mitral annular calcification.Circulation, 1981
- Effect of Age on the Response of the Left Ventricular Ejection Fraction to ExerciseNew England Journal of Medicine, 1980
- Hypertrophic cardiomyopathy in the agedAmerican Heart Journal, 1978
- Bacterial endocarditis in subjects 60 years of age and older.Circulation, 1975