Treatment of heart failure in patients aged 75 years or older: Comparison with younger patients

Agustín Urrutia, Josep Lupón, Salvador Altimir, Beatriz González, Joan Herreros, Crisanto Díez, Ramón Coll, Vicente Valle, Celestino Rey-Joly

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Abstract

Objectives: to analyze the differences in clinical features, therapy and outcome in elderly patients and those aged less than 75 years with a diagnosis of heart failure. Patients and methods: patients managed in a multidisciplinary heart failure unit in whom data on diagnosis, treatment and mortality were available at 1 year of follow-up were included. To analyze differences between the two age groups, χ2 test and Student's t-test or the Kruskal-Wallis test were used, according to the type of variables and normality of the distribution (95% confidence interval). Results: there were 323 patients, with a mean age of 64.9 years, SD 10.5 (range: 35-85); 73% were men. Fifty-seven patients were aged ≥ 75 years. There were no differences between the two groups in the etiology of heart failure. Women were more frequent in the group aged 75 years or older (42.1% versus 23.8%, p = 0.003) and respiratory disease (29.8% versus 18.4%, p = 0.05) and anemia (42.1% versus 24.8%, p = 0.008) were more common. The group aged < 75 years was more frequently treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor antagonists (91.7% versus 77.2%, p = 0.001), beta-blockers (81.6% versus 49.3%, p < 0.001) and statins (62.8% versus 43.1%, p = 0.004). A greater number of patients aged > 75 were treated with hydralazine + nitrates (19.2% versus 6.8%, p = 0.003) and amiodarone (36.8% versus 16.9%, p = 0.001). Carvedilol doses were lower in the elderly group: 14.6 mg (SD 10.6) versus 29.4 mg (SD 18.4), p < 0.001. Doses of ACE inhibitors were similar in the two groups and furosemide doses were higher in patients aged ≥ 75 years: 67.0 mg (SD 2.5) versus 56.2 mg (SD 27.3), p = 0.008. Mortality 1 year after analysis of treatment was significantly higher in patients aged ≥ 75 years (22% versus 8%). Conclusions: differences in treatment between elderly patients and those aged < 75 years with heart failure were evident in this sample, especially in the use of beta blockers. Predictably, mortality was significantly higher in patients aged ≥ 75 years.
Original languageEnglish
Pages (from-to)264-269
JournalRevista Espanola de Geriatria y Gerontologia
Volume41
Issue number5
DOIs
Publication statusPublished - 1 Jan 2006

Keywords

  • Heart failure
  • Old-old
  • Treatment

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