Clinical Medicine Insights: Geriatrics

Ryotaro Wake¹, Hidetaka Iida², Shinichi Shimodozono², Yukio Yamada², Takanori Kusuyama², Hiroaki Takeshita² and Minoru Yoshiyama¹

¹Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan. ²Department of Cardiology, Tsukazaki Hospital, Hyogo, Japan.

Abstract

An epidemic increase in heart failure (HF) mortality, hospitalization, and prevalence rates has been observed among older persons associated with increased an incidence and improved survival in recent years, in spite of a decrease in coronary artery and cerebrovascular disease mortality. Importantly, increases in HF mortality and morbidity rates were confined to the population over 65 years of age in the Framingham study. In contrast to middle-aged patients with HF, factors other than left ventricular (LV) systolic dysfunction contribute to HF in older patients. Epidemiological studies have established that 40 to 80 percent of older patients with heart failure, despite preserved ejection fraction without valve disease, are attributed to LV diastolic dysfunction.