Epidemiological and clinical insights into heart failure among the elderly: Implications for management

Abstract

Introduction

Heart failure (HF) presents a significant healthcare challenge in the elderly population.

Objective

This study aimed to describe the epidemiological, clinical, and therapeutic profile of elderly individuals with HF within our hospital structure.

Method

A transversal retrospective study conducted over an 18 year period (2006–2023) included all patients aged over 65 with HF, followed up in the therapeutic unit for heart failure in the cardiology department of our university hospital. Data were collected using Excel.

Results

Among the 3990 patients monitored for HF, 1902 were aged over 65 years (47.6%), predominantly men (64.3%), with a mean age of 75.4 yo (66–104). Prevalent cardiovascular risk factors included hypertension (37.2%), diabetes mellitus (30%), dyslipidemia (10%), and tobacco use (31.6%). Notable comorbidities included stroke (17%), chronic obstructive pulmonary disease (1.72%), and end-stage chronic kidney disease (10.3%). Ischemic heart disease (74.8%), dilated cardiomyopathy (11.4%), and valvular heart disease (4.3%) were the principal etiologies of HF. Dyspnea predominated, mainly categorized as New York Heart Association (NYHA) stage II. Atrial fibrillation was present in 11.3% of patients. The distribution of HF types included HFrEF (62.2%), HFpEF (11.9%), and HFmrEF (25.9%). Adherence to pharmacotherapy varied, with most patients adhering to beta-blockers (83.5%), angiotensin-converting enzyme inhibitors (ACE-I) (93.6%), and furosemide (86.2%). The hospitalization rate for acute decompensated HF was 49.2%, with an overall mortality rate of 11.2%.

Conclusion

In conclusion, this study outlines HF characteristics in elderly patients, emphasizing high prevalence of risk factors and comorbidities, predominant ischemic etiology, and challenges in management despite pharmacotherapy adherence. Integration of multidisciplinary approaches and tailored interventions may enhance outcomes in this vulnerable population.