Background: Congestive heart failure (HF) represents a major public health problem with an age-related increasing prevalence. Despite the high mortality and morbidity in elderly patients with HF, limited clinical and prognostic data are available for development of appropriate prevention and treatment strategies. Methods: A cohort of 3327 outpatients consecutively enrolled in the Registry of Italian Network on Congestive Heart Failure by 133 cardiology centers was studied. Univariate and multivariate analyses were performed to compare patients 40%), an ischemic/valvular etiology, and atrial fibrillation/flutter. Elderly patients received angiotensin-converting enzyme inhibitors, β-blockers, and anticoagulants less frequently than younger patients did. The 1-year mortality rate was significantly higher in patients >70 years old (22% vs 13.7%, P <.001). Age was an independent predictor of 1-year mortality, increasing 2.8% by each year of age. Independent predictors of 1-year mortality in elderly patients were (1) ≥1 hospital admission in the previous year (relative risk [RR] 2.09, 95% Cl 1.51-2.87), (2) systolic blood pressure (RR 0.98, 95% Cl 0.97-0.99), (3) NYHA class III-IV (RR 1.57, 95% Cl 1.20-2.07), and (4) age (RR 1.028, 95% Cl 1.001-1.056). Conclusions: Our study confirms that elderly patients (1) are seen in a more advanced stage of HF, (2) are less likely to receive evidence-based treatments, (3) show more frequently preserved systolic function, and (4) have a worse prognosis. Consequently, there is a need to develop more effective and targeted management strategies for this escalating health problem.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine