Bader Feras, Atallah Bassam, Brennan Lisa F, Rimawi Rola H, Khalil Mohammed E
Cleveland Clinic Abu Dhabi, United Arab Emirates, Heart and Vascular Institute, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE.
Department of Pharmacy Services, Cleveland Clinic Abu Dhabi, United Arab Emirates, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE.
Heart Fail Rev. 2017 Mar;22(2):219-228. doi: 10.1007/s10741-017-9598-3.
Chronic heart failure (HF) is a disease with significantly higher prevalence in the elderly or patients older than 65 years old. Typically, older patients have more risk factors for HF, more comorbidities, and are more likely to have recurrent admissions for acute decompensations. With HF burden on health care systems primarily related to hospital and nursing home costs, it is critical that elderly patients are approached with a clear understanding of certain unique clinical, laboratory, imaging, and pharmacokinetic differences that can alter their management and outcomes. Psychosocial factors have major implications on adherence to therapy as well as decisions on advanced care for elderly HF patients. In this article, we highlight ten peculiar management considerations when approaching older patients with HF. We discuss issues related to epidemiology, diagnostic challenges, pharmacotherapy, and palliative care; all of which can impact this unique population and, more importantly, the disease burden as a whole.
慢性心力衰竭（HF）在老年人或65岁以上患者中的患病率显著更高。通常，老年患者有更多的心力衰竭危险因素、更多的合并症，并且更有可能因急性失代偿而反复住院。由于心力衰竭对医疗系统的负担主要与医院和疗养院费用相关，因此，清楚了解某些可能改变老年患者治疗和预后的独特临床、实验室、影像学和药代动力学差异至关重要。社会心理因素对老年心力衰竭患者的治疗依从性以及高级护理决策具有重大影响。在本文中，我们重点介绍了在治疗老年心力衰竭患者时需要考虑的十个特殊管理要点。我们讨论了与流行病学、诊断挑战、药物治疗和姑息治疗相关的问题；所有这些都会影响这一独特人群，更重要的是，会影响整个疾病负担。
