University of Oxford, Nuffield Department of Primary Care Health Sciences, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, United Kingdom.
Maturitas. 2017 Dec;106:26-30. doi: 10.1016/j.maturitas.2017.08.011. Epub 2017 Aug 25.
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution. The evidence for treatment of HF with preserved ejection fraction, or HFpEF, is much less well established in all age groups. Older people with HF are usually managed in primary care with input from specialist HF teams when needed. General practitioners are trained to take a generalist approach, which allows them to deliver holistic, person-centred care. The wider multidisciplinary team is also important during the patient's HF journey, with a particular need to consider palliative care towards the end of life. This article summarises the important aspects of HF management in older people from the perspective of primary care.
心力衰竭（HF）是一种常见的疾病，主要影响老年人。症状包括呼吸困难和疲劳，会显著降低生活质量。HF 很少单独发生，大多数患者有几种共存的疾病，需要多种药物治疗。对于射血分数降低的心力衰竭（HFrEF），有大量的治疗证据；然而，许多试验并未纳入患有多种疾病的老年人，因此其研究结果在应用于这一群体时应谨慎。在所有年龄段，射血分数保留的心力衰竭（HFpEF）的治疗证据都要少得多。有 HF 的老年人通常在初级保健中接受管理，在需要时可获得专科 HF 团队的支持。全科医生接受的培训是采用通科方法，从而能够提供全面、以患者为中心的护理。在患者的 HF 病程中，更广泛的多学科团队也很重要，尤其是在生命末期需要考虑姑息治疗。本文从初级保健的角度概述了老年人 HF 管理的重要方面。
