Congestive heart failure in the elderly.

Changes occurring in the cardiovascular system as healthy subjects age, specifically vascular rigidity and decreased ventricular compliance, increase risks for the development of systolic hypertension, left ventricular hypertrophy, and diastolic dysfunction. These changes of "usual aging" act as independent risk factors which increase the frequency of morbid events accompanying hypertension and coronary artery disease as these diseases increase with age. The rate of congestive heart failure, for example, increases exponentially, developing a three-year mortality of 80% in patients older than 65. Advances in prevention, diagnosis, and management over the past decade have delayed the onset of cardiovascular events, extending healthy life span remarkably. These advances are reviewed, placing special attention on the changes of aging that effect the clinical management of older patients.