Lye M
Department of Geriatric Medicine, University of Liverpool.
Scott Med J. 1997 Oct;42(5):138-40. doi: 10.1177/003693309704200507.
Over 80% of patients with chronic heart failure are over the age of 65 years. A number of community based studies over the years have indicated that up to half of elderly patients with heart failure are undiagnosed and therefore untreated. The high proportion of elderly patients with heart failure who are undiagnosed is probably due to the non-specific presentation of the condition, heart failure symptoms being over shadowed by co-morbid conditions and the haemodynamic presentation of diastolic dysfunction, vide infra. Measurement of plasma atrial natriuretic peptide levels may be helpful in identifying elderly patients at risk of, or in the early stages of heart failure. Paradoxically, there are also a number of elderly patients who are being treated for heart failure who do not have the condition. Even with the secular changes occurring in lifestyles (smoking, diet, exercise) the prevalence of heart failure will continue to increase well into the next century because of the continuing increase in the number of older people. Difficulties with diagnosis of heart failure may be related to the observation that cardiologists tend to concentrate on young cardiac patients.
超过80%的慢性心力衰竭患者年龄在65岁以上。多年来的一些基于社区的研究表明，高达一半的老年心力衰竭患者未被诊断出来，因此未得到治疗。老年心力衰竭患者未被诊断出的比例很高，这可能是由于该病的非特异性表现、心力衰竭症状被合并症掩盖以及舒张功能障碍的血流动力学表现（见下文）。测量血浆心房利钠肽水平可能有助于识别有心力衰竭风险或处于心力衰竭早期的老年患者。矛盾的是，也有一些正在接受心力衰竭治疗的老年患者实际上并没有患这种病。即使生活方式（吸烟、饮食、运动）发生了长期变化，但由于老年人数量持续增加，心力衰竭的患病率在进入下个世纪后仍将继续上升。心力衰竭诊断困难可能与心脏病专家倾向于关注年轻心脏病患者这一现象有关。
