Digital Management of Heart Failure in Aging Societies: Health System Transformation and Social Implications - A Narrative Review

Heart failure (HF) represents a multisystem syndromic challenge that imposes significant clinical and economic burdens on aging societies, with global costs estimated at US 284. 17 billion. Conventional hospital-centered care paradigms are limited by episodic and reactive frameworks that frequently fail to detect physiological decompensation during critical post-discharge phases. This narrative review synthesizes evidence focusing primarily on the 2016-2026 period, while integrating foundational seminal studies dating back to 2006, to evaluate the interdisciplinary impact of digital health interventions on HF management. Empirical findings demonstrate a fundamental shift toward proactive, pathophysiology-driven care supported by remote patient monitoring, implantable sensors, and artificial intelligence. Key clinical outcomes include a hazard ratio of 0. 80 for unplanned hospitalizations in landmark telemedical trials and a 92. 5% diagnostic accuracy for neural network models. Organizationally, hybrid "Hospital-at-Home" models and transition-of-care coaching have demonstrated significant reductions in readmissions. This review concludes that a sustainable digital transformation is contingent upon achieving alignment between technological capability, longitudinal economic reimbursement models, and robust governance to resolve the technological equity (“Techquity”) divide affecting high-risk aging populations.