Time to focus on the more typical heart-failure patients

Heart failure affects older individuals disproportionately, with more than 75% of the patients aged 65 years of age or more. 1 US Department of Health and Human ServicesMorbidity and mortality chartbook on cardiovascular, lung, and blood disease, 1990–1994. National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD1994 Google Scholar Patients with heart failure are usually in their mid to late 70s, with an equal proportion of men and women. Despite this pattern, most clinical studies have focused on younger, predominantly male populations. For example, the patients enrolled in the Studies of Left Ventricular Dysfunction (SOLVD), an investigation of the efficacy of angiotensin-converting-enzyme (ACE) inhibitors for patients with heart failure and left-ventricular dysfunction, had an average age of 61, and 80% were men. 2 The SOLVD InvestigatorsEffect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991; 325: 293-302 Crossref PubMed Scopus (6637) Google Scholar Risk of morbidity from renovascular disease in elderly patients with congestive cardiac failureSome elderly patients with occult renovascular disease on ACE inhibitors will be at risk of developing uraemia. Renal function should be closely monitored to detect any deterioration early. Full-Text PDF