June 5, 2006Current Opinion in Cardiology
Drug therapy of chronic heart failure in the elderly: the current state of clinical-trial evidence
Key result
Standard guideline-directed HF therapies provide substantive clinical benefit and acceptable tolerability in elderly patients.
Why the study?
There have been very few prospective, placebo-controlled trials specifically in elderly heart-failure patients to determine the efficacy and tolerability of standard chronic heart-failure therapies.
Do standard chronic heart failure therapies improve mortality and morbidity in elderly patients with chronic heart failure?
Population
Elderly patients with chronic heart failure
Comparison
Standard chronic heart failure therapies including beta-blockers, ACE inhibitors, ARBs, aldosterone receptor antagonists, and digoxin
Design
Review of current clinical trial evidence
Authors
Discussion
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Overview
Beta-blockers may benefit elderly HF patients; leaves open optimal regimens and combinations in frail subgroups.
Structured PICO
Do standard chronic heart failure therapies improve mortality and morbidity in elderly patients with chronic heart failure?
P
Population
Elderly patients with chronic heart failure
I
Intervention
Standard chronic heart failure therapies (beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, aldosterone receptor antagonists, and digoxin)
O
Outcome
Mortality and morbidityhard clinical
Standard chronic heart failure therapies provide mortality and morbidity benefits in the elderly and should not be withheld due to age or fear of intolerance.
Limitations
- There have been very few prospective, placebo-controlled trials specifically in elderly heart-failure patients.
- The risk/benefit relationship of angiotensin-converting-enzyme therapy in the elderly has not been adequately determined.
- Data are limited regarding mortality in elderly patients treated with angiotensin II receptor blockers.
- Very few prospective, placebo-controlled trials specifically in elderly heart-failure patients
- Risk/benefit relationship of ACE inhibitor therapy in the elderly has not been adequately determined
- Limited data regarding mortality with ARBs in elderly patients
Cite This Study
Dulin et al. (2006) conducted a review in Chronic heart failure in the elderly. Standard chronic heart-failure therapies (beta-blockers, ACE inhibitors, ARBs, aldosterone antagonists, digoxin) was evaluated. Standard chronic heart-failure therapies provide substantive clinical benefit and are well tolerated in elderly patients, based on subgroup analyses of major trials.