Drug Therapy of Heart Failure in the Elderly

Heart failure has many causes, but in the elderly is frequently due to ischaemic heart disease, hypertension or valve lesions. Management principles are similar to those for younger patients. However, in the very elderly, it may not be appropriate to persist with aggressive therapy aimed at mortality reduction at the expense of significant adverse effects. Accurate diagnosis of the mechanism of heart failure is essential to allow rational prescribing and to minimise the adverse effects of inappropriate drug use. This article discusses the approach to diagnosis and the spectrum of agents currently available for treatment of heart failure, and their limitations in the elderly.