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Pharmacological Management of Systolic Heart Failure in Older Adults

Ali Ahmed, MD, MPH, FACP, FACC, Division of Gerontology and Geriatric Medicine, Department of Medicine, School of Medicine, Department of Epidemiology and International Health, School of Public Health and Geriatric Heart Failure Clinic, University of Alabama at Birmingham; Section of Geriatrics and Geriatric Heart Failure Clinic, VA Medical Center; and Alabama Heart Failure Project, Alabama Quality Assurance Foundation; Birmingham, AB, USA.
Phillip L. Thornton, PhD, CGP, FASCP, Department of Pharmacy Practice, Auburn University James I. Harrison School of Pharmacy and Department of Medicine, Division of Gerontology and Geriatric Medicine and Geriatric Heart Failure Clinic, University of Alabama at Birmingham; Birmingham, AB, USA.

Heart failure is common in older adults and is associated with high mortality and hospitalization rates, and is the only cardiovascular syndrome with increasing incidence and mortality. Angiotensin-converting enzyme (ACE) inhibitors and beta-blockers reduce mortality and hospitalization rates for heart failure patients with left ventricular systolic dysfunction. Unfortunately, these life-saving drugs continue to be underutilized. ACE inhibitors and beta-blockers should be prescribed to all eligible systolic heart failure patients. Generalist physicians, who care for most heart failure patients, are perfectly capable of prescribing these life-saving drugs to older adults with systolic heart failure and should be encouraged to do so.