Heart Failure in Older Persons: Considerations For The Primary Care Physician

Abstract

Heart failure (HF) affects over 500,000 Canadians, with 50,000 new patients diagnosed each year. While mortality from cardiovascular diseases has progressively declined in Canada, the burden of HF is expected to continue rising as a result of population aging and improved survival of patients with other cardiovascular diseases. HF is the leading cause of hospitalization and death among those aged 65 years and over, with a mortality rate of up to 50% within 5 years of diagnosis. Elderly HF patients are complex: a recent Ontario study of home care recipients with HF found that these clients had more health instability, took more medications, and had more co-morbidities compared with other home care clients. Optimal management of HF in “complex seniors” requires that clinicians understand the interactions between HF and age-associated syndromes such as frailty, cognitive impairment, and functional decline. As the majority of Canadian patients with HF are treated by primary care providers (PCPs), this article is directed at PCPs caring for older adults with HF. It is meant as a brief overview and discusses how the Canadian Cardiovascular Society (CCS) Consensus Guidelines on HF can be applied in daily practice.