Drug therapy of chronic heart failure in the elderly: the current state of clinical-trial evidence.

Abstract:

PURPOSE OF REVIEW:beta-Blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, aldosterone receptor antagonists, and digoxin are the most common drug classes used to treat chronic heart failure. We examine current clinical trial evidence concerning heart-failure management in the elderly. RECENT FINDINGS:beta-Blockers provide significant mortality benefit to elderly heart-failure patients and are remarkably well tolerated. Angiotensin-converting-enzyme inhibitors improve mortality and morbidity in systolic heart failure. However, the risk/benefit relationship of angiotensin-converting-enzyme therapy in the elderly has not been adequately determined. Angiotensin II receptor blockers improve morbidity in elderly and non-elderly chronic heart-failure patients; however, data are limited regarding mortality in these patients. Aldosterone receptor antagonists provide significant mortality benefit to elderly chronic heart-failure patients. Digoxin is beneficial as an additive therapy in the treatment of systolic heart failure regardless of advanced age. SUMMARY:Agents that provide substantive clinical benefit overall also appear to do so in the elderly, based on subgroup analysis of major trials. There have been very few prospective, placebo-controlled trials specifically in elderly heart-failure patients. Elderly heart-failure patients generally tolerate standard chronic heart-failure therapies well. Standard chronic heart-failure therapies should not be withheld from elderly patients based on concerns regarding efficacy or fear of medication intolerance.

journal_name

Curr Opin Cardiol

authors

Dulin BR,Krum H

doi

10.1097/01.hco.0000231411.15049.20

subject

Has Abstract

pub_date

2006-07-01 00:00:00

pages

393-9

issue

4

eissn

0268-4705

issn

1531-7080

pii

00001573-200607000-00020

journal_volume

21

pub_type

杂志文章,评审
  • Myocardial viability in patients with coronary artery disease and left ventricular dysfunction: transplantation or revascularization?

    abstract::Coronary artery bypass surgery performed in patients with coronary artery disease and left ventricular dysfunction improves survival compared with antianginal therapy alone. The mechanisms for this survival advantage with revascularization therapy have not been systematically elucidated. Many of these patients have "h...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199607000-00008

    authors: DeNofrio D,Loh E

    更新日期:1996-07-01 00:00:00

  • Global patterns of health care for acute coronary syndromes.

    abstract:PURPOSE OF REVIEW:Despite similar guidelines, remarkable global differences exist in the management of acute coronary syndromes. This review describes recent insights in global patterns of patient baseline characteristics, treatment strategies, medication use, and outcome in acute coronary syndromes. RECENT FINDINGS:R...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000142063.30214.d2

    authors: Sinnaeve PR,Van de Werf FJ

    更新日期:2004-11-01 00:00:00

  • E-counseling as an emerging preventive strategy for hypertension.

    abstract:PURPOSE OF REVIEW:Lifestyle counseling that includes exercise training, diet modification, and medication adherence is critical to hypertension management. This article summarizes the efficacy of lifestyle counseling interventions in face-to-face, telehealth, and e-counseling settings. It also discusses the therapeutic...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000080

    authors: Nolan RP,Liu S,Payne AY

    更新日期:2014-07-01 00:00:00

  • Cardiovascular implications and complications of the coronavirus disease-2019 pandemic: a world upside down.

    abstract:PURPOSE OF REVIEW:The new pandemic of coronavirus disease-2019 (COVID-19) has produced a global tumult and has overburdened national health systems. We herein discuss the cardiovascular implications and complications of this pandemic analyzing the most recent data clustered over the last several months. RECENT FINDING...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章

    doi:10.1097/HCO.0000000000000838

    authors: Manolis AS,Manolis TA,Manolis AA,Melita H

    更新日期:2020-12-30 00:00:00

  • Tilt-table testing and syncope.

    abstract::Syncope is a common clinical problem with multiple potential causes. Recent studies have delineated the natural history and most frequent causes of recurrent syncopal episodes. The medical history and detailed physical examination are particularly important. Clinical electrophysiologic testing has also played a crit...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:

    authors: Benditt DG,Asso A,Remole S,Lurie K

    更新日期:1992-02-01 00:00:00

  • Management of heart failure in the elderly.

    abstract:PURPOSE OF REVIEW:Heart failure is a major chronic illness with no definitive cure. With improving healthcare and with an aging population in many countries, heart failure has become a common disease of the elderly. Pharmacological management of heart failure in the elderly remains a challenge. The syndrome of heart fa...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000375

    authors: Alghamdi F,Chan M

    更新日期:2017-03-01 00:00:00

  • Risk stratification in hypertrophic cardiomyopathy.

    abstract::Hypertrophic cardiomyopathy is a primary myocardial disorder with an autosomal pattern of inheritance, characterized by asymmetric left ventricular hypertrophy with myocyte and myofibrillar disarray. Approximately 30% to 50% of all cases are accounted for by mutations in the beta-cardiac myosin heavy chain gene on chr...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199405000-00011

    authors: Vassalli G,Seiler C,Hess OM

    更新日期:1994-05-01 00:00:00

  • Dyslipidemia and cardiovascular changes in children.

    abstract:PURPOSE OF REVIEW:In this review, we firstly highlight the role of dyslipidemia as a trigger in the initiation and progression of endothelial dysfunction, considered the earliest atherosclerotic lesion and patent in children with risk factors.In this context, we also revise methods that reflect the impact of endothelia...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000249

    authors: Pires A,Sena C,Seiça R

    更新日期:2016-01-01 00:00:00

  • Update on digoxin and other oral positive inotropic agents for chronic heart failure.

    abstract::The benefit of digoxin in chronic heart failure has been debated fervently for decades. In the 1970s, the use of digoxin was challenged due to the high incidences of digitalis toxicity and the lack of data on the effects of digoxin in patients with chronic heart failure. In the 1980s, interest in digoxin was renewed a...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199705000-00004

    authors: Reddy S,Benatar D,Gheorghiade M

    更新日期:1997-05-01 00:00:00

  • An update in the management of acute decompensated heart failure.

    abstract:PURPOSE OF REVIEW:This review will provide an overview of recent advances in the management of acute decompensated heart failure, focusing on major publications from the past few years. RECENT FINDINGS:There have been several publications investigating different strategies in the management of acute decompensated hear...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000038

    authors: Maze R,Haddad H

    更新日期:2014-03-01 00:00:00

  • Preventive cardiology in the elderly.

    abstract::Cardiovascular disease is the leading cause of death world-wide in populations older than 65 years of age. The variation in cardiovascular mortality rates in this population indicates a substantial potential for effective coronary prevention. The highest risk for development of coronary heart disease is in individuals...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199703000-00017

    authors: Wenger NK

    更新日期:1997-03-01 00:00:00

  • The molecular genetics of congenital heart disease: a review of recent developments.

    abstract:PURPOSE OF REVIEW:Our understanding of the interactions of genes and pathways during heart development continues to expand with our knowledge of the genetic basis of congenital heart disease. Along with the discovery of specific genes that cause lesions, recent research has focused on the interactions of some previousl...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328337b4ce

    authors: Wolf M,Basson CT

    更新日期:2010-05-01 00:00:00

  • Penetrating atherosclerotic ulcer.

    abstract:PURPOSE OF REVIEW:Penetrating aortic ulcer (PAU) is defined as ulceration of an aortic atherosclerotic plaque penetrating through the internal elastic lamina into the media. With the advances in imaging techniques, the differential diagnosis between PAU and other aortic ulcers remains a challenge. This review aims to s...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000782

    authors: Evangelista A,Moral S

    更新日期:2020-11-01 00:00:00

  • The role of coronary revascularization in the management of heart failure: identification of candidates and review of results.

    abstract::As a result of the increasing size of waiting lists and lengthening of waiting times for heart transplantation, coronary revascularization has emerged as an important therapeutic option in the management of patients with ischemic cardiomyopathy. A critical challenge is the identification of candidates with regions of ...

    journal_title:Current opinion in cardiology

    pub_type: 临床试验,杂志文章,评审

    doi:10.1097/00001573-199605000-00008

    authors: Blitz A,Laks H

    更新日期:1996-05-01 00:00:00

  • Anticoagulation for prosthetic heart valves: unresolved questions requiring answers.

    abstract:PURPOSE OF REVIEW:The efficacy of anticoagulation for valvular prostheses is the result of a delicate balance between the risk of thromboembolic (TE) events and bleeding. Here, we review data on anticoagulation for valve prostheses with a focus on clinical trials that address key unanswered questions. RECENT FINDINGS:...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000259

    authors: Yanagawa B,Whitlock RP,Verma S,Gersh BJ

    更新日期:2016-03-01 00:00:00

  • Will left-ventricular assist device therapy replace heart transplantation in the foreseeable future?

    abstract:PURPOSE OF REVIEW:Implantation of circulatory assist devices as a permanent alternative to heart transplantation, so-called Destination Therapy, has become a promising new option for treatment of patients with advanced heart failure who are not candidates for heart transplantation. RECENT FINDINGS:The landmark REMATCH...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000153949.42189.03

    authors: Lietz K,Miller LW

    更新日期:2005-03-01 00:00:00

  • Molecular genetics of congenital heart disease.

    abstract::This review of advances made toward understanding the molecular basis of congenital heart disease covers studies on subjects ranging from atrioventricular septal defects to zebrafish models. Genetically abnormal mice with atrioventricular septal defects have abnormal endocardial cushion development with the delayed ap...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199705000-00014

    authors: Gelb BD

    更新日期:1997-05-01 00:00:00

  • Biventricular pacing in congestive heart failure: a boost toward finer living.

    abstract::With 550,000 new cases each year, congestive heart failure is a major medical problem. Several medical therapies, including digoxin, angiotensin-converting enzyme inhibitors, and beta-blockers, have reduced the number of re-hospitalizations and slowed the progression of congestive heart failure. Angiotensin-converting...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200201000-00014

    authors: Luck JC,Wolbrette DL,Boehmer JP,Ulsh PJ,Silber D,Naccarelli GV

    更新日期:2002-01-01 00:00:00

  • Medical and surgical therapy for cardiac remodeling.

    abstract::Ventricular remodeling refers to changes in ventricular geometry, volume, mass, and myocellular structure in response to myocardial injury or alteration in loading conditions. Although initially adaptive as a consequence of the initial damage to the myocardium, progressive ventricular remodeling is ultimately a malada...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199905000-00002

    authors: Bozkurt B

    更新日期:1999-05-01 00:00:00

  • Arterial tortuosity in genetic arteriopathies.

    abstract:PURPOSE OF REVIEW:Arterial tortuosity is emerging as a common feature in genetically mediated thoracic aortic disease that may be prognostic. This review will summarize recent literature on arterial tortuosity in the setting of genetic arteriopathies. RECENT FINDINGS:Although arterial tortuosity has been primarily des...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000218

    authors: Morris SA

    更新日期:2015-11-01 00:00:00

  • Do calcium channel blockers and HMG-CoA reductase inhibitors attenuate allograft arteriopathy?

    abstract::Recent epidemiologic studies of the risk factors for early and late phases of transplant coronary artery disease (TxCAD) have identified metabolic abnormalities such as hyperlipidemia and insulin resistance as important risk factors, independent of rejection. In randomized trials, calcium channel blockers and hydroxym...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199803000-00007

    authors: Valantine-von Kaeppler HA

    更新日期:1998-03-01 00:00:00

  • Noninvasive assessment of hemodynamics: an emphasis on bioimpedance cardiography.

    abstract::Evaluation of the hemodynamic response in heart failure is a useful adjunct in clinical management. Invasive monitoring has been the accepted gold standard of hemodynamic assessment but carries with it significant associated risks. Noninvasive hemodynamic assessment in heart failure previously has been either unreliab...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200005000-00005

    authors: Rosenberg P,Yancy CW

    更新日期:2000-05-01 00:00:00

  • Carotid artery stenting: a 2009 update.

    abstract:PURPOSE OF REVIEW:Carotid endarterectomy (CEA) is still considered the gold standard in the treatment of patients with significant carotid stenosis and has proven its value over the past decades. Endovascular techniques have evolved, and carotid artery stenting (CAS) is challenging CEA to become the better treatment. V...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328330c302

    authors: Zeebregts CJ,Meerwaldt R,Geelkerken RH

    更新日期:2009-11-01 00:00:00

  • Therapy for primary cardiac tumors: is there a role for heart transplantation?

    abstract::Primary cardiac tumors are rare clinical entities. Benign tumors are often amenable to surgical excision, whereas malignant tumors are seldom resectable. The literature has reported that 28 patients have undergone orthotopic heart transplantation for inoperable primary cardiac tumors. The results of these transplants ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200003000-00010

    authors: Gowdamarajan A,Michler RE

    更新日期:2000-03-01 00:00:00

  • Tissue Doppler imaging for evaluation of myocardial function in patients with diabetes mellitus.

    abstract:PURPOSE OF REVIEW:Heart failure and diabetes mellitus are frequently associated, and diabetes appears to potentiate the clinical presentation of heart failure related to other causes. The purpose of this review is to examine recent advances in the application of tissue Doppler imaging for the assessment of diabetic hea...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000131535.32657.87

    authors: Marwick TH

    更新日期:2004-09-01 00:00:00

  • Transmyocardial laser revascularization for inoperable coronary artery disease.

    abstract::Interest in transmyocardial laser revascularization for the treatment of otherwise inoperable coronary artery disease has increased rather dramatically in recent years. The results of several industrially sponsored clinical series have been reported recently, all with significant improvement in angina pectoris that ap...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:

    authors: Sundt TM 3rd,Rogers JG

    更新日期:1997-09-01 00:00:00

  • Infections, heat shock proteins, and atherosclerosis.

    abstract::Recent evidence indicates that infections or a pathogen burden contribute to the development and progression of atherosclerosis. While the mechanism of infection contributing to the pathogenesis is not fully elucidated, I hypothesize that heat shock proteins may be a link between infections and atherosclerosis. Heat s...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200307000-00001

    authors: Xu Q

    更新日期:2003-07-01 00:00:00

  • Genetic testing in cardiovascular medicine: current landscape and future horizons.

    abstract:PURPOSE OF REVIEW:The number of clinically available genetic tests for heritable cardiovascular diseases has recently increased because of novel gene discoveries and advancements in DNA sequencing technologies. The purpose of this review is to provide up-to-date genetic testing information and guidance on how to incorp...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32835fb728

    authors: Sturm AC,Hershberger RE

    更新日期:2013-05-01 00:00:00

  • Pediatric cardiac electrophysiology.

    abstract::Over the past year, many advances have been made in the management of cardiac arrhythmias in the pediatric patient. It has become evident that the new surgical procedures for congenital cardiac disease can result in arrhythmia-associated morbidity and mortality. New pharmacologic agents such as adenosine have been s...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199102000-00016

    authors: Kaminer SJ,Gelband H

    更新日期:1991-02-01 00:00:00

  • The role of tricuspid valve repair and replacement in right heart failure.

    abstract:PURPOSE OF REVIEW:The presence of tricuspid regurgitation in the setting of right ventricular dysfunction is associated with poor prognosis. The purpose of this review is to describe the pathophysiology of functional tricuspid regurgitation, summarize the current reports favoring a more aggressive approach toward tricu...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3283512051

    authors: Pinney SP

    更新日期:2012-05-01 00:00:00