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
  • Subclinical bioprosthetic aortic valve thrombosis: clinical and translational implications.

    abstract:PURPOSE OF REVIEW:A recently published study has alerted the cardiovascular community to the existence of a significant and previously unrecognized risk of subclinical valve thrombosis following implantation of surgical and catheter-based bioprosthetic valves. The purpose of this article is to review our current unders...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000373

    authors: Yanagawa B,Mazine A,Bhatt DL,Clavel MA,Côté N,Cheema AN,Pibarot P,Verma S

    更新日期:2017-03-01 00:00:00

  • Low cholesterol syndrome and drug development.

    abstract:PURPOSE OF REVIEW:Low cholesterol syndromes were considered curiosities. The present article reviews some hypolipidaemic disorders and the drugs developed from the insights they provided. RECENT FINDINGS:Abetalipopoproteinaemia and hypobetalipoproteinaemia are associated with low cholesterol concentrations and caused ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000745

    authors: Handhle A,Viljoen A,Ramachandran R,Wierzbicki AS

    更新日期:2020-07-01 00:00:00

  • Clinical practice and implications of recent diabetes trials.

    abstract:PURPOSE OF REVIEW:Diabetes is an increasingly prevalent risk factor for coronary and other vascular disease. Recent trials in patients with diabetes have examined the effects of intensive glycemic control on cardiovascular outcomes, and treatment of common concomitant risk factors, in particular hypertension and dyslip...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328347b139

    authors: Webster MW

    更新日期:2011-07-01 00:00:00

  • Comparative imaging techniques and models.

    abstract::The explosion of high-resolution imaging technology in recent years has led to the increasing problem of choosing imaging modalities appropriate to specific clinical questions. In terms of structural information, for example, the relative benefits of ultrasound versus magnetic resonance imaging versus computed tomogr...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199212000-00015

    authors: Simpson IA,Sahn DJ

    更新日期:1992-12-01 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

  • Electrophysiology: the Wolff-Parkinson-White syndrome.

    abstract::Though tachyarrhythmias occur commonly in patients with the Wolff-Parkinson-White syndrome, many patients remain asymptomatic. Recent studies suggest that routine electrophysiologic testing in these individuals is of limited value. However, electrophysiologic testing remains very helpful in the symptomatic patient fo...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:

    authors: Wharton JM,Prystowsky EN

    更新日期:1991-02-01 00:00:00

  • Fibrates in the treatment of cardiovascular risk and atherogenic dyslipidaemia.

    abstract:PURPOSE:New data have emerged over the last few years about the role of fibrates in treatment of microvascular and macrovascular disease. RECENT FINDINGS:Endpoint studies have been conducted with fibrates in coronary heart disease (CHD) since 1971 and initial results were contradictory. Fibrates later showed benefits ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32832c0b3d

    authors: Wierzbicki AS

    更新日期:2009-07-01 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

  • Echocardiography in pulmonary hypertension.

    abstract:PURPOSE OF REVIEW:Pulmonary hypertension is a progressive disease of the pulmonary vasculature characterized by increased vascular resistance and pressure overload of the right ventricle. This review aims to describe the diagnostic and prognostic role of echocardiography in pulmonary hypertension with particular consid...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000217

    authors: Bossone E,Ferrara F,Grünig E

    更新日期:2015-11-01 00:00:00

  • DiGeorge syndrome: an update.

    abstract:PURPOSE OF REVIEW:This article is an update on DiGeorge syndrome research focusing on the synergy of human and model systems genetics toward the understanding of conotruncal and aortic arch defects. RECENT FINDINGS:The identification of mutations of the human T-Box1 (TBX1) gene and progress on research of Tbx1 functio...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200405000-00002

    authors: Baldini A

    更新日期:2004-05-01 00:00:00

  • Evidence supporting secondary prevention strategies.

    abstract::Currently 14 million individuals in the United States have coronary disease. Within the next 2 decades, this number is expected to increase to 21 million persons. To minimize the excessive risk of recurrent cardiac events in these people, evidence-based, cost-effective prevention strategies must be developed. This rev...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199907000-00005

    authors: Blazing MA,O'Connor CM

    更新日期:1999-07-01 00:00:00

  • Management of resistant hypertension.

    abstract:PURPOSE OF REVIEW:Resistant hypertension is defined as blood pressure above patient goal despite three different antihypertensive agents at optimal dose including a diuretic. Resistant hypertension is increasingly common issue in clinical practice and it is a major risk factor of cardiovascular disease. RECENT FINDING...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000635

    authors: Hasan MA,Stewart MH,Lavie CJ,Ventura HO

    更新日期:2019-07-01 00:00:00

  • Pacing delivered rate and rhythm control for atrial fibrillation.

    abstract:PURPOSE OF REVIEW:Device therapy for atrial fibrillation remains contentious despite the recognized benefit of atrial pacing in sinus node dysfunction. There are various new specialized pacing algorithms that aim to provide rhythm or rate control in atrial fibrillation. We review the various options for device therapy ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000210302.56736.60

    authors: Redfearn DP,Yee R

    更新日期:2006-03-01 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

  • 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

  • Advanced left-ventricular lead placement techniques for cardiac resynchronization therapy.

    abstract:PURPOSE OF REVIEW:Due to complex venous anatomy and limitations in lead delivery tools and technology, the incidence of failed left-ventricular lead implants continues to be as high as 10%. RECENT FINDINGS:A move towards an interventional approach to left-ventricular lead implantation has provided viable alternatives ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000028

    authors: Manlucu J,Yee R

    更新日期:2014-01-01 00:00:00

  • Next-generation sequencing to identify genetic causes of cardiomyopathies.

    abstract:PURPOSE OF REVIEW:This review examines the application of next-generation sequencing (NGS) technologies in the identification of the causation of nonsyndromic genetic cardiomyopathies. RECENT FINDINGS:NGS sequencing of the entire genetic coding sequence (the exome) has successfully identified five novel genes and caus...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328352207e

    authors: Norton N,Li D,Hershberger RE

    更新日期:2012-05-01 00:00:00

  • New advances in class III antiarrhythmic drug therapy.

    abstract::In the past 2 years, significant advances have been made in class III antiarrhythmic drug therapy. In patients with ventricular arrhythmias and implantable cardioverter defibrillators (ICDs), antiarrhythmic agents are increasingly being used as adjunct therapy to decrease the frequency of ICD discharges. Sotalol was r...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200001000-00006

    authors: Sager PT

    更新日期:2000-01-01 00:00:00

  • Cardiac allograft vasculopathy: pathology, prevention and treatment.

    abstract:PURPOSE OF REVIEW:Cardiac transplantation is a recognized therapy for end-stage heart failure. Graft coronary artery disease is a chief determinant of long-term survival following cardiac transplantation. There are multiple purported etiologies for graft coronary artery disease including both immunologic and nonimmunol...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000203184.89158.16

    authors: Kass M,Haddad H

    更新日期:2006-03-01 00:00:00

  • Cardiovascular implantable electronic device lead extraction: evidence, techniques, results, and future directions.

    abstract:PURPOSE OF REVIEW:Cardiovascular implantable electronic devices are widely used to treat symptomatic arrhythmias, prevent sudden cardiac death, and improve symptoms and cardiac function. Continued population growth and expanding indications have resulted in a progressive increase in the number of cardiovascular implant...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000247

    authors: Sadek MM,Goldstein W,Epstein AE,Schaller RD

    更新日期:2016-01-01 00:00:00

  • Complex aortic arch aneurysm and dissections: hybrid techniques for surgical and endovascular therapy.

    abstract:PURPOSE OF REVIEW:Open aortic arch surgery is highly invasive and may result in significant morbidity. Recent innovations in thoracic stent-graft technology have facilitated methods of replacing the aortic arch without deep hypothermic circulatory arrest or even cardiopulmonary bypass. We present a review of the curren...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3283317c91

    authors: Desai ND,Szeto WY

    更新日期:2009-11-01 00:00:00

  • Management of patients with end-stage renal disease: coronary artery bypass graft surgery versus percutaneous coronary intervention.

    abstract:PURPOSE OF REVIEW:Coronary artery disease is common in patients with end-stage renal disease (ESRD) on hemodialysis. ESRD patients are prone to atherosclerosis and are likely to present with advanced CAD requiring coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI). RECENT FINDINGS:...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000539

    authors: Karkhanis R,Tam DY,Fremes SE

    更新日期:2018-09-01 00:00:00

  • Vagal stimulation for heart failure.

    abstract:PURPOSE OF REVIEW:On the very solid background of experimental and clinical studies pointing to the cardiovascular risks associated with depressed vagal reflexes and supported by specific experiments in animal models of heart failure, we are witnessing a rapidly growing interest in the very untraditional approach to th...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3283413961

    authors: Schwartz PJ

    更新日期:2011-01-01 00:00:00

  • Mechanical circulatory support of the failing heart.

    abstract::Over the past 30 years, there have been significant pharmacological and technological advances in the treatment of cardiogenic shock. Although most patients who develop cardiogenic shock can be effectively treated with conventional therapy, including inotropic and vasodilating drugs and intra-aortic balloon pumps, a s...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199403000-00013

    authors: Votapka TV,Pennington DG

    更新日期:1994-03-01 00:00:00

  • Myocardial contrast echocardiography in acute coronary syndromes.

    abstract::Myocardial contrast echocardiography (MCE) is an emerging technique in which microbubble contrast agents are visualized in the coronary microvasculature. MCE is an ideal modality for the noninvasive evaluation of acute coronary syndromes because it provides portable, simultaneous assessment of regional wall motion and...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200209000-00003

    authors: Ward RP,Lang RM

    更新日期:2002-09-01 00:00:00

  • Diet as preventive medicine in cardiology.

    abstract::Because the main cause of death in patients with established coronary heart disease (CHD) is sudden cardiac death (SCD), physicians should develop specific strategy, including dietary changes, to prevent it. In the long term, reduction of the diet-dependent chronic risk factors of CHD, hypercholesterolemia, hypertensi...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200009000-00009

    authors: de Lorgeril M,Salen P

    更新日期:2000-09-01 00:00:00

  • The added value of simultaneous myocardial perfusion and left ventricular function.

    abstract::The focus of this review is the advantages of simultaneously assessing myocardial perfusion and left ventricular function. Nuclear cardiology imaging techniques as well as the development of technetium-labeled perfusion tracers now permit combined myocardial-perfusion and left-ventricular function studies at a single ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199911000-00002

    authors: Borges-Neto S,Shaw LK

    更新日期:1999-11-01 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

  • Recent advances in non-interventional pediatric cardiac catheterization.

    abstract:PURPOSE OF REVIEW:The role of cardiac catheterization in pediatric cardiology has changed significantly in the past 10-15 years. As interventional procedures dominate the field, it is important to examine the recent advances in non-interventional pediatric cardiac catheterization. RECENT FINDINGS:Meaningful and accura...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000154067.99851.4a

    authors: Kanter JP,Hellenbrand WE

    更新日期:2005-03-01 00:00:00

  • Aortic root rupture: implications of catheter-guided aortic valve replacement.

    abstract:PURPOSE OF REVIEW:The safety and efficiency of trans catheter aortic valve implantation (TAVI) has been clearly demonstrated. In high-risk patients, the number of procedures is constantly increasing and in western European countries this procedure is employed in more than 30% of isolated aortic valve replacements. The ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3283655bb5

    authors: Berdajs D

    更新日期:2013-11-01 00:00:00