Drug therapy of heart failure caused by systolic dysfunction in the elderly

The presence of multiple medical illnesses often distinguishes elderly pati ents with heart failure and can make pharmacologic management of symptomati c heart failure challenging in this population. Physiologic changes that oc cur with normal aging may complicate clinical assessment. Limited data from large clinical trials of heart failure therapy are applicable to aged pati ents. Available data suggest that elderly patients should be treated with t he same regimen as younger patients but that more careful attention should be paid to dosing, especially when initiating a new drug. History and physi cal examination techniques can be used to uncover evidence of congestion an d inadequate perfusion and are critical adjuncts when making therapeutic de cisions. The objectives of therapy for elderly patients with heart failure must be individualized within the larger context of patients' goals and sta ge of life.