Heart failure in the 21st century: A cardiogeriatric syndrome

Chronic heart failure (CHF) is principally a cardiogeriatric syndrome, and it has become a major public health problem in the 21st century due largely to the aging population. Age-related changes throughout the cardiovascular system in combination with the high prevalence of cardiovascular diseases at older age predispose older adults to the development of CHF, Features th at distinguish CHF at advanced age from CHF occurring during middle age inc lude an increasing proportion of women, a shift from coronary heart disease to hypertension as the most common etiology, and the high percentage of ca ses that occur in the setting of preserved left ventricular systolic functi on. Although the pharmacotherapy of CHF is similar in older and younger pat ients, the presence of multiple comorbidities in older patients mandates a multidisciplinary approach to care. Manifest CHF is associated with a poor prognosis, especially in elderly persons, and there is an urgent need to de velop more effective strategies for the prevention and treatment of this in creasingly common disorder to reduce the individual and societal burden of this devastating illness in the decades ahead.