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British Medical Bulletin 46:202-229 (1990)
© 1990 The British Council

research-article

Treatment of heart failure in the elderly

J McMurray and D G McDevitt

Department of Cardiology, Western Infirmary Glasgow, UK
Department of Clinical Pharmacology, Ninewells Hospital & Medical School Dundee, UK

Abstract

Heart failure is a syndrome of breathlessness, fatigue and oedema The effects of ageing on myocardial function and the prevalence of often multiple cardiac pathologies makes heart failure a disease of the elderly, usually characterized by primary or secondary myocardial systolic dysfunction. Appropriate treatment, which requires precise diagnosis, involves correction of precipitating or aggravating factors and the rational use of drug therapy. Diuretics and ACE inhibitors offer a combination of both symptom control and improvement in prognosis. Other agent such as digoxin, xamoterol and nitrates may be particularly useful in the treatment of patients with associated problems such as atrial fibrillation and angina. Because both ageing and heart failure may alter pharmacokinetics and pharmacodynamics, safe and effective treatment of heart failure in the elderly requires understanding of the clinical pharmacology of the drugs used


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