Heart failure in the elderly: age-related differences in clinical profile and mortality

Background Age influence in the prognosis in unselected patients with heart failure has not been widely studied. Aims To evaluate possible differences in clinical profile and outcome of patients hospitalized with HF according to age. Methods and results During 1996, a total of 1065 hospital in-patients had confirmed heart failure, with follow-up data through 2002. Patients were separated in two groups ≤75 and >75 years of age. Older patients were less frequently men (32 vs. 52%) and had a higher prevalence of previous stroke (14 vs. 10%). Echocardiography was performed less frequently in older patients (55% vs. 78%) and normal systolic function (55 vs. 40%), and aortic stenosis (12 vs. 7%) were more prevalent. They received less anticoagulants (11 vs. 43%) and β-blockers (2 vs. 7%), while the opposite happened with aspirin (32 vs. 23%) and diuretics (88 vs. 80%). During follow-up, 507 patients died: 55.9% vs. 38.5%. Being >75 years of age was the strongest predictor of mortality HR: 1.7, CI 95% 1.5–2.1, P<0.0001. Conclusion Patients with 76 or more years admitted with HF have a different clinical profile. Echocardiography, oral anticoagulation and β-blockers were underused in these patients. Age was the strongest predictor of long-term mortality.