Some treatments for congestive heart failure in elderly include: Lifestyle modifications: Reducing sodium intake; no more than 2 grams of sodium is often recommended; Regulating fluid intake; the typical "8 glasses a day" does not apply to seniors with CHF.
Full Answer
What are the treatment options for congestive heart failure in elderly?
Some treatments for congestive heart failure in elderly include: Lifestyle modifications: Reducing sodium intake; no more than 2 grams of sodium is often recommended; Regulating fluid intake; the typical "8 glasses a day" does not apply to seniors with CHF. Fluid intake should be directed by your physician.
What are the causes of heart failure in the elderly?
First, HF is a frequent outcome of virtually all cardiovascular diseases. Hence, patients with most cardiovascular diseases (i.e. hypertension, acute coronary syndromes, cardiac surgery, etc.) are prone to developing ventricular remodelling and HF when elderly.
What are the symptoms of congestive heart failure in the elderly?
Congestive heart failure in elderly can affect the organs of the body including: Shortness of breath; particularly when lying flat or during exercise. Seniors may be wakened in the night gasping for breath. Cold or cold symptoms that last longer than a week in conjunction with some of the above symptoms
What is end-stage heart failure (AHF)?
End-stage, known as advanced heart failure (AHF), is more common among the elderly. HF patients' disease trajectory is more variable and unpredictable than the trajectory for most oncologic illnesses. Despite a growing armamentarium of resources the management of AHF patients can be complex.
What can be done for heart failure in the elderly?
Heart failure is always treated with a combination of medication and lifestyle changes, but some elderly heart failure patients may benefit from a cardiac rehabilitation program, particularly if they've experienced a cardiac event such as a heart attack.
Can an elderly person recover from heart failure?
As a clinical condition, yes, heart disease cannot be completely eliminated for patients of any age. However, we have treatments that can make it better. It's a progressive illness, and it's not something we can cure, but we can slow it down.
How can the elderly strengthen their heart?
There are many steps you can take to keep your heart healthy.Try to be more physically active. ... If you smoke, quit. ... Follow a heart-healthy diet. ... Keep a healthy weight. ... Keep your diabetes, high blood pressure, and/or high cholesterol under control. ... Don't drink a lot of alcohol. ... Manage stress.
How do you make your heart stronger with congestive heart failure?
Choose an aerobic activity that you enjoy such as walking (outside or on a treadmill), stationary cycling, swimming, and rowing or water aerobics. Ask your doctor before lifting weights. Exercise should be done regularly to gain the benefits; national guidelines suggest most days of the week if not everyday.
Can heart failure get better?
Heart failure is a chronic disease needing lifelong management. However, with treatment, signs and symptoms of heart failure can improve, and the heart sometimes becomes stronger. Doctors sometimes can correct heart failure by treating the underlying cause.
How long can an 80 year old live with heart failure?
In a recent study, it was reported that patients hospitalized with moderate systolic heart failure faced a median expected survival time of 2.4 years if they were aged 71 to 80 years and 1.4 years if they were aged 80 years or more. In patients with more advanced systolic dysfunction, life expectancy was even shorter.
What is the best exercise for a heart patient?
Examples: Brisk walking, running, swimming, cycling, playing tennis and jumping rope. Heart-pumping aerobic exercise is the kind that doctors have in mind when they recommend at least 150 minutes per week of moderate activity.
Can you reverse heart failure?
Although heart failure is a serious condition that progressively gets worse over time, certain cases can be reversed with treatment. Even when the heart muscle is impaired, there are a number of treatments that can relieve symptoms and stop or slow the gradual worsening of the condition.
What is good for the heart of elderly?
High quality proteins, such as poultry and fish – fatty fish like tuna or salmon are packed with heart healthy Omega-3 fatty acids and vitamin D. Healthy fats, such as avocados, olive oil, flax seeds, raw nuts, and fish oils. Low-fat dairy products, such as unsweetened low-fat yogurt or skim milk.
Does walking help heart failure?
Walking helps congestive heart failure patients in several ways: Reduces heart attack risk, including cutting the risk of having a second heart attack. Strengthens their hearts and improves lung function. Long term, aerobic activity improves your heart's ability to pump blood to your lungs and throughout your body.
Does walking improve ejection fraction?
Official Answer. Exercise including walking can improve ejection fraction if it is done 3 to 5 times per week for at least 20 to 40 minutes per session at a moderate-intensity pace, but it must be built up gradually.
What should be avoided in heart failure?
Avoid cured and processed meats, which are high in sodium. Burgers and steaks, even unseasoned, present their own problem: they're high in the types of fat that can lead to clogged arteries. Instead, aim to eat more fish than red meat, especially salmon, tuna, trout, and cod.
What are some ways to manage heart failure in older patients?
The best thing for older people with heart failure is to keep moving. Keep exercising. Pay attention to diet, and avoid high-sodium foods. Take your medicines. And create a dialogue with your healthcare providers. If something doesn’t feel right, they should talk to their physician and be good reporter, sharing as much information as possible so doctors can continue to provide the best treatment. They should stay hopeful and remain positive. This is a new age, and the treatments that we have for heart failure are better than they’ve ever been, and that extends to older patients as well.
How do you treat advanced stage heart failure in older adults?
For more serious cases, we can provide heart transplants, ventricular assist devices ( artificial heart pumps known as VADs) or a continuous infusion of inotropes, which are medicines that help the heart pump blood and can sustain people for many months or years. We also offer access to experimental therapies and drugs.
What new treatments are on the horizon?
I’m very excited about what the digital age will ultimately allow us to do with respect to new heart failure treatments. Soon we will have access to miniature devices that can be implanted into a person’s body without needing surgery. They’ll help a failing heart or kidney by reshaping the organ to help it function properly. There is also a lot of research on remote monitoring devices that can detect and prevent heart failure before it starts. The new technology will include very tiny implantable, ingestible or wearable devices that let doctors see in real time what a person’s heart pressures are. Artificial intelligence (AI) will interpret the collected data, which will give doctors a better picture of what’s happening than a one-time test in the doctor’s office. Then we’ll be able to help control heart problems remotely just by adjusting medications or giving individualized therapies. Where we’ll be in five to 10 years with this is really exciting. There are also medicines in the pipeline that will help increase survival for people with heart failure.
How important is exercise and resistance training for seniors?
It’s a matter of going out there every day, and stretching so the muscles and joints are loose and flexible. No matter how old a person is, they can build muscle. That’s important, because after age 55, a person begins to lose muscle mass. So it’s important for older people to lift weights, exercise and keep their aerobic capacity up.
Can taking too many medications impact older adults with heart failure?
Yes. As we age, the body doesn’t handle the medicine in the same way. It metabolizes medicines differently, which is why taking too many medications can be a problem for older patients with heart failure. As we age, the liver and kidneys don’t work as well, so drugs can sometimes build up in the system. Older people on medicines for their heart might be on five, six or 10 other drugs. So they’re taking a whole cocktail of medicines that might not work well together and could have side effects. It’s helpful to re-prioritize medications with your doctor. Over-the-counter pain medications can sometimes be very dangerous in older people because they can raise blood pressure and harm the kidneys. They can also have a sedative effect on people and cause delirium.
How well do heart transplants work?
Transplants are not always the best treatment for older patients, and the demand for donor hearts always outpaces supply. But we’re doing more heart transplants at UChicago Medicine, and I’m happy to see them saving more lives. We’re seeing big improvements in survival rates. The average survival rate is now over 11 years. Twenty years ago, the idea that someone could live 20 or 30 years with a transplanted heart was a fantasy. Not anymore.
Is heart disease irreversible for older adults?
As a clinical condition, yes, heart disease cannot be completely eliminated for patients of any age. However, we have treatments that can make it better. It’s a progressive illness, and it’s not something we can cure, but we can slow it down. It can progress so slowly so it doesn’t seem like it’s progressing at all.
How to prevent heart failure?
It makes sense to find ways to manage your stress , since it can increase your blood pressure. Deep breathing, meditation, and even yoga are options. Another suggestion is to get sufficient sleep.
How to do cardiac rehab?
Here are some basic guidelines when it comes to cardiac rehab: 1 Begin slowly, increasing your walking pace gradually. If you feel out of breath, then slow down. 2 Remember to cool down at the end of exercising by walking slower. 3 If walking outside, walk with someone. 4 Talk to your doctor before lifting weights. 5 If you notice any symptoms, such as shortness of breath, pain, or palpitations, stop exercising and contact your doctor right away.
How to stop shortness of breath from lifting weights?
If walking outside, walk with someone. Talk to your doctor before lifting weights. If you notice any symptoms, such as shortness of breath, pain, or palpitations, stop exercising and contact your doctor right away.
How to get out of breath after cardiac rehab?
Here are some basic guidelines when it comes to cardiac rehab: Begin slowly, increasing your walking pace gradually. If you feel out of breath, then slow down. Remember to cool down at the end of exercising by walking slower. If walking outside, walk with someone. Talk to your doctor before lifting weights.
How does exercise help the heart?
The benefits of exercise are well-documented and quite extensive. Exercise, particularly aerobic activity such as dancing, can work to improve the heart in a number of ways such as strengthening the heart and cardiovascular system , reducing heart disease risk factors such as obesity, improving circulation in the body, ...
Is smoking a risk factor for heart disease?
Tobacco use is a major risk factor for heart disease, so if you are a smoker, ask your doctor to help you with a plan to quit. You should also try to avoid second-hand smoke. Talking to your doctor about controlling your blood pressure or your cholesterol if either are issues is equally important.
Can a doctor prescribe a medication for heart failure?
There is also a possibility that the doctor will prescribe a medication to help control the problem. Working with your doctor and uncovering your risk factors for heart failure can help you develop a plan to reduce your risk.
What age group is considered HF?
Komajda et al. have provided very important information on an essential and relatively unstudied group of heart failure (HF) patients—those 80 years of age and older . 1 Their findings from the Euro Heart Failure Survey (EHFS) II provide unique information on the characteristics and outcomes in this group and secular trends in their management. In this editorial, we will try to place their findings in the broader context of HF management, highlighting what is known and, more importantly, what is not known about this patient group.
Is heart failure a disease of the elderly?
The background: heart failure as a disease of the elderly. HF is predominantly a disease of the elderly. The mean age of HF patients is >70 years in most developed countries, and the prevalence of HF rises dramatically with age, from 1–2% among individuals aged 45–54 years to >10% among those aged ≥75 years.
Do octogenarians have HF?
Octogenarians also had a higher prevalence of new-onset HF (45% vs. 35% in the younger patients; P <0.001). This is not unexpected since new-onset HF is known to occur more frequently in elderly patients and in females. However, its pathogenesis is probably different in younger and older patients as acute coronary syndromes and atrial fibrillation are frequent causes of new-onset HF in the total patient population, while they were less prevalent than hypertension in the octogenarians studied here.
Does age affect digoxin?
Lastly, the Digitalis Investigation Group (DIG) study database has provided important information regarding efficacy and tolerability in elderly patients. Increasing age had no influence on the effects of digoxin treatment on outcomes, although it was associated with increased hospitalizations for suspected digoxin toxicity and withdrawals from digoxin therapy. 5 Interestingly, in a parallel substudy that enrolled nearly 1000 patients with HFPEF, who were generally older, digoxin showed an early favourable trend toward improved outcomes, although it is difficult to speculate about the mechanism of this finding. 15
Do octogenarians need more help?
1 Octogenarians were more likely to live alone or in special accommodation, less likely to live in their own home and with other family members, they needed more help from services for caring , and had more self-care problems and walking disorders. Thus, the elderly need more help but are more socially isolated. It is difficult to imagine that such conditions would have no consequences on the quality of life and outcomes of these patients.
Is duration of life important in elderly patients?
However, duration of life remains an important target in elderly patients too. The benefits of recommended therapies are, however, not so clearly shown by RCTs, and there is a discrepancy between the patients studied in these trials and real patients with HF. 6 Even if patients with HF have a mean age of 75 years, the evidence for current treatment is based on RCTs including patients with a mean age of ∼60 years, with generally only <30% of the patients older than 70 years.
Is HF more likely in older patients?
These last mechanisms explain why the clinical picture of HF in older patients differs substantially from that of the syndrome usually described and studied in randomized clinical trials (RCTs). Elderly patients with HF are more likely to be women (as their life span is longer), as well as more likely to suffer from hypertension, have a normal LV ejection fraction (EF), and suffer from co-morbidities. 3, 4 Compared with younger patients, elderly patients often have an inadequate assessment while in hospital, with underprescription and underdosing of recommended, life-saving therapies. Age has been repeatedly shown to be an independent predictor of increased mortality and hospitalization rates. 2, 5
How much does HF increase with age?
The incidence of HF progressively increases with age, reaching around 20% among people over 75 years old. Indeed, HF represents the leading cause of hospitalization in patients older than 65 years in Western countries.
What are the symptoms of HF?
Typical signs and symptoms are known to be less common in the elderly population, due to the presence of other comorbidities, together with atypical manifestations like confusion, somnolence, anorexia, and reduced level of activity.[16] Dyspnoea is the primary symptom of HF, clinical expression of elevated lung pressures.
What is the drug for HF?
Angiotensin-converting enzyme inhibitors (ACEIs)/Angiotensin receptor blockers (ARBs )Concerning ACEIs, perindopril was the first drug that showed a trend to reduce the primary endpoint of HF hospitalization or all-cause death in the PEP-CHF (Perindopril for Elderly People With Chronic Heart Failure) trial (HR = 0.69, 95% CI: 0.47−1.01; P = 0.055). [ 39] In the CONSENSUS (Cooperative North Scandinavian Enalapril Survival Study) trial, enalapril showed a reduction in mortality and improvement of symptoms in HFrEF patients. [ 40] Moreover, some studies have demonstrated the higher the dose of ACEIs in the elderly patient, the lesser HF related mortality. [ 41]
What are the three categories of HF?
Regarding left ventricular ejection fraction (LVEF), HF can be classified into three categories: (1) HF with preserved ejection fraction (HFpEF); (2) HF with intermediate ejection fraction (HFmEF) or (3) HF with reduced ejection fraction (HFrEF). Management and treatment of these subclassifications significantly differ, although prognosis is somewhat poor. On average, older HF patient are more likely to be female and have HFpEF. [ 21] Because of the heterogeneity in the presentation of HFpEF, different scales such as H2FPEF score or HFA-PEFF score have been proposed to ease the diagnosis. [ 22, 23] Once the diagnosis of HF has been made, functional status is graded using the New York Heart Association (NYHA) classification ( Table 4 ). The American College of Cardiology (ACC) and American Heart Association (AHA) classification is based on the evolution and progression of the disease in four stages ( Table 5 ). Last, but not least, numerous prognostic markers of HF hospitalization and/or death have been identified in patients with HF, with age also being associated with worse prognosis. [ 24, 25] Specific geriatric conditions, such as frailty, sarcopenia or malnutrition may also associate poorer prognosis, and will be addressed later on this review.
Why do elderly people need diuretics?
Diuretics are essential to avoid signs of congestion of HF, although their effects on morbidity or mortality have not been demonstrated. [ 1] Elderly patients are prone to adverse reactions (due to the decline of renal glomerular filtration rate or tendency to hyperkalaemia); hence cautious monitoring is recommended, especially when high doses of loop diuretics are used. Diuretics may also aggravate incontinence, which in turn may lead to self-patient down titration or fluid restriction, thus worsening a previously abnormal renal function.
What is self care?
Self-care is defined as a process of maintaining health through health promoting and preventive practices. It is a concept formed of three main aspects: (1) self-care maintenance; 2) self-care monitoring (observing one-self for changes in signs and symptoms); and (3) self-care management (response to those changes when they occur). [ 99] This matter is of great importance, as some physical or neurological conditions, common in the elderly, greatly impact on quality of life. So, HF patients are frequently unable to perform essential tasks needed for HF self-care, and self-perception of care has been found to poorly correlate with real ability. [ 100] In this regard, poor self-care ability involves lack of adherence to treatment, failure to identify early signs of congestion, and failure to implement appropriated therapeutic measures, thus associating higher HF readmissions and one-year mortality. [ 100, 101]
What are the physiological changes in the heart and cardiovascular system?
[ 11] Some of the main mechanisms involved in cardiovascular aging include: (1) oxidative stress due to mitochondrial dysfunction; [ 12] (2) chronic inflammation (also defined as “inflammaging”), especially in obese patients, together with changes in microbiota and immune dysfunction; [ 13] and (3) low renewal rate of cardiomyocytes, closely related to limited cardiac regeneration capacity. [ 14]
How does congestive heart failure affect the elderly?
Congestive heart failure in elderly can affect the organs of the body including: Kidneys which may not get enough oxygen and cannot secrete salt and water properly. Lungs which may become congested with fluid and cause shortness of breath. Liver may retain fluid and not be able to excrete toxins. Intestines become less efficient absorbing nutrients ...
What are the causes of congestive heart failure in elderly people?
Heart valve disorders (can be too narrow or leaky) Diabetes. Being obese or overweight. Diseases that demand more oxygen than the body can supply and may increase risk of congestive heart failure in elderly include: Hypothyroidism. Anemia.
What is CHF in elderly?
Congestive heart failure in elderly , otherwise referred to as CHF, is a condition in which the heart's function as a pump is inadequate to meet the body's needs. It can occur when the heart is weakened or damaged from diseases or the demand for oxygen by the body is more than the heart can supply. CHF is progressively more common ...
Why does the heart get stiffer?
This is further complicated by aging as there is a loss of muscle cells which results in the heart becoming thicker and stiffer.
How common is CHF?
CHF is progressively more common with increasing age and is a serious condition. It has been reported to affect 25 percent of people older than 85 years of age.
What are the causes of CHF?
Diseases that damage or weaken the heart and may increase risk of CHF include: Heart attacks. Long standing high blood pressure. High blood cholesterol. Infection of the heart (myocarditis or endocarditis) Coronary artery disease. Longstanding and/or excessive alcohol or drug abuse.
How long does a person live with CHF?
People diagnosed with CHF usually have a life expectancy of 1 to 5 years though the course is extremely variable between every person.
