Congestive heart failure affects > 5% of those aged 65-75 and 10-20% of those aged > 80 in the UK and plains are likely to rise in the wake of improved therapies for hypertension and myocardial infarction.Congestive heart failure affects > 5% of those aged 65-75 and 10-20% of those aged > 80 in the UK and plains are likely to rise in the wake of improved therapies for hypertension and myocardial infarction. It is ofttimes multifactorial in this group. The mostly common causes are hypertension and coronary heart disease, with valvular heart disease playing an increasing part The most common precipitant of pre-existing heart failure is non-compliance with medication or diet; non-steroidal anti-inflammatory remedys are particularly likely to exacerbate the condition. Diagnosis may be difficult since typical signs are frequently absent or masked in older folks but plasma levels of brain natriuretic peptide appear to be a reliable indicator and may provide diagnostic proof in the future. Systolic heart failure is managed by means of conventional therapy (diuretics, angiotensin-converting enzyme inhibitors and [beta]-blockers). The management of diastolic heart failure is les well defined, on the other hand symptoms should be managed, ischaemia hindered and the underlying causes identified and treated. Nurse-directed, multidisciplinary intervention (including education of patient and family, social support, review of medication, dietary modification and weight monitoring) have riseed in improvements in event-free survival and quality of life. COPYRIGHT 2002 Oxford University Press |
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