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Drug treatment of systolic and of diastolic heart failure in elderly persons.
J Gerontol A Biol Sci Med Sci 2005; 60(12):1597-605JG

Abstract

Underlying causes, risk factors, and precipitating causes of heart failure (HF) should be treated. Patients with HF and an abnormal left ventricular ejection fraction (systolic HF) or normal left ventricular ejection fraction (diastolic HF) should be treated with diuretics if fluid retention is present, with an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker if the patient cannot tolerate an ACE inhibitor because of cough, angioneurotic edema, rash, or altered taste sensation, and with a beta blocker unless contraindicated. If severe systolic HF persists, an aldosterone antagonist should be added. If HF persists, isosorbide dinitrate plus hydralazine should be added. Calcium channel blockers should be avoided if systolic HF is present. Digoxin should be avoided in men and women with diastolic HF if sinus rhythm is present and in women with systolic HF. Digoxin should be given to men with systolic HF if symptoms persist, but the serum digoxin level should be maintained between 0.5 and 0.8 ng/ml. Cardiac synchronized pacing should be considered in patients with severe systolic HF despite optimal medical therapy, with sinus rhythm, and with ventricular dyssynchrony.

Authors+Show Affiliations

Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY 10595, USA. WSAronow@aol.com

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16424295

Citation

Aronow, Wilbert S.. "Drug Treatment of Systolic and of Diastolic Heart Failure in Elderly Persons." The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 60, no. 12, 2005, pp. 1597-605.
Aronow WS. Drug treatment of systolic and of diastolic heart failure in elderly persons. J Gerontol A Biol Sci Med Sci. 2005;60(12):1597-605.
Aronow, W. S. (2005). Drug treatment of systolic and of diastolic heart failure in elderly persons. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 60(12), pp. 1597-605.
Aronow WS. Drug Treatment of Systolic and of Diastolic Heart Failure in Elderly Persons. J Gerontol A Biol Sci Med Sci. 2005;60(12):1597-605. PubMed PMID: 16424295.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Drug treatment of systolic and of diastolic heart failure in elderly persons. A1 - Aronow,Wilbert S, PY - 2006/1/21/pubmed PY - 2006/4/6/medline PY - 2006/1/21/entrez SP - 1597 EP - 605 JF - The journals of gerontology. Series A, Biological sciences and medical sciences JO - J. Gerontol. A Biol. Sci. Med. Sci. VL - 60 IS - 12 N2 - Underlying causes, risk factors, and precipitating causes of heart failure (HF) should be treated. Patients with HF and an abnormal left ventricular ejection fraction (systolic HF) or normal left ventricular ejection fraction (diastolic HF) should be treated with diuretics if fluid retention is present, with an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker if the patient cannot tolerate an ACE inhibitor because of cough, angioneurotic edema, rash, or altered taste sensation, and with a beta blocker unless contraindicated. If severe systolic HF persists, an aldosterone antagonist should be added. If HF persists, isosorbide dinitrate plus hydralazine should be added. Calcium channel blockers should be avoided if systolic HF is present. Digoxin should be avoided in men and women with diastolic HF if sinus rhythm is present and in women with systolic HF. Digoxin should be given to men with systolic HF if symptoms persist, but the serum digoxin level should be maintained between 0.5 and 0.8 ng/ml. Cardiac synchronized pacing should be considered in patients with severe systolic HF despite optimal medical therapy, with sinus rhythm, and with ventricular dyssynchrony. SN - 1079-5006 UR - https://www.unboundmedicine.com/medline/citation/16424295/Drug_treatment_of_systolic_and_of_diastolic_heart_failure_in_elderly_persons_ L2 - https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/60.12.1597 DB - PRIME DP - Unbound Medicine ER -