New developments in the pharmacotherapeutic management of heart failure in elderly patients: Concerns and considerations.

New developments in the pharmacotherapeutic management of heart failure in elderly patients: Concerns and considerations.

Expert Opin Pharmacother. 2017 Apr 04;:

Authors: Screever EM, Meijers WC, van Veldhuisen DJ, de Boer RA

Abstract
INTRODUCTION: Heart failure (HF) remains a major public health problem worldwide, affecting approximately 23 million patients, and is predominantly a disease of the elderly population. Elderly patients mostly suffer from HF with preserved ejection fraction (HFpEF), which often presents with multiple co-morbidities and they require multiple medical treatments. This, together with the heterogeneous phenotype of HFpEF, makes it a difficult syndrome to diagnose and treat. Areas covered: Although HF is most abundant in the elderly, this group is still underrepresented in clinical trials, which results in the lack of evidence-based medical regimens. The current review has focused on new potential therapies for this poorly studied population. The focus will be on several classes of drugs currently recommended or might be expected soon. These will include sacubitril/valsartan (former LCZ696), Omecamtiv mecarbil, Vericiguat, Ivabradine, mineralocorticoid receptor antagonists (MRAs) and potassium binders. Expert opinion: Mentioned medicaments appear promising, but additionally, personalized approaches will be needed to treat elderly patients optimally. Medical doctors should not only focus on solely HF therapy, but co-morbidities and polypharmacy should also influence therapeutic decision making. Furthermore, the importance of quality of life as a management endpoint should not be underestimated in the frail elderly.

PMID: 28375036 [PubMed - as supplied by publisher]

http://ift.tt/2oHG8n0