is There Any Evidence-based Medicine for the Very Old?

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Incidence of Precipitating Factors as Causes of Hospital Admissions in Patients with Heart Failure % Patients 40 30 20 10 0 Causes of hospitalizations (179 pts.; age, 75+10 years) Poor Inadequate Hypertension compliance treatment Ischemia Arrhythmias Michaelsen et al., Heart 1998;80:437
Management of HF in the Elderly: General Measures • Educate the patients and their family ↑ compliance! • Limit sodium intake (< 1.5 Gm/day) • Monitor body weight daily • Avoid smoking • Only moderate alcohol consumption (e.g. < 1-2 drinks/day) • Low-intensity aerobic exercise (3-5 times/week) • Treat concomitant diseases – Hypertension, and/or diabetes, CAD… – anemia, thyroid disease, sleep disorders, depression… • Minimize use of NSAIDs
Page 1 and 2: Heart Failure 2005 The octogenarian
Page 3 and 4: Mean Age of the Patients with Heart
Page 5 and 6: Factors Distinguishing HF in the El
Page 7 and 8: Baseline Characteristics of Patient
Page 9 and 10: % of patients 35 30 25 20 15 10 5 0
Page 11: Probability Non-cardiac Comorbidity
Page 15 and 16: Pharmacological therapy of heart fa
Page 17 and 18: Drug ACEi Loop diuretics Beta-block
Page 19 and 20: Elderly Age is an Independent Predi
Page 21 and 22: Effects of ACE inhibitors on outcom
Page 25 and 26: BRING UP Reasons for Not Commencing
Page 27 and 28: % 100 75 50 25 0 84.3 70- 80 years
Page 29 and 30: % Effect of Bisoprolol on Mortality
Page 31 and 32: Beta-blockers Reduce Mortality also
Page 33 and 34: SENIORS: Baseline Characteristics A
Page 35 and 36: LVEF 35 % > 35 % Age 70-75 y > 75
Page 39 and 40: Drug ACEi Loop diuretics Beta-block
Page 41 and 42: 10 5 0 -5 -10 -15 -20 -25 -30 -35 L
Page 43 and 44: % 40 30 20 10 Lack of effect of age
Page 45 and 46: Randomised Controlled Trial of Card
Page 47 and 48: Randomized Controlled Trial of Spec
Page 49: Efficacy of Disease Management Prog

is There Any Evidence-based Medicine for the Very Old?

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