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Review

Treatment of heart failure with preserved systolic function in the elderly

    Anita Deswal

    † Author for correspondence

    Section of Cardiology & Winters Center for Heart Failure Research, Michael E DeBakey Veterans Affairs Medical Center & Baylor College of Medicine, VAMC (111B), 2002 Holcombe Blvd, Houston, TX 77030, USA.

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    Email the corresponding author at adeswal@bcm.tmc.edu

    &
    Lily Zhang

    Section of Cardiology, Baylor College of Medicine, Houston, TX, USA.

    Search for more papers by this author

    Email the corresponding author at lilyz@bcm.tmc.edu

    Published Online:31 Mar 2008https://doi.org/10.2217/1745509X.4.2.157

    Abstract

    Heart failure with preserved systolic function (HF-PSF) may account for 50% or more of patients with heart failure, occurring more commonly in the elderly with comorbid conditions such as hypertension, diabetes, obesity and coronary artery disease. HF-PSF is associated with high morbidity and mortality. A recent study demonstrated that, although survival improved significantly over time among heart failure patients with reduced ejection fraction, there was no such trend toward improvement among patients with HF-PSF. There exists an urgent need to develop effective treatment strategies, specifically for patients with HF-PSF. Current therapeutic recommendations for HF-PSF are aimed at the symptomatic management as well as the treatment of concomitant comorbidities, including hypertension, atrial fibrillation and myocardial ischemia. In spite of two large, recent studies evaluating therapies for HF-PSF, no specific strategies have been proven to substantially benefit outcomes in patients with HF-PSF. This review evaluates the development of therapeutic strategies for HF-PSF and provides an overview of recently completed and currently ongoing clinical trials in patients with HF-PSF, as well as possible therapeutic targets for future study.

    Papers of special note have been highlighted as either of interest (•) or of considerable interest (••) to readers.

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