Advances in Clinical and Experimental Medicine
2019, vol. 28, nr 10, October, p. 1351–1358
Publication type: original article
Treatment of heart failure in the elderly in Poland. The results of the Polish part of EURObservational Research Programme: The Heart Failure Pilot Survey
1 Department of Human Physiology, Medical University of Lodz, Poland
2 State Higher Vocational School of Konin, Poland
3 Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Poland
4 1st Department of Cardiology, Poznan University of Medical Sciences, Poland
5 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
6 2nd Department of Cardiology, Poznan University of Medical Sciences, Poland
7 Department of Cardiology, Medical University of Lodz, Poland
Background. Pharmacotherapy remains the fundamental method of treating heart failure (HF). Treatment of the elderly is less based on the principles of evidence-based medicine (EBM) and doses do not reach the prescribed value.
Objectives. The aim of the study was to identify any distinct treatment of HF in the elderly compared to those under 65 years of age.
Material and Methods. This study describes the Polish part of the EURObservational Research Programme: The Heart Failure Pilot Survey (ESC-HF Pilot). Eligibility to the program was limited to people with HF in 26 centers in Poland. After the first phase, more data was collected at 3 and 12 months. It covered a total of 893 people.
Results. Treatment of HF is conducted largely in accordance with the applicable guidelines. The percentage of people over 65 years of age who use angiotensin-converting-enzyme inhibitors/angiotensin-II receptor blockers (ACE-I/ARB), β-blockers and mineralocorticoid-antagonists remains high. Also, during the 12-month follow-up the frequency of the use of β-blockers did not decrease, and a decrease in the number subjects treated with ACE-I was compensated by increasing percentage of the use of ARB. A major problem also seems to be the appropriate treatment to prevent thromboembolic complications in the case of coexistence of atrial fibrillation (AF). There is a large group of older people who do not receive proper anticoagulation.
Conclusion. The study showed the existence of differences in the treatment of HF in the elderly. It partly does not proceed in accordance with the guidelines, especially in the presence of multiple comorbidities.
pharmacotherapy, elderly, heart failure treatment
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