abstract
congestive heart failure affects >5% of those aged 65-75 and 10-20% of those aged >80 in the UK, and levels are likely to rise in the wake of improved therapies for hypertension and myocardial infarction. It is often multifactorial in this group. The most common cause are hypertension and coronary heart disease, with valvular heart disease playing in an increasing role. The most common precipitant of pre-existing heart failure is non-compliance with medication or diet; non-steroidal anti-inflammatory drugs are particularly likely to exacerbate to condition. Diagnosis may be difficult since typical signs are often absent or masked in older people, but plasma levels of brain natriuretic peptide appear to be a reliable indicator and may provide diagnostic test in the future. systolic heart failure is managed by conventional therapy. the management of diastolic heart failure is less well defined, but symptoms should be managed, ischaemic prevented and the underlying causes identified and treated. nurse-directed, multidisciplinary intervention have resulted in improvements in event-free survival and quality of life.
introduction
congestive heart failure is among the most common discharge diagnoses in elderly hospitalized patients. it affects 1-2% of the population of the United Kingdom, and its prevalence rises from