Diagnosis and management of heart failure: implications of the recent European Society of Cardiology Guidelines for the older patient

The European Society of Cardiology has recently published new guidelines on the diagnosis and management of heart failure [1]. This updates previous guidelines and adds several important new recommendations in the light of signiWcant recent advances in knowledge. A number of the sections in the guidelines are readily extended to the older patient with heart failure, but many of the points highlighted warrant speciWc comment as they have important implications for clinical practice. More data on the epidemiology of heart failure has become available in the last few years. In Europe, the prevalence of symptomatic heart failure ranges from 0.4%–2% [2, 3]. In older patients the presence of left ventricular systolic dysfunction may be as high as 10% [4] when assessed echocardiographically with structural heart disease widespread [5]. Normal systolic function heart failure is encountered frequently in older patients and this may have implications for treatment [6].