Drug therapy of chronic heart failure in the elderly: The current state of clinical-trial evidence

Current Opinion in Cardiology

Volumn 21, Issue 4, 2006, Pages 393-399

  Dulin, Brian R ^a   Krum, Henry ^a  

^a MONASH UNIVERSITY   (Australia)

Author keywords

blocker; Aldosterone inhibitor; Angiotensin II receptor blocker; Angiotensin converting enzyme; Chronic heart failure; Digoxin; Elderly

Indexed keywords

ALDOSTERONE ANTAGONIST; ANGIOTENSIN 2 RECEPTOR ANTAGONIST; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; BISOPROLOL; BUCINDOLOL; CANDESARTAN; CARVEDILOL; DIGITALIS; DIGOXIN; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; METOPROLOL; NEBIVOLOL; PLACEBO; SPIRONOLACTONE; VALSARTAN;

AGING; CLINICAL TRIAL; DISEASE COURSE; DISEASE EXACERBATION; DISEASE SEVERITY; DIZZINESS; DRUG ACTIVITY; DRUG EFFECT; DRUG FATALITY; DRUG TOLERABILITY; FOLLOW UP; HEART ARRHYTHMIA; HEART ATRIUM FIBRILLATION; HEART FAILURE; HEART LEFT VENTRICLE; HOSPITALIZATION; HUMAN; HYPERKALEMIA; HYPOTENSION; KIDNEY DYSFUNCTION; MORBIDITY; MORTALITY; PRIORITY JOURNAL; RENIN ANGIOTENSIN ALDOSTERONE SYSTEM; REVIEW; SEX RATIO; STATISTICAL SIGNIFICANCE; TREATMENT OUTCOME;

ADRENERGIC BETA-ANTAGONISTS; AGED; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CARDIOTONIC AGENTS; DIGOXIN; DRUG TOLERANCE; HEART FAILURE; HUMANS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RECEPTOR, ANGIOTENSIN, TYPE 2; RECEPTORS, ALDOSTERONE; TREATMENT OUTCOME;

EID: 33748205023     PISSN: 02684705     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.hco.0000231411.15049.20     Document Type: Review

References (44)

1. National Heart, Lung, and Blood Institute. Congestive heart failure in the United States: a new epidemic. Data facts sheets. Bethesda: National Heart, Lung, and Blood Institute, National Institutes of Health; 1996.
2. Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2001;38:2101-2113.
3. National Center for Health Statistics. National hospital discharge survey: annual summary, 1995. Vital statistics series 13, no. 133. DHHS publication no. 98-1794. Hyattsville, MD: National Center for Health Statistics; 1998.
4. Komajda M, Follath F, Swedberg K, et al. The EuroHeart Failure Survey programme - a survey on the quality of care among patients with heart failure in Europe. Part 2: treatment. Eur Heart J 2003; 24:464-474.
5. Maggioni AP, Sinagra G, Opasich C, et al. Treatment of chronic heart failure with beta adrenergic blockade beyond controlled clinical trials: the BRING-UP experience. Heart 2003; 89:299-305.
6. Muntwyler J, Cohen-Solal A, Freemantle N, et al. Relation of sex, age and concomitant diseases to drug prescription for heart failure in primary care in Europe. Eur J Heart Fail 2004; 6:663-668.
7. Sin DD, McAlister FA. The effects of beta-blockers on morbidity and mortality in a population-based cohort of 11,942 elderly patients with heart failure. Am J Med 2002; 113:650-656.
8. Gupta R, Tang WH, Young JB. Patterns of beta-blocker utilization in patients with chronic heart failure: experience from a specialized outpatient heart failure clinic. Am Heart J 2004; 147:79-83.
9. Sabbah HN. The cellular and physiologic effects of beta blockers in heart failure. Clin Cardiol 1999; 22 (suppl 5):V16-V20.
10. Xiao RP, Tomhave ED, Wang DJ, et al. Age-associated reductions in cardiac beta1- and beta2-adrenergic responses without changes in inhibitory G proteins or receptor kinases. J Clin Invest 1998; 101:1273-1282.
11. Bristow MR. Mechanism of action of beta-blocking agents in heart failure. Am J Cardiol 1997; 80:26L-40L.
12. Bristow MR, Ginsburg R, Umans V, et al. Beta 1- and beta 2-adrenergic-receptor subpopulations in nonfailing and failing human ventricular myocardium: coupling of both receptor subtypes to muscle contraction and selective beta 1-receptor down-regulation in heart failure. Circ Res 1986; 59:297-309.
13. Bristow MR. Changes in myocardial and vascular receptors in heart failure. J Am Coll Cardiol 1993; 22 (4 suppl A):61A-71A.
14. Bristow MR, Ginsburg R, Minobe W, et al. Decreased catecholamine sensitivity and beta-adrenergic-receptor density in failing human hearts. N Engl J Med 1982; 307:205-211.
15. Hall JA, Kaumann AJ, Brown MJ. Selective beta 1-adrenoceptor blockade enhances positive inotropic responses to endogenous catecholamines mediated through beta 2-adrenoceptors in human atrial myocardium. Circ Res 1990; 66:1610-1623.
16. Beta-Blocker Evaluation of Survival Trial Investigators. A trial of the beta-blocker bucindolol in patients with advanced chronic heart failure. N Engl J Med 2001; 344:1659-1667.
17. Allada C, Keogh AM, Kotlyar E, et al. Carvedilol in elderly heart failure patients. J Am Coll Cardiol 2002; 39 (suppl A):1113-1146.
18. Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. N Engl J Med 1996; 334:1349-1355.
19. CIBIS-II Investigators and Committees. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet 1999; 353:9-13.
20. MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 1999; 353:2001-2007.
21. Erdmann E, Lechat P, Verkenne P, Wiemann H. Results from post-hoc analyses of the CIBIS II trial: effect of bisoprolol in high-risk patient groups with chronic heart failure. Eur J Heart Fail 2001; 3:469-479.
22. Flather MD, Shibata MC, Coats AJ, et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 2005; 26:215-225. Concluded that nebivolol, a β-blocker with vasodilating properties, is an effective and well-tolerated treatment for heart failure in the elderly.
23. Packer M, Coats AJ, Fowler MB, et al. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 2001; 344:1651-1658.
24. Dulin BR, Haas SJ, Abraham WT, Krum H. Do elderly systolic heart failure patients benefit from beta blockers to the same extent as the non-elderly? Meta-analysis of >12,000 patients in large-scale clinical trials. Am J Cardiol 2005; 95:896-898. A meta-analysis of all-cause mortality data involving elderly and non-elderly CHF patients from five completed β-blocker trials.
25. Krum H, Hill J, Fruhwald F, et al. Tolerability of beta-blockers in elderly patients with chronic heart failure: The COLA II study. Eur J Heart Fail 2006 (in press).
26. The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987; 316:1429-1435.
27. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991; 325:293-302.
28. The NETWORK Investigators. Clinical outcome with enalapril in symptomatic chronic heart failure; a dose comparison. Eur Heart J, 1998; 19:481-489.
29. Cleland JG, Tendera M, Adamus J, et al. Perindopril for elderly people with chronic heart failure: the PEP-CHF study. The PEP investigators. Eur J Heart Fail 1999; 1:211-217.
30. Packer M, Poole-Wilson PA, Armstrong PW, et al. Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group. Circulation 1999; 100:2312-2318.
31. Pitt B, Nicklas JM. Target doses of ACE inhibitors in heart failure: where should we aim? Eur Heart J 1998; 19:370-371.
32. Pitt B, editor. Studies of left ventricular dysfunction: the SOLVD anthology. Merck Frosst: Kirkland, Quebec; 1995.
33. Jong P, Yusuf S, Rousseau MF, et al. Effect of enalapril on 12-year survival and life expectancy in patients with left ventricular systolic dysfunction: a follow-up study. Lancet 2003; 361:1843-1848.
34. Flather MD, Yusuf S, Kober L, et al. Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients. ACE-Inhibitor Myocardial Infarction Collaborative Group. Lancet 2000; 355:1575-1581.
35. Pfeffer MA, Swedberg K, Granger CB, et al. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet 2003; 362:759-766.
36. McMurray JJ, Ostergren J, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial. Lancet 2003; 362:767-771.
37. Baruch L, Glazer RD, Aknay N, et al. Morbidity, mortality, physiologic and functional parameters in elderly and non-elderly patients in the Valsartan Heart Failure Trial (Val-HeFT). Am Heart J 2004; 148:951-957.
38. Cohn JN, Tognoni G. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 2001; 345:1667-1675.
39. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999; 341:709-717.
40. Juurlink DN, Mamdani MM, Lee DS, et al. Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med 2004; 351:543-551.
41. The Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med 1997; 336:525-533.
42. Rich MW, McSherry F, Williford WO, et al. Effect of age on mortality, hospitalizations and response to digoxin in patients with heart failure: the DIG study. J Am Coll Cardiol 2001; 38:806-813.
43. Ahmed A, Rich MW, Love TE, et al. Digoxin and reduction in mortality and hospitalization in heart failure: a comprehensive post hoc analysis of the DIG trial. Eur Heart J 2006; 27:178-186.
44. Deedwania PC, Gottlieb S, Ghali JK, et al. Efficacy, safety and tolerability of beta-adrenergic blockade with metoprolol CR/XL in elderly patients with heart failure. Eur Heart J 2004; 25:1300-1309.