DIASTOLIC HEART FAILURE IN ELDERLY PATIENTS: PP.1.31

Abstract

Objective: Hypertension (H) is one of the main causes for heart failure (HF) in elderly people. Besides diastolic heard failure adds up to 40% of all cases and the prevalence of diastolic heart failure increases with age. The aim of this study was to evaluate the prevalence of diastolic heart failure in elderly subjects with hypertension. Design and Method: 47 elderly subjects were included (22 males, 25 females, mean age 79 + 8 years). They all entered our Geriatric ward with a diagnosis of heart failure. Design of the study included: 1) clinical measurement of blood pressure; 2) NYHA class evaluation;3) electrocardiogram; 4) echocardiogram. Results: 73.2% subjects had hypertension. Prevalence of heart failure increased with aging (78.5% >age 80). Mean blood pressure values were: SBP 140 + 15 mmHg and DBP 88 + 15 mmHg. 34.7% had controlled blood pressure. Among all cases 23 affected by diastolic heart failure had a 48.5% ejection fraction. During the first weak of hospitalisation those patients also showed a higher NYHA Class score. Those in Class I NYHA had a higher percentage of worsening heart failure if affected by uncontrolled hypertension. Hypertensive patients in Class 2 or 3 NHYA had a similar recovering rate both with controlled and uncontrolled hypertension. However hypertensive subjects showed a definite worsening of heart failure in NHYA Class (18%) versus controlled ones (5%). In a multivariable model these differences depended on age, gender, BMI, Diabetes Mellitus, CK-MB, atrial fibrillation. Through the same investigation we detected that a history of hypertension was an independent predictive factor of NYHA Class diastolic heart failure (p < 0.05). Conclusions: Prevalence of heart failure is higher in hypertensive elderly people and it increases with aging. These is also a significant relation between uncontrolled hypertension and diastolic heart failure.