Clinical features of extremely elderly patients with heart failure

AimThe purpose of this study is to investigate the impact of abnormal blood pressure on the risk of all‐cause and cardiovascular mortality in a large cohort of older Japanese people aged ≥65 years.MethodsThis cohort study enrolled 54 760 participants from Okayama City aged ≥65 years who underwent basic health checkups from April 2006 to March 2008. Based on blood pressure, the participants were divided into six categories, from C1 (lowest) to C6 (highest). To assess the association of blood pressure with all‐cause and cardiovascular mortality, we used survival analysis to estimate hazard ratios (HRs) for all‐cause mortality and subdistribution HRs (SHRs) for cardiovascular mortality on C3. We then repeated the analyses based on age groups (65–74 years, 75–84 years, and ≥85 years).ResultsThe fully adjusted HRs for all‐cause mortality, which included all individual potential confounders, were 1.11 (95% confidence interval [CI]: 1.04–1.19) for C5 and 1.23 (95% CI: 1.09–1.38) for C6, respectively. The fully adjusted SHRs for cardiovascular mortality were 1.11 (95% CI: 1.01–1.21) for C4, 1.19 (95% CI: 1.05–1.34) for C5, and 1.36 (95% CI: 1.09–1.70) for C6. In the age‐stratification, an increased risk of hypotension was observed with older age. The HR for C1 was 1.28 (95% CI: 1.16–1.41) for ≥85 years.ConclusionsHypertension increased the risk of all‐cause and cardiovascular mortality among those aged 65–74 and 75–84 years, but not among those aged ≥85 years. Geriatr Gerontol Int 2024; ••: ••–••.

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Regional Variation in the Clinical Practice and Prognosis in Patients With Heart Failure With Reduced Ejection Fraction in Japan　― A Report From the Japanese Registry of Acute Decompensated Heart Failure (JROADHF) ―

Sato

Yoshihisa

Ide

et al. 2023

Circ J

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grounds and treatments have been reported in patients with coronary artery disease and cardiomyopathies, which are 2 of the leading causes of HF. 13-15 However, regional variations in Japanese patients with HF remain unclear, so we hypothesized that addressing such variations could potentially improve HF management and prognosis. Thus, the aim of the present study was to clarify regional variations in both clinical practice and prognosis of Japanese patients with HFrEF using the Japanese Registry of Acute Decompensated Heart Failure (JROADHF). 16 Methods Study SettingThe JROADHF database is a retrospective, multicenter, H eart failure (HF) as a common clinical syndrome with high morbidity and mortality has been increasing worldwide, 1,2 so to improve the prognosis of patients with HF, task forces have summarized the accumulating evidence and proposed evidence-based treatments as guidelines. 3-6 The cardioprotective evidence is abundant for patients with HF with reduced ejection fraction (HFrEF) in particular, 3-6 but HF is a heterogeneous syndrome with various etiologic and pathophysiologic factors. 7,8 Regional variations in clinical practice and prognosis have been reported in the USA, Europe, and Asia, which suggests region-specific risk factors and gaps. 9,10 Japan has one of the fastest aging populations and the number of patients with HF is predicted to keep increasing. 11,12 In addition, regional variations in patients' back-

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Clinical features of extremely elderly patients with heart failure

Abstract: We should be careful of atrial fibrillation and renin-angiotensin system inhibitors in managing extremely elderly patients with heart failure. Geriatr Gerontol Int 2017; 17: 2194-2199.

Cited by 3 publications

References 24 publications

Differential characteristics of acute heart failure in very elderly patients: the prospective RICA study

Differential characteristics of acute heart failure in very elderly patients: the prospective RICA study

Impact of high blood pressure on the risk of mortality among Japanese people aged 65 years and older

Regional Variation in the Clinical Practice and Prognosis in Patients With Heart Failure With Reduced Ejection Fraction in Japan　― A Report From the Japanese Registry of Acute Decompensated Heart Failure (JROADHF) ―

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Clinical features of extremely elderly patients with heart failure

Abstract: We should be careful of atrial fibrillation and renin-angiotensin system inhibitors in managing extremely elderly patients with heart failure. Geriatr Gerontol Int 2017; 17: 2194-2199.

Cited by 3 publications

References 24 publications

Differential characteristics of acute heart failure in very elderly patients: the prospective RICA study

Differential characteristics of acute heart failure in very elderly patients: the prospective RICA study

Impact of high blood pressure on the risk of mortality among Japanese people aged 65 years and older

Regional Variation in the Clinical Practice and Prognosis in Patients With Heart Failure With Reduced Ejection Fraction in Japan ― A Report From the Japanese Registry of Acute Decompensated Heart Failure (JROADHF) ―

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Regional Variation in the Clinical Practice and Prognosis in Patients With Heart Failure With Reduced Ejection Fraction in Japan　― A Report From the Japanese Registry of Acute Decompensated Heart Failure (JROADHF) ―