Heart failure: Overcoming the physiologic dilemma through evidence-based practice

Treatment options for patients with heart failure (HF) have improved in recent years. Medication combinations along with improved device management have improved survival rates and quality of life for patients with HF. Most patients with HF are older than 65 years. Because patients with HF with multiple comorbidities and any physical or cognitive impairments are often excluded from trials or studies, the evidence to guide therapy for most older patients with HF is not always representative and requires customization. Health care providers must remember that older patients with HF with multiple comorbidities and polypharmacy are at great risk for adverse effects and drug-to-drug interactions.