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Frailty and multiple comorbidities in the elderly patient with heart failure: implications for management

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Abstract

Heart failure (HF) in the elderly is a major public health problem, and its prevalence is rising. Outcomes of HF in the elderly have not changed in the past 2 decades despite the introduction of novel HF therapies. This may be due to the combined impact of multiple comorbidities and frailty. The majority of elderly patients with HF are frail with multiple comorbidities. These comorbidities, along with frailty, contribute to the poor outcome of HF in the elderly and pose independent management challenges. More research is needed to better understand the interaction between frailty and multiple comorbidities and the mechanisms by which they impact HF and its management; develop prognostic tools that incorporate frailty and multiple comorbidities and provide more accurate prediction of outcomes; test available treatments in typical elderly patients; and develop and test novel interventions that directly address the adverse impact of multiple comorbidities and frailty.

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Acknowledgments

The Funding sources N.I.H. 5T32HL087730: Training Grant in Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke and N.I.H. R37AG18915; The Claude D. Pepper Older Americans Independence Center of Wake Forest University N.I.H. P30AG21332.

Conflicts of interest

Khalil Murad, MD: None. Dalane W Kitzman, MD: Served as consultant for and/or received grant support from Synvista (>$10K), Bristol-Meyers-Squibb (>$10K), Novartis (>$10K), Boston Scientific (>$10K), Relypsa (>$10K), Forest Laboratories, and Med.

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Authors and Affiliations

  1. Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Khalil Murad

  2. Section of General Internal Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Khalil Murad

  3. Cardiology Section, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Dalane W. Kitzman

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  1. Khalil Murad
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Correspondence to Khalil Murad.

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Murad, K., Kitzman, D.W. Frailty and multiple comorbidities in the elderly patient with heart failure: implications for management. Heart Fail Rev 17, 581–588 (2012). https://doi.org/10.1007/s10741-011-9258-y

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