An Update on the Role of Digoxin in Older Adults with Chronic Heart Failure



Geriatrics and Aging. 2008;11(1):37-41. 

In This Article

Abstract and Heart Failure: A Geriatric Syndrome

Heart failure (HF) is the leading cause of hospitalization among older adults. Digoxin has been shown to reduce hospitalization due to worsening HF. However, at the commonly prescribed dose of 0.25 mg/day, digoxin does not reduce mortality. New data suggest that at low doses (0.125 mg/day or lower) digoxin not only reduces hospitalization due to HF, but may also reduce mortality. Further, at lower doses, it also reduces the risk of digoxin toxicity and obviates the need for routine serum digoxin level testing. Digoxin in low doses should be prescribed to older adults with symptomatic HF.

Heart failure (HF) is common, and with the aging of the population, its incidence and prevalence are projected to rise.[1,2] Heart failure is a geriatric syndrome as most people with HF are older adults, and HF is the leading cause for hospitalization for the population 65 years and older. Heart failure among older adults is different in many ways than it is among younger individuals. The assessment of HF in older adults is often complicated by underreporting of symptoms, functional impairment, other morbidities with symptoms similar to those of HF, and the presence of a normal left ventricular ejection fraction.[3,4]


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