Evolution of a Geriatric Syndrome: Pathophysiology and Treatment of Heart Failure With Preserved Ejection Fraction

Bharathi Upadhya, MD; Barbara Pisani, MD; Dalane W. Kitzman, MD


J Am Geriatr Soc. 2017;65(11):2431-2440. 

In This Article

General Approach

Management goals in elderly adults with HFpEF include relief of symptoms, improvement in functional capacity and quality of life, prevention of acute exacerbations and related hospital admissions, and prolongation of survival. A systematic approach should comprise several of the following elements: diagnosis and staging of disease, search for reversible etiology, judicious use of medications, patient education, enhancement of self-management skills, coordination of care across disciplines, and effective follow-up. Individuals with HF should have a scale, weigh themselves regularly, and know what steps to take if their weight increases beyond a prespecified range. Nurses can adjust diuretics over the telephone as needed, and in some cases the individuals can make the adjustment themselves. There must be easy access to healthcare providers so that problems can be addressed early to avoid decompensation and hospitalizations. Examples of easy access include periodic telephone calls, frequent follow-up appointments, and monitoring programs using the telephone and the Internet.