Heart Failure in the Elderly

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In heart failure, the heart cannot pump enough blood through the body. The heart cannot fill with enough blood or pump with enough force, or both. Heart failure develops over time as the pumping action of the heart gets weaker. It can affect either the right, the left, or both sides of the heart. Heart failure does not mean that the heart has stopped working or is about to stop working.

Heart failure can also be called congestive heart failure, systolic heart failure, diastolic heart failure, left-sided heart failure, or right-sided heart failure. In most cases, heart failure affects the left side of the heart when it cannot pump enough oxygen-rich blood to the rest of the body. When heart failure affects the right side, the heart cannot pump enough blood to the lungs, where it picks up oxygen.

In normal hearts, blood vessels called veins bring oxygen-poor blood from the body to the right side of the heart. It is then pumped through the pulmonary artery to the lungs, picking up oxygen. From there, the blood returns to the left side of the heart. Then it is pumped through a large artery called the aorta that distributes blood throughout the body.

When the heart is weakened by heart failure, blood and fluid can back up into the lungs, and fluid builds up in the feet, ankles, and legs. People with heart failure often experience tiredness and shortness of breath.

Heart failure is a serious condition. Scientists estimate that 5 million people in the U.S. have heart failure and that number is growing. It contributes to 300,000 deaths each year. Heart failure is most common in those who are age 65 years and older and is the number one reason older people are hospitalized.

Heart failure tends to be more common in men than in women, but because women usually live longer, the condition affects more women in their 70s and 80s.

The most common symptoms of heart failure include:

  • Shortness of breath or difficulty breathing
  • Feeling extremely exhausted

  • Swelling. Swelling is caused by fluid build-up in the body and can lead to weight gain and frequent urination, as well as coughing.

How to Prevent Elderly Heart Failure

Heart failure can happen to almost anyone. It is most common in people over 65, and is more common in African-Americans. Also, men have a higher rate of heart failure than women. It is the number one reason for hospitalization for people over age 65.

Heart failure is caused by other diseases or conditions that damage the heart muscle. It is often caused by coronary artery disease, including heart attacks. Diabetes and high blood pressure also contribute to heart failure risk.

Coronary artery disease is the leading cause of death in men and women. It happens when the arteries that supply blood to the heart become hardened and narrowed. People who have had a heart attack are at high risk to develop heart failure.

There are a number of things that you can do to reduce risk of coronary artery disease and heart failure. Keeping your cholesterol levels healthy can help prevent coronary artery disease. For most people, the targets are:

  • LDL, or "bad" cholesterol -- below 100
  • HDL, or "good" cholesterol -- above 40 in men and above 50 in women
  • Triglycerides, another fat in the blood -- below 150

High blood pressure causes the heart to get larger and work harder, which can then lead to heart failure. You should aim for a blood pressure level of 130/80 or below. Talk to your doctor about ways to lower your blood pressure.

Diabetes can also contribute to heart failure. Diabetes is characterized by having too much glucose, or sugar, in the blood for a long time. This can cause heart problems because high blood glucose can damage parts of the body such as the heart and blood vessels. This damage weakens the heart, often leading to heart failure.

You can help prevent heart disease by losing weight if you are overweight, quitting smoking, and limiting the amount of alcohol you drink. Doctors also recommend that you eat a diet low in salt because salt can cause extra fluid to build up in your body.

Limiting foods that are high in saturated fat or cholesterol, such as meats, butter, dairy products with fat, eggs, shortening, lard, and foods with palm oil or coconut oil, can help you maintain a heart-healthy diet. Heart-healthy foods include those high in fiber, such as oat bran, oatmeal, whole-grain breads and cereals, fruits, and vegetables.

Exercise also helps keep your heart strong. Aim for at least 30 minutes a day of exercise.


National Institute on Aging (NIA), one of the 27 Institutes and Centers of the National Institute of Health (NIH) leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life.

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2 Comments

My grandpa is 82 years old and has Dementia. He has a history of 1 heart attack and has a defibulator. He also has a history of blood clot in lung and since then has been on oxygen at home at night and when needed due to low oxygen, Today I have noticed he is short of breath, seems to be congested (1st thought nasal congestion) So I put some nasal strips on his nose to help open airway, gave him albuterol treatment, mucinex (incase chest congestion) and some Cold medicine. I checked vitals they were b/p 153/87, pulse 79 and pulse ox was 90% (normally 93-98%) and blood sugar was 138. I just went in laid him down for bed put his oxygen on him set at 2.5. I noticed with oxygen on he seems to still be breathing heavy and having trouble breathing. and his left ankle/foot is swelled with fluid. His right foot was pretty much normal. ............................I don't have car and not only have him but 3 kids. ages 3, 4 and 5. should I call a squad? or he also has a doctor that sees him in home Idk if he does night calls but was gonna give a shot because I cant drive him to hospital, I can call squad but I also don't have way to go with him I cant ride due to having 3 kids with me. and all our family lives hours away. what Im worried about s if his severe dementia will causes issues with doctor even knowing whats wrong n why he is there because in past he can never explain to doctors what he is experiencing its usually always based off what I see, n what he may tell me which he is telling me hes having trouble catching breathe what should I do?
quite well written ,particularly for lay people. as always drawings would be helpful.

r,h,adams