[Heart failure in the elderly].

The prevalence of heart failure substantially increases with advancing age. Nevertheless, heart failure in the elderly is commonly under-diagnosed, because dyspnoea and fatigue are often attributed to the natural process of aging. Age-related alterations of the cardiovascular system and the presence of multiple comorbidities not only change the clinical features of heart failure, but also have an impact on heart failure treatment in this population. Cautious uptitration of the individual drugs and vigorous clinical and laboratory monitoring is mandatory to avoid undesired side effects. Although guideline-recommended heart failure therapy is derived from trials that included mainly middle-aged patients with few comorbidities, it has proven beneficial even in the very elderly. Today, guideline-recommended heart failure therapy is still too often withheld from elderly patients out of fear of potential side effects.