Differences in the clinical characteristics of elderly heart failure patients in Spain: results from the SEC-Excelente registry

Abstract Introduction Heart failure (HF) is a significant public health problem due to its high morbimortality and high consumption of healthcare resources. Several studies have pointed to some differences in the characteristics of older patients with HF compared to younger ones, but the under-representation of the elderly in the studies means that the evidence is limited. Purpose To analyse the differences in clinical characteristics of patients with HF according to age (≥75 years and 75 years). Methods A study was carried out, and patients were treated in HF units attached to the cardiology services of 68 hospitals in Spain with SEC-Excellent accreditation. The patients were included consecutively in two one-month cutoffs (March and October) between 2019 and 2023. The following data were collected: demographic, clinical, analytical, echocardiographic and treatment variables. For the differences between the two groups, the chi-square or Fisher's exact test was used, as appropriate, for qualitative variables and the Mann-Whitney U test for quantitative variables. Results 2,468 patients were included, 1,100 (44.6 %) older than 75 years. Most patients were included during the hospitalisation, and older patients are more frequently followed in community HF units (17.9 vs 25.4; p0.001). Elderly patients included are more frequently chronic than new diagnosis HF patients, without differences in the percentage of patients with HF admission the previous year compared to younger ones (32.2 vs 32.8 %; p=0.790). Elderly HF patients are frequently women with a high prevalence of cardiovascular risk factors, atrial fibrillation and comorbidities. They have worse renal function, functional class, and higher natriuretic peptide levels. HFpEF was more common in elderly patients (table 1). Also, elderly patients received fewer treatments with prognostic benefits, although they received more diuretics. They are rarely derived from cardiac rehabilitation programs, without differences in inclusion in structurally structured programmes of HF (Table 2). Conclusions In our cohort of HF patients, elderly patients had more comorbidities and more frequent HFpEF than younger ones. Implementation of drugs with prognostic benefit was lower, and referral to cardiac rehabilitation programmes was less frequent than in younger ones, without differences in the inclusion in specific HF programmes.Table 1 Table 2