Influence of age on neurohormonal activation and prognosis in patients with chronic heart failure.

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Abstract
Aims Heart failure is a major medical problem in the elderly. Neurohormonal activation plays a role in the pathophysiology of heart failure, but is also affected by ageing. The present study was carried out to examine the influence of age on neurohormonal activation and prognosis in patients with chronic heart failure. Methods and Results We studied 372 patients with moderate to severe chronic heart failure (New York Heart Association [NYHA] functional class III–IV), who were treated with angiotensin converting enzyme (ACE) inhibitors (95%), diuretics (99%), and digoxin (59%). Their mean age was 68±8 years (range 38–80), left ventricular ejection fraction 0·23±0·08, and 77% were males. The relationship between age and plasma neurohormones (norepineprine, epinephrine, dopamine, renin, aldosterone, atrial natriuretic peptide, N-terminal atrial natriuretic peptide, and endothelin), and age and prognosis was examined. Only atrial natriuretic peptide and N-terminal atrial natriuretic peptide showed an independent, positive correlation with age (PP74 years) had a significantly higher mortality (risk ratio 1·9) than younger patients (P74 years), age alone was an independent predictor for mortality.

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