Ageing and heart failure: the place of ACE inhibitors in heart failure with preserved systolic function

A series of epidemiological studies have reported that heart failure is frequent in the elderly and that preserved left ventricular systolic function (LVSF) may represent as much as 50% of elderly patients with heart failure. It is difficult to estimate precisely the prognosis for heart failure with preserved LVSF, but it is often perceived to be better than for systolic dysfunction. However, some surveys reported similar mortality rates for these two types of left ventricular dysfunction. The results of pharmacotherapy are often disappointing, and there is a clear lack of studies evaluating the efficacy of different drugs in the treatment of heart failure with preserved LVSF. This gap should be filled by the Perindopril for Elderly People with Chronic Heart Failure (PEP-CHF) trial.