In a sense, it represents an exaggerated expression of the pathophysiology seen with the normal aging of the heart and can be conceptualized as "presbycardia
." (37) Indeed, HFpEF is more common in the elderly, but it is also more common in patients of African descent.
Sugiyama et al., "Age-dependent increase in deleted mitochondrial DNA in the human heart: Possible contributory factor to presbycardia
," American Heart Journal, vol.
Current views of heart failure may be no more accurate than musings on presbycardia
were 50 years ago. Since primary care heart failure patients are older and have more comorbidities than participants in randomized clinical trials, important questions are raised about the generalizability and effectiveness of interventions on the basis of our best scientific evidence.