Editor's Correspondence |

Frailty Is a Strong Modulator of Heart Failure–Associated Mortality—Reply

Philip Jong, MD; Jack V. Tu, MD, PhD
Arch Intern Med. 2003;163(6):738. doi:10.1001/archinte.163.6.737-a.
Text Size: A A A
Published online


In reply

We agree with Dr Workman that end-of-life care is an integral management issue in many patients with end-stage heart failure and other terminal illness. As suggested by Dr Workman and Dr Rozzini et al, the goal of care in these patients may not be improvement in survival but enhancement in quality of life. However, for most community-dwelling heart failure patients who are not terminally ill, we assert that much more remains to be done (and can be done) to improve their care and outcomes. Our data showed that the mortality rates among patients 75 years or older were high, regardless of the number of concurrent comorbid conditions. While we did not focus in our study on strategies that could improve the prognosis of this sick population, other authors1 have documented that undertreatment of elderly patients with heart failure might be partly responsible for the elevated mortality rates in this subgroup. We believe that increasing practice of evidence-based heart failure care, including the appropriate use of angiotensin-converting enzyme inhibitors and β-blockers, could prolong life by preventing premature deaths in many patients with heart failure in the community today.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles