These are two questions that a cardiologist at Saint Louis University is seeking to answer as part of research sponsored by the National Institutes of Aging. The project, funded by a $721,000 grant from the NIA, begins this summer and will continue for four years.

"Congestive heart failure is a disease of increasing prevalence, accounting for high morbidity and mortality," said lead researcher Paul J. Hauptman, M.D., a cardiologist at Saint Louis University School of Medicine. "This is a disease of the elderly, so as baby boomers age we need to start understanding more about how physicians in multiple specialty areas actually treat these patients. Ultimately, we want to figure out how to best take care of patients with end-stage heart failure."

The risk of heart failure, which affects 2 to 3 million Americans, is more common among elderly patients and increases with age. About 5 percent of those who are 75 have the condition, compared to 1 percent of those age 50.

Dr. Hauptman's study has two major parts:

• The study evaluates a medical therapy, the infusion of inotropic drugs, which is associated with high costs, unproven clinical efficacy and the potential to shorten survival while achieving palliation. "This therapy makes patients feel better, but it's unclear whether it helps them live longer," Hauptman said.

  Researchers will use administrative and clinical data from several Medicare databases for the period 1997 to 2001. The population of older Medicare beneficiaries receiving and the physicians prescribing this therapy will be described and contrasted with the demographics and outcomes of older patients hospitalized for heart failure but not receiving the drugs.

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