Heart failure is an elderly disease, interesting 10% of the population aged more 80 years. Hypertension is this principal cause. Heart failure with preserved ejection fraction becomes predominant with age. Echocardiography is important to determine ejection fraction, left ventricular pressures and curable etiologies. Prognostic is more severe. Pharmacocinetic alterations need a careful utilization of drugs. Treatment must follow international recommendations, including use of renin-angiotensin-aldosterone inhibitors and betablockers. After 80 years, these drugs are underused. Severe salt restriction must be avoided. Strict biological monitoring is necessary.