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so the last talk will be on heart failure with preserved ejection fraction and I will try and talk about this okay so heart failure preserved ejection fraction there are some key points you have to remember about this condition the starting point is half peph is a diagnosis is is a disease of the elderly and it is a disease that is defined by comorbidities a very important point to keep so this is the cardiovascular health study you see that these are community members amongst community members the prevalence of heart failure above the age of 65 is close to 10% but predominantly 80% of those patients are have path just delineating the pact that this is a disease of the elderly okay on average in terms of comorbidities an average half PAP patient would have at least four comorbidities theres something called the Charleston comorbidity index if you compare half peph with cancer this is right up there on average for comorbidities with heart failure with preserved ejection fraction why i