The number of patients with heart failure (HF) is increasing with the aging society. The growing number of elderly people suffering from HF and the rising costs of health care are major social problems. There is increasing evidence regarding age-associated changes in the cardiovascular system. Cardiac structural remodeling, including increased left ventricular (LV) stiffness and reduced cardiovascular reserve, have been observed in aged patients. Such mechanical changes may cause susceptibility to increased cardiac filling pressure and the development of HF. In addition, older age is associated with higher prevalence of multiple comorbidities, that renders them more susceptible to HF with preserved ejection fraction (HFpEF). In this joint symposium, several important issues regarding HF in elderly will be discussed.