Objective To study the clinical efficacy of low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure.Methods 100 cases of elderly patients with severe heart failure treated in our hospital from January 2013 to December 2016 were selected as the research object in this study.They were randomly divided into control group and experimental group, with 50 cases in each group.Patients in the control group were treated with conventional therapy, while the experimental group was treated with low dose thyroxine combined with irbesartan and hydrochlorothiazide.The clinical efficacy of the two group were compared and analyzed.Results After the corresponding treatment, the total effective rate of the experimental group was 88.0%,significantly higher than that of the control group(70.0%), the difference was statistically significant(P<0.05).After treatment, the experimental group of patients with left ventricular ejection fraction index, four triiodothyronine and three triiodothyronine levels were significantly higher than those before treatment, the control group of patients with left ventricular ejection fraction were significantly higher than before treatment, the difference was statistically significant(P<0.05).Conclusion Low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure has better clinical effect, can improve the therapeutic effect in a certain extent, with further clinical promotion and application significance.