Русский
Treatment of comorbid patients over 80 years old: Focus at arterial hypertension (analysis of real clinical practice)
DOI: https://dx.doi.org/10.18565/therapy.2023.8.38-46
Safronenko V.A., Chesnikova A.I.
Rostov State Medical University of the Ministry of Healthcare of Russia, Rostov-on-Don
The aim: estimation of the efficacy of AH outpatient treatment in elderly patients depending on CHF and SAS presence.
Material and methods. 320 patients with arterial hypertension over 80 years of age were divided into 4 groups taking into account CHF and SAS presence: 1A – a group with AH, SAS and CHF (n=84); 1B – with AH and SAS without CHF (n=84); 2A – with hypertension and CHF without SAS (n=77); 2B – with AH without CHF and without SAS (n=75). The target level of systolic blood pressure (SBP) in patients with senile asthenia is 140–150 mmHg.
Results. Patients in group 1A were more likely to have no AHT and AH monotherapy (ACE inhibitors), as well as less frequent use of triple therapy. In «strong» patients (i.e., without SAS), combination therapy was more often used to treat hypertension. Thus, in group 2B, comparatively with 2A group, the frequency of two-component therapy was higher, and when compared with group 1B, not only two-, but also three-component therapy was registered in a higher percentage of cases. In the presence of SAS in patients with hypertension, the risk of hospitalization increased by 3.57 (p=0,0002), with CHF – by 4,39 (p <0,0001), and with a combination of CHF and SAS – by 7,26 times (p <0,0001).
Conclusion. The presence of CHF and SAS worsens the AHT efficacy in hypertensive patients over 80 years old, leading to a more frequent development of orthostatic hypotension and hospitalizations due to cardiovascular events.
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About the Autors
Victoria A. Safronenko, PhD in Medical Sciences, associate professor of the Department of internal medicine No. 1, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
E-mail: v.chugunova@mail.ru
ORCID: https://orcid.org/0000-0002-6965-5019
Anna I. Chesnikova, MD, professor, head of the Department of internal medicine No. 1, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
E-mail: rostov-ossn@yandex.ru
ORCID: https://orcid.org/0000-0002-9323-592X
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