Chronic heart failure (CHF) is one of the leading medical-social problem of the modern society due to its high incidence, frequent comorbidity with diabetes mellitus type 2 (DM), increased mortality, high risk of chronic vessel complications. In case of its comorbidity with DM and anemia of different degree of severity it can affect the outcome of the disease and the patients’ quality of life. The purpose of the study was to determine the impact of CHF, DM and anemia on the quality of life of elderly and senile patients and possibility of telmisartan in its correction. Material and methods. We conducted a comprehensive survey of 120 patients with (HF) of ischemic origin, DM and anemia. All examined patients according to their comorbidities were randomized into the following subgroups: I – patients with СHF without DM type 2 (n=12), II – patients with СHF, complicated by comorbid anemia (n=32), III – patients with CHF, DM and anemia (n=76). The control group for comparative studies comprised 12 people with CHF without comorbid pathology. Quality of life was determined by the questionnaire Mezzich J. E., Cohen M., Ruiperez N. et al, 1999. Results and discussion. The level of physical welfare was the highest in the control group patients (6.2±0,56 points). Value of the index of psychological and emotional welfare in the control group patients was 57% more than in the patients with CHF and DM, its lowest value was determined in the patients of III group – 2.1±0.25 points, which differs significantly from the patients of the control group (p<0.05) and the patients of the I group (p<0.05). The lowest level of self-service and independence of activity was detected in the patients with CHF, DM and anemia (4.1±0.14 points), having been significantly different from the corresponding value in the group of patients with CHF and anemia (6.3±1.11 points, p<0.05), and the control group (9.4±0.62 points, p<0.05). Workability index was lower in patients of all experimental groups than in the control group patients. Thus, both in the patients with CHF and AS and in the patients with combined course of CHF, DM and anemia the difference between the corresponding values was statistically significant, same as comparing to the patients of control group (2.5±0.60 points and 3.8±0.09 points to 5.4±1.08 points, correspondingly, p<0.05). The level of interpersonal interaction and socio-emotional support was statistically significantly lower in comparison with the control group only in the patients of III experimental group. The level of public support in the patients with CHF and AS was statistically improbable lower than in the control group (6.4±1.03 against 8.6±0.65 points, p>0.05). In the patients with CHF, DM and anemia the following figure was 4.6±0.32 points, having been statistically significantly different from the patients of the control group (p<0.05). Figure of the personal implementation was the highest in the control group patients (7.4±0.64 points). Due to the CHF and anemia its decreasing to 5.67±0.52 points was determined, though we found no statistically significant difference comparing to the control group (p>0.05). The lowest level of personal implementation was detected in the III experimental group of patients with CHF, DM type 2 and anemia (2.8±0.40 points, p<0.05). Index of religious implementation was almost equal in all investigated groups. Comparing with the control group overall perception of quality of life in patients with CHF and anemia was lower by 23%, and in patients with CHF, DM and anemia – by 42% respectively (p<0.05 in both cases). Conclusions. Thus, patients with CHF of elderly and senile age with comorbid DM type 2 and anemia are characterized by significant worsening of the overall perception of quality of life, the same as physical and physiological welfare, self-service, workability and personal implementation.
Keywords: chronic heart failure, diabetes mellitus type 2, anemia, quality of life
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