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УЖМБС 2020, 5(2): 18–28
https://doi.org/10.26693/jmbs05.02.018
Medicine. Reviews

Treatment and Prevention of Chronic Heart Failure in Elderly Patients with Type 2 Diabetes Mellitus. Part I. (Literature Review)

Gorb Yu. G., Strona V. I., Komir I. R.
Abstract

The issues of pharmacotherapy of chronic heart failure in elderly patients with type 2 diabetes mellitus are considered. Particular attention is paid to the correction of disorders of carbohydrate and lipid metabolism, which play a leading role in the development of cardiovascular diseases comorbid with diabetes, the consequence of which is chronic heart failure. The study results proved that the dominant role of oxidative stress and the importance of individualization of drug therapy in people over 65 years of age with type 2 diabetes was demonstrated to maximize the simplification of the treatment regimen and reduce the risk of hypoglycemic reactions. The choice of target level of glycosylated hemoglobin, blood glucose, blood pressure and lipids in this category of patients is determined by the presence of comorbidities and life expectancy. The basic principles of antihyperglycemic, antihypertensive, lipid-lowering, antithrombotic therapy in elderly patients with type 2 diabetes mellitus are highlighted, taking into account the specific features of the mechanisms of action, possible side effects of drugs, as well as their influence on the course of chronic heart failure, and the possibilities of improving myocardial energy processes using means metabolic therapy. The drug therapy, which is carried out in elderly and elderly patients, is characterized by a high frequency of adverse reactions, which significantly complicates the course of the disease and worsens its prognosis. The combination of drugs of different pharmacological groups, which most often led to the development of adverse reactions in elderly patients, was determined. Conclusion. The use of metformin with drugs of other groups that affect carbohydrate metabolism in elderly patients and their interaction was proved to be appropriate. The importance of individualization of therapeutic approaches to elderly patients with type 2 diabetes mellitus and chronic heart failure, including, above all, optimization of glycemic control, modification of other risk factors, correction of cognitive disorders in order to improve the quality and duration of their life, was emphasized. We also considered the duration, dosage, and risks of side effects of prescribing hypolipidemic drugs for elderly and elderly patients (over 85 years).

Keywords: type 2 diabetes mellitus, chronic heart failure, treatment and prevention in elderly patients

Full text: PDF (Ukr) 242K

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