Russian Heart Failure Journal 2009year Optimization of the individualized approach to management of elderly patients with CHF in the outpatient conditions


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2009/

Optimization of the individualized approach to management of elderly patients with CHF in the outpatient conditions

Larina V. N., Bart B. Ya.

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Urgency. ACEI take the leading place in the treatment of patients with CHF. Prognosis of elderly patients with CHF also benefits from the use of ACEI. Aim. Optimizing the individualized approach and complex therapy in elderly patients with CHF in the outpatient conditions. Materials and methods. Study enrolled 53 patients with II-IV FC CHF aged from 60 to 85 years. Evaluation of patients included echoCG, laboratory tests, 6-min walking test, and determination of quality of life at baseline and during the fosinopril treatment. In addition, clinical status of patients was evaluated using the clinical condition scale (CCS) and the presence and severity of anxiety and depression. Results. Inclusion of the ACEI fosinopril into the complex therapy improved the clinical condition and quality of life in patients, reduced signs of depression and anxiety, although patients did not receive antidepressants. The therapy was well tolerated in the vast majority of patients. Serum potassium did not increase in the course of treatment. The administered therapy was associated with statistically significant decreases in diastolic BP and heart rate and statistically non-significant decreases in systolic and pulse BP. Data of echoCG examination showed decreases in mean pulmonary artery pressure and LV end-diastolic pressure. Therefore the high efficacy and safety of fosinopril substantiate recommendation of a broader use of the drug in the complex therapy for CHF in elderly patients in the outpatient conditions.
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