Chronic heart failure in patients with arterial hypertension and ischemic heart disease: age and gender specifics

Author(s):  
Elena Aleksandrova ◽  
Tatiyana Shindina ◽  
Maksim Maksimov

Studying of the prevalence of CHF in patients with arterial hypertension and ischemic heart disease, and of the specifity of CHF in patients of different sex and age. Retrospective analysis of CHF prevalence in 2048 patients, prospective study of different types of CHF in 285 patients with conduction of echocardiography and 6 min walk test. The prevalence of CHF in our group was 29 %, in men it was found 2.8 times more often than in women. 71 % of patients with CHF were older than 60 years. Significant differences were revealed in etiology of CHF in men and women, and in patients of different age. CHF with E < 45 % was diagnosed in 35.8 % of patients, men had this type of CHF 5.8 times more often than women. CHF with preserved EF was in 64.2 % of patients, the amount of women with this variant of CHF increases to 33.3 %. Purposeful examination of patients with arterial hypertension and IHD is needed for early detection of CHF.

2018 ◽  
Vol 11 (4) ◽  
pp. 1967-1974
Author(s):  
Praveen Panchaksharimath ◽  
A. N. Praveen ◽  
R. Manjunath

Drug utilization study is a powerful exploratory tool to evaluate the present trends of drug prescribing and appropriateness of prescription. To analyse the age and gender related differences in utilization of different classes of drugs in patients for Ischemic heart disease (IHD) management. This cross-sectional observational study was conducted from August 2017 to March 2018 in Cardiology department, PMSSY, BMC&RI, Bengaluru. The demographic, and drug prescription data of IHD patients were analyzed according to age group (18–59 years versus ≥ 60 years) and gender wise. Out of 520 patients diagnosed with IHD, 68% were male patients and 60% were aged ≥ 60 years. The most common co-morbid condition was Hypertension (66%) and was significant in patients aged ≥ 60 years (P= 0.0033). Anti-platelet drugs (100%) followed by Lipid lowering drugs (96%) were most commonly prescribed. The average number of drugs per prescription was found to be 6.44. Prescription of Dual anti-platelet therapy was found to be significant among men (<0.0001). Prescription of Diuretics (p = 0.045) and Pregabalin (p = 0.031) were significantly higher among females and Prescription of Angiotensin receptor blockers (ARBs) was significantly higher among those aged 18–59 years. Hypertension and Diabetes Mellitus were the most common co-morbidities observed with IHD. ARBs, Diuretics, Proton pump inhibitors, Anti Diabetic Agents and Pregabalin showed significant differences in the drug utilization with respect to age and gender. Dual anti-platelet therapy was observed to be significantly higher among males. This study has been registered in CTRI (CTRI/2018/05/013949).


Author(s):  
Seon Young Hwang ◽  
Kyung Ae Kim ◽  
Oh Jong Choi

Early risk stratification and preventative strategies are required in patients with ischemic heart disease (IHD) to prevent heart failure (HF). We aimed to investigate the rate of progression to HF and to investigate the factors predicting the development of HF in a population with IHD for 10 years. A descriptive study was conducted using Korea National Health Insurance Service-National Sample Cohort (NHI-NSC) data (2005–2015). Among the patients diagnosed with IHD for the first time in 2005–2006, 2271 men and 2037 women who responded to the health check-up survey were finally selected. Cox Proportional Hazard regression analyses and the Kaplan–Meier survival analysis were used. HF incidence rates were 5.1% in men and 8.0% in women. The mean duration of transition to HF was 4.85 ± 2.73 years in men and 4.73 ± 2.73 years in women. The non-incidence rate of HF was higher in men than in women (Log-rank test, p = 0.0003). Bivariate analyses showed that older age, prevalence of hypertension and diabetes, less alcohol, and lower physical exercise were associated with the incidence of HF in both men and women. Multivariate analyses found that HF incidence in aged subjects ≥70 years was 1.46 times higher in men and 1.44 times higher in women compared to those in their 30 s (p < 0.001). Prevalence of hypertension reduced the incidence of HF by 0.78 and 0.87 for men and women, respectively. The prevalence of diabetes increased 1.23 times only in men. These findings suggest that special attention such as periodic counseling and education is needed to prevent progression to HF in elderly and diabetic patients during follow-up after IHD.


2017 ◽  
Vol 24 (3) ◽  
Author(s):  
Nina Matsegora ◽  
Nataliia Mitasova

Objective. To conduct a comprehensive study of patients with ischemic heart disease (IHD) in combination with arterial hypertension (AH) complicated by chronic heart failure (HF) 2A and 2B, by studying parameters of intracardiac hemodynamics considering the pressure in the pulmonary artery.Research results. We examined 120 patients with coronary heart disease in combination with hypertension aged 44 to 90 years old (mean age 72.29 ± 1.66), the majority were men (86.7%). All patients were divided into two groups according to the degree of heart failure: HF 2A - 54 persons, with HF 2B - 66 people. The groups were compared in age, gender, functional class of IHD, severity of AH and HF.Analysis of heart ultrasound showed the following. In IHD in combination with hypertension, complicated by HF 2A, the pressure in the pulmonary artery rises in an average to 46.46 ± 3.64 mm Hg and it increases in HF 2B to 57.00 ± 5.19 mm Hg., that corresponding to the average level of pulmonary hypertension (p<0.01); at the same time, the fraction of ejection of left ventricle in the first patients decreases moderately up to 45.96 ± 2.01%, in others - to 39.93 ± 1.99% (p ˂0.01).In patients with IHD in combination with hypertension complicated by chronic heart failure the structural and functional changes are formed on the side of the left heart, accompanied by an increase in their size due to hypertrophy, formation of stagnant phenomena, regurgitation, functional state disorders by the restrictive type, progressive systolic and diastolic dysfunction, increased pressure in the pulmonary artery.Conclusions. Consideration of pulmonary hypertension, along with other parameters of intracardiac hemodynamics, is an important component in determining the degree and nature of heart failure, which requires the selection of adequate and timely therapeutic tactics.


2021 ◽  
pp. 53-57
Author(s):  
Sofiia Dolinska ◽  
Viktoriia Potaskalova ◽  
Mykola Khaitovych

Due to the development of the pharmaceutical industry, today there are a large number of drugs with similar properties and efficacy, but little-studied pharmacodynamics and pharmacokinetics. There fore many medicines are prescribed more often and in larger quantities than necessary. That is why patients and doctors often face the problem of polypharmacy in various fields of medicine including cardiology. The paper presents the results of the analysis of 249 case histories of inpatients with cardiac profile. All patients with underlying cardiac pathology (arterial hypertension, ischemic heart disease) had concomitant diseases. Patients with arterial hypertension had other concomitant diseases, most often gout, diseases of the digestive system, anemia. Chronic heart failure was found in the majority of patients with arterial hypertension, ischemic heart disease, chronic rheumatic heart disease. We have determined which pharmacological groups of drugs are prescribed to patients with arterial hypertension or chronic heart failure and concomitant diseases: more than 60 % of patients are prescribed drugs that are unsuitable for their condition. We analyzed and compared treatment standards in Ukraine and the world and carried out that doctors in Ukraine use modern and effective methods of treatment. The risks of prescribing a large number of drugs to patients are analyzed and the risks of dangerous drug interactions that can threaten the life or health of the patient are identified. In particular, in the treatment of cardiac patients, doctors used combinations of calcium antagonists and beta-blockers, NSAIDs and antithrombotic drugs, corticosteroids and antibacterial drugs of the fluoroquinolone group, ACE inhibitors and potassium-preserving diuretics, antiarrhythmic drugs and highly active diuretics, etc. We compared medicinal prescriptions for the treatment of cardiovascular diseases with an interval of 10 years and revealed that in 2008 the therapy often did not comply with the international and Ukrainian treatment protocols, however, in 2018, unwanted drug interactions were found 4 times less often. That reflects the trend of doctors’ awareness of pharmacology and evidence-based medicine.


2002 ◽  
Vol XXXIV (1-2) ◽  
pp. 16-21
Author(s):  
A. T. Zabbarova ◽  
E. I. Bogdanov ◽  
M. M. Ibatullin

It had been performed a correlation of clinical and MRI characteristics of hypertonic angioencellopathy of cronical forms in men and women. It was done for the purpose of investigating sexual factor significance in cerebrovascular pathology. 50 men and 35 women who had clinical manifestations of discirculatory encephalopathy have been examined. It was revealed that in men paresis development is manly determined by total volume of brain substance lesion and by presence of large cortical-subcortical infactions, striocapsular infarctions and edge-zone infarctions; in women cognitive disorders are determined by total volume of brain substance. Diffuse forms are spread in men with accompanying ischemic heart disease, in women with prolonged arterial hypertension and with high level of arterial pressure. Ischemic heart disease in women is a result of the disease focal form.


The combination of atrial fibrillation and/or flutter and chronic heart failure is a frequent problem for many patients. Radiofrequency ablation is effective in the strategy for controlling the rhythm of patients with atrial fibrillation and/or flutter, but always requires concomitant therapeutic support. The study involved 70 patients with atrial fibrillation and/or flutter after radiofrequency ablation which were divided into groups according to the functional class of chronic heart failure. Gender and age of patients; types of ischemic heart disease; stages of chronic heart failure; degrees of arterial hypertension; the form of atrial fibrillation and flutter; class EHRA; the presence of diabetes mellitus type 1 or 2 we evaluated. The female sex prevailed in the group of II functional class of chronic heart failure than in I functional class or III functional class. Ischemic heart disease, first of all angina of effort, in patients with III functional class of chronic heart failure was significantly more frequent. In group of III functional class of chronic heart failure there were significantly more patients with 3 degrees of arterial hypertension. Male patients, regardless of functional class of chronic heart failure, more often than females are conducted invasive methods of treatment for atrial fibrillation/flutter. With increasing of functional class of angina the functional class of chronic heart failure is increasing. Among patients II and III functional class of chronic heart failure prevails the arterial hypertension III degree, which may be a predictor of adverse prognosis.


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