. Object of the study: Chronic heart failure due to CAD in elderly and old patients. Purpose of the study: To improve the efficacy of CAD treatment against a background of CAD in elderly and old patients based on the study of the functional state of the endothelium, intensity of free-radical oxidation, cardio-hemodynamics, quality of life and comparative analysis of angiotensin-2 receptor antagonist, condesartan and ACE inhibitor lisinopril on the dynamics of the above parameters. Methods of research: Clinical instrumental, laboratory, immunoenzyme methods, biochemoluminescence, statistical methods. Theoretical and practical results: The peculiarities of endothelial dysfunction as to ET-1, NO metabolites, FRO intensity were revealed in elderly and old patients. The physicians are recommended to use the findings of biochemical parameters and use candesartan when treating the elderly and old (especially over 75) patients with CHF. Assessment of the quality of life should be performed using Minnesota questionnaire recommended for use in cardiology departments. Novelty: For the first time, it was established that elevation of ET-1 level in elderly and old patients positively correlated not only with the age of the patients, severity of the FC of CHF but also with the history of co-morbid background, HD, DM, angina. It was proven that endothelial dysfunction characteristic for ischemic CHF in old and elderly patients was accompanied with reduction of depot form of NO (S-nitrosotiole) and end products of NO metabolism (nitrites and nitrates). Difference in the levels of these parameters depending on the age of the patients (60-74 years vs 75 years and more) was determined. It was noted that at various trigger factors of disorders in No-dependent function of the endothelium, nitrates and nitrites changed in a different way: they decreased significantly in patients over 75 with CHF vs the patients aged 60-74. Possible increase of NO metabolite level in patients with FC III CHF vs FC II CHF as well as in patientswith DM and HD vs the patients without HD and DM. Advantages of candesartan vs lisinopril at treatment of elderly patients, especially over 75, was substantiated scientifically. For the first time correlation between nitrates, nitrites and Imax at increase of CHF severity in different age groups with and without HD and DM was shown. Degree of introduction: The findings of the research were introduced to the work of Institute of Therapy named after L.T. Malaya (Academy of Medical Sciences of Ukraine), city clinical hospital No. 27, regional hospital for students, Balakleya CDH, Sumy Hospital for Veterans of the Great patriotic War, Sumy Regional Hospital, as well as teaching process of therapy department of Kharkiv State Medical University. Sphere of application: medicine, cardiology, therapy.
