Shapovalenko I. Features of the course of coronary heart disease in the elderly and senile age, depending on the presence of cardiovascular risk factors

The dissertation presents a theoretical generalization and proposes a new solution to the actual problem of modern cardiology - improving life expectancy in elderly and senile patients with coronary heart disease (CHD) in different generations of Ukraine by substantiating the impact of major cardiovascular risk factors, as well as individualizing measures to prevent cardiovascular death. A mathematical model was developed for predicting the individual probability of cardiovascular death before and after 80 years, which took into account the following indicators: systolic blood pressure (SBP) (OR = 1.9), diastolic blood pressure DBP (OR = 2.5), blood glucose (OR = 2.7), total cholesterol (OR = 3.8), high density lipoprotein cholesterol (HDL cholesterol) (OR = 3.4), low density lipoprotein cholesterol (LDL cholesterol) (OR = 4.1), hemoglobin (OR = 2.7), arterial hypertension (AH) (OR=8.6), type 2 diabetes mellitus (OR = 4.3), smoking (OR = 4,5), body mass index (BMI) (OR = 1.9). A strategy and a commitment to treatment have been developed in elderly and senile patients with CHD. To achieve the purpose of the study were analyzed 3689 histories of diseases of 855 patients. After final inclusion of the inclusion and exclusion criteria, the observation period and the number of hospital admissions, the data included 517 patients aged 60-87 years who were observed to undergo a clinical and laboratory examination at the Department of Cardiology of the State Institution "Chebotaryov Institute of Gerontology, NAMS of Ukraine". The beginning of the observation was considered the date of the first hospitalization to the cardiology department of the State Institution "Chebotaryov Institute of Gerontology, NAMS of Ukraine". To achieve the goal set in the dissertation work and to realize the objectives of the study, a comprehensive methodological approach including anamnesis collection, clinical examination, collection of anthropometric data, general blood count; biochemical blood test, lipid profile, which made it possible to find out the peculiarities of the development and flow of comorbid states in the examined individuals. The processing of the obtained data was carried out using modern statistical research methods. The results of the work are based on the analysis of case histories of 517 elderly and senile patients with CHD, of whom 159 patients were examined in the current study and 358 patients were retrospectively analyzed. It is established that in subsequent generations there is an increase in the frequency of obesity, hypertension, and carbohydrate metabolism disorders. At the same time, the incidence of smoking and the level of LDL cholesterol decreased.