Optimized treatment of elderly patients with type 2 diabetes mellitus and hypertension in general practice

Abstract

Background. Population aging has become a leading demographic feature of Ukraine. According to the World Health Organization, the number of elderly and senile people will increase to almost 40 % in the coming decades. Hypertension and type 2 diabetes mellitus (DM) are among the leading factors of cardiovascular risk. It is known that excessive oxidant stress and low-grade subclinical chronic systemic inflammation are determining factors of endothelial dysfunction, vascular reactivity disorders, increased peripheral vascular resistance, carbohydrate, and lipid metabolism disorders, which leads to increased blood pressure and plasma glucose levels. Hypertension and type 2 DM are among the leading cardiovascular risk factors. The purpose of the study was to increase the effectiveness of treatment and improve the quality of life of elderly patients with combined pathology of hypertension and type 2 DM by additional inclusion of empagliflozin and L-arginine in the basic therapy. Materials and methods. Fifty elderly patients with comorbid pathology were under our observation for second stage hypertension, coronary heart disease (functional class II) and type 2 DM in the stage of subcompensation. Participants were divided into two groups: the first one, controls (n = 25), received generally accepted basic therapy. In the second group (n = 25), the following drugs were added to the basic therapy: empagliflozin 10 mg/day, L-arginine 300 mg/day. Results. Clinical observation in outpatient conditions lasted for 3 months. Comprehensive therapy in the elderly patients with comorbid pathology of hypertension and type 2 diabetes, with the additional inclusion of empagliflozin and L-arginine to the basic therapy, contributes to a significant positive effect on the clinical course, reduces the risk of progression of this constellation. Conclusions. The application of the proposed comprehensive therapy in outpatient conditions under the control of a family doctor will significantly improve the quality of life of patients and prevent the development of complications