Congestive heart failure in the elderly diabetic.
The elderly diabetic is a potential congestive heart failure patient. Cardiac involvement is multifactorial, particularly ischemic conditions because of the accumulation at that age of vascular risk factors and therefore the frequency of coronary damages. The elderly diabetic very often has high blood pressure, with the risk of developing a hypertensive heart disease. Beyond these issues, the effects of chronic hyperglycaemia and insulin resistance on the heart specifically alter left ventricle compliance and therefore diastolic function, thus accelerating the effects proper to aging. No specific recommendation has been published on the management of the elderly diabetic with congestive heart failure. Even at an advanced age, with a clinical diagnosis of congestive heart failure that is sometimes difficult to make, the cardiological evaluation should be conducted rigorously within a global evaluation, and treatment should follow the same rules as in younger patients, with great caution given to the iatrogenic risks inherent to this population.
Verny
C
C
Service de gériatrie, CHU de Bicêtre, Le Kremlin-Bicêtre, France. christiane.verny@bct.aphp.fr
D000368:Aged; D000375:Aging / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism; D003925:Diabetic Angiopathies / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D006333:Heart Failure / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence
D001786:Blood Glucose; D007004:Hypoglycemic Agents