Clinical traits of chronic heart failure in patients with arterial hypertension and senile asthenia syndrome: an observational cross-sectional study

Abstract

Background. A steady population aging and high incidence of arterial hypertension (AH) lead to a stable increase in chronic heart failure (CHF). The rate of senile asthenia syndrome (SAS) rises in people aged over 80 years and becomes an independent factor of cardiovascular complications.Objectives. The identification of risk factors (RF), comorbidity and clinical symptoms in elderly patients with CHF, AH and SAS.Methods. The study covered 161 AH and CHF patients aged over 80 years. Cohort 1 contained “frailty” patients with AH, CHF and SAS, cohort 2 — “strong” patients with AH, CHF but no SAS. RF, concomitant pathology, clinical symptoms and six-minute walk test were evaluated in all patients. Statistical analyses were performed with Statistica 12.0.Results. Cohort 1 had a higher incidence of atrial fibrillation (AF) (p = 0.001) and chronic kidney disease (CKD) (p = 0.036) compared to cohort 2. Frailty women revealed a higher AF incidence vs. frailty men (p = 0.0002). No-SAS patients had statistically significantly higher body mass index (BMI) (p = 0.047) and obese proportion (by 13.8%). Cohort 1 contained a significantly higher CHF FC III (functional class III), and cohort 2 — CHF FC II rate (p = 0.041). CHF FC III was significantly more frequent in frailty women, and CHF FC II — in frailty men (p = 0.018). Cohort 1 had higher clinical severity scores and a lower exercise tolerance compared to cohort 2 (p < 0.001).Conclusion. Patients with CHF and SAS had a more frequent comorbidity with AF and CKD, greater number of comorbidities and a significantly higher CHF FC III rate, especially in women. Frailty patients showed a greater CHF severity and lower exercise tolerance compared to noSAS individuals.