Features of treatment and rehabilitation of patients suffering from stable coronary heart disease with comorbid background at the outpatient stage

Abstract

This literature review highlights the relevance of both cardiovascular diseases in general and coronary heart disease in particular. The features of the therapy of coronary heart disease and some comorbid conditions are considered: atrial fibrillation, arterial hypertension, diabetes mellitus, chronic kidney disease, gastrointestinal tract diseases, bronchial patency disorders, iron deficiency anemia, inflammatory diseases of the oral cavity, angle-closure glaucoma, new coronavirus infection COVID-19. Attention is drawn to the paradoxical relationship between cholesterol levels and the risk of cardiovascular complications and death in patients with end – stage CKD. The effect of omeprazole on reflux-induced myocardial ischemia is described. The possibility of using cardioselective beta -blockers in patients with COPD is emphasized. The choice of the form of nitrate release in inflammatory diseases of the oral cavity requires special attention. An urgent problem is the interaction of antiviral drugs and drugs of basic therapy of coronary heart disease in patients with a new coronavirus infection COVID – 19. Thus, patients taking CYP3A4 inhibitors are recommended to use prasugrel. The article examines the effect of comorbidity on the severity of persistent loss of body functions. Attention is drawn to the existing problems of rehabilitation of patients with coronary heart disease at the outpatient stage: patients ignoring non – drug rehabilitation methods, insufficiently attentive attitude to the issue of full – fledged secondary prevention. It is necessary to further improve the algorithms for the tactics of management of comorbid patients with coronary heart disease at the outpatient stage and a more detailed solution to the issue of medical and labor expertise and rehabilitation of this category of patients.