The gender characteristics of clinical somatic and psycho-emotional status in patients with chronic cardiac insufficiency

The article presents the results of evaluation of gender characteristics of clinical somatic and psycho-emotional status in patients with chronic heart failure and old myocardium infarction, including analysis of their relationship with psycho-emotional conditions and possibilities of pharmaceutical correction. All patients were subjected to common techniques of clinical examination including, besides medical history information gathering, physical examination, test with six minutes walking, evaluation of clinical conditions according NYHA scale (R. Cody, 1993 modification of V.Yu. Mareiev 2000). The sampling for examination included 150 patients survived myocardium infarction, 75 males and 75 females. All examined patients were randomized on three groups. The patients of first group (25 males and 25 females) were given basic therapy and Perindopril (Prestarium, Servier) as inhibitor of angiotensin converting enzyme in dosage of 5-10 mg per day. The patients of second group (25 males and 25 females) besides basic therapy were given Valsartanum (Diovan, Novartis) in dosage of 80-160 mg per day. The scheme of treatment of patients of third group (25 males and 25 females) besides basic therapy (with inhibitor of angiotensin converting enzyme and/or blocker of angiotensin receptors) included Sertralinum (Zoloft, Phizer) in dosage of 50 mg per day. In the group of examined patients with chronic heart failure and old myocardium infarction, males were younger than females. The psycho-emotional overloads as risk factor were observed more frequently in female patients. It is established that in group of patients with chronic heart failure and old myocardium infarction frequently occurs diabetes mellitus being that in 2.3 times more often in females than in males. The arterial hypertension was detected in all females with chronic heart failure and old myocardium infarction. The duration of arterial hypertension also has its characteristics: females suffered from arterial hypertension twice more often than males. The applied therapy provided comparative clinical effect both in males and females of all groups. Against the background of therapy the maximal effect was observed in group of patients received Perindopril in combination with Sertralinum. The following gender characteristics of risk factors in patients with chronic heart failure and old myocardium infarction were detected: in females arterial hypertension was occurred 1.4 times more often (100%) and diabetes mellitus was detected 2.3 times more often (30%) in comparison with males. The duration of arterial hypertension also had gender characteristics because females suffered from arterial hypertension 2 times more often than males. Taking into account increased level of anxiety in most of the patients with chronic heart failure and old myocardium infarction the application of Sertralinum in composition of combined therapy results in additional positive clinical effects that is expressed more reliably in females.